Treating Acne With Azelaic Acid

Girl applying cream in mirror
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Azelaic acid is a prescription medication used to treat mild to moderate acne vulgaris.  It comes in a gel, lotion, and cream.

Azelaic acid is sold under the brand names Azelex, Finacea, and Finevin.  You can also get generic azelaic acid.

How Azelaic Acid Works

Azelaic acid works to clear up acne in several ways.  First, it kills propionibacteria acne, the bacteria that are responsible for inflamed acne breakouts.

Azelaic acid is a comedolytic.  This means it reduces the number of comedones or pore blockages.  This medication also helps your skin shed cells more effectively.  This also helps keep the pores clear.  Fewer pore blockages ultimately lead to less inflamed pimples. 

Speaking of inflamed pimples, azelaic is good for those too.  It helps reduce inflammation of acne blemishes.

Another benefit of azelaic acid it's it's ability to improve post-inflammatory hyperpigmentation, or those discolored spots pimples leave behind.  Complexions that are prone to hyperpigmentation will especially benefit from azelaic acid.

Make sure you're applying your azelaic acid to all areas where you know you break out.  Don’t just spot treat existing blemishes.  This will help keep new pimples from forming.


Azelaic acid typically isn't used as a first-line treatment in most cases, and that's because it's a very slow worker compared to other acne medications.  If you're using azelaic acid, try to be patient. 

You might notice some improvement after a month or so.  But it can take several months more to really get acne under control.  Just keep using your medication as consistently as you can.

Even with the months-long wait for a clearing, there are good reasons to use azelaic acid in favor of other acne treatments. 

Does tretinoin leave your skin completely irritated?  Is benzoyl peroxide just too drying?  Compared to other acne medications, azelaic acid is fairly gentle.   So, if your skin is especially sensitive and you can't handle some of the other topical acne medications, azelaic acid is a very good option. 

And, since all topical retinoids and many oral acne medications are off-limits during pregnancy, azelaic acid makes a good acne treatment choice for pregnant and nursing moms. 

Possible Side Effects 

While this is a fairly gentle treatment, there's still a possibility of side effects.  The most common:

  • Itching, burning or stinging
  • Redness
  • Dryness or peeling

For those with darker complexions, be on the lookout for lightening of the skin in areas where the medication is used.  This happens only rarely, but you should let your doctor know right away if you notice any changes in your skin color.

As always, if you have any questions or concerns about your acne treatment, ask your dermatologist.


"Azelaic Acid." MedlinePlus. 02 Feb 2016. U.S. National Library of Medicine and National Institutes of Health. 23 Feb 2016 <>.

Kong YL, Tey HL.  "Treatment of acne vulgaris during pregnancy and lactation."  Drugs.  2013 Jun; 73(8):770-87.

Sieber MA, Hegel JK.  "Azelaic acid: Properties and mode of action."  Skin Pharmacol Physiol.  2014; 27 Suppl 1:9-17.

Vargas-Diez E, Hofmann MA, Bravo B, et. al. "Azelaic acid in the treatment of acne in adult females: case reports."  Skin Pharmacol Physiol.  2014;27 Suppl 1:18-25.

Yin NC, McMichael AJ.  "Acne in patients with skin color: practical management."  Am J Clin Dermatol. 2014 Feb;15(1):7-16. doi: 10.1007/s40257-013-0049-1.