Azelaic acid

This dicarboxylic acid occurs naturally in grains and is also produced by yeasts on the skin. Cosmetic and pharmaceutical grades are manufactured through controlled synthesis, ensuring purity and consistent properties. It dissolves poorly in water, so it requires a suitable suspension, solvent or specialised carrier.

Azelaic acid has anti-inflammatory properties, limits the growth of microorganisms associated with acne, normalises keratinisation in sebaceous gland ducts and reduces excessive tyrosinase activity. This helps with inflamed spots, blocked pores, redness and post-inflammatory marks. It is neither a conventional AHA nor a BHA, and its action does not rely on intensive surface peeling.

We recommend it for acne-prone, oily and pigmented skin, as well as skin prone to rosacea. It is also suitable for sensitive skin, although stinging, itching or dryness may occur at first. It is sensible to introduce the product every other evening and gradually increase the frequency. If the skin barrier is compromised, hydration and the protective barrier should be restored first.

Two randomised, vehicle-controlled phase III trials showed that a 15 per cent gel significantly reduced the number of inflammatory lesions and the intensity of erythema in papulopustular rosacea compared with the vehicle (Archives of Dermatology, 2003). Clinically tested concentrations for acne and rosacea are usually 15 to 20 per cent, while cosmetic products often use lower amounts.

Cosmetic concentrations are approximately 5 to 10 per cent, while dermatological formulations use 15 to 20 per cent. An even dispersion without coarse crystals is essential. Combining it with retinoids or exfoliating acids may increase irritation, so active ingredients should be introduced gradually and SPF used during the day.

When using targeted skincare with active ingredients, it is best to start gradually and avoid changing several products at once during the first few weeks. This makes it easier to distinguish the effects from irritation. Visible changes in texture or tone usually require several weeks of regular use. Daily SPF protection, gentle cleansing and a well-functioning skin barrier have a significant influence on achieving good, lasting results.