Azelaic acid is a staple in my skincare routine.

It’s a gentle exfoliant that is suitable for everyday use and treats several skin conditions effectively.

Yet some users report that they experience purging after using it.

Here’s what you need to know about the side effects that azelaic acid can have.

What is azelaic acid?

Azelaic acid effects on skin

Let’s start with the geeky details about azelaic acid before we move on to its actual use.

Azelaic acid is a dicarboxylic acid that can naturally be found in wheat, rye, and barley. What’s even more interesting is that it can be derived from yeast, but not any kind of yeast. Here, we’re talking about the yeast that’s found on healthy skin.

It normally comes in the form of white powder and is actively used in skincare and hair products.

When sold by brands, you’re likely to find it available as a gel, cream, or foam product.

The compound is widely known among people with acne-prone skin or rosacea-prone skin.

Why?

Because it can regulate skin cell turnover, it offers anti-inflammatory properties, can lighten up the skin complexion, and acts as an antibacterial agent.

Azelaic acid is a topical treatment that can provide gentle exfoliation and can help treat melasma.

It’s a powerful solution for hyperpigmentation as it limits melanin production and stops the overproduction of keratin. As a direct effect of that, it reduces the chances of acne breakouts.

Due to its antibacterial and antioxidative properties, it can also prevent irritation, redness, and inflamed skin.

In the US, it’s a prescription drug but in European countries, it can be bought freely, as long as its concentration is no more than 10%. Some of the most popular brands that are prescribed are Azelex, Sknoren, and Finacea. And over-the-counter brands include The Ordinary, The INKEY List, Revolution Skincare, and more.

Is azelaic acid safe to use?

Generally speaking, yes, azelaic acid is safe to use. It gets prescribed as a medical treatment by dermatologists.

However, there are some azelaic acid side effects that you must be aware of before starting to use this ingredient. These effects are mostly experienced by people who’ve never used products with this ingredient before.

Different formulations of azelaic acid have different side effects. One thing to keep in mind is that foam formulations are believed to trigger the least side effects.

It’s also important to think about your skin type as different skin types experience different side effects.

Side effects of azelaic acid in sensitive skin

Azelaic acid may make sensitive skin even more sensitive and easily irritated. It can even trigger allergic reactions.

This is why most dermatologists suggest using the product every other day in small amounts instead of every day. Of course, patch testing is always a must.

Side effects of azelaic acid in dark skin

If you have dark skin, azelaic acid has been reported to lead to post-inflammatory hypopigmentation on occasions. This can cause skin lightening as a result of inflammation and melanin production.

Side effects of azelaic acid in skin prone to acne

For acne-prone skin, using azelaic acid may look like a huge risk at the beginning. When starting the treatment, your acne could appear even worse than before. It could lead to purging, which I’ll dedicate a whole section to in a bit.

So what are the general side effects you can see from using azelaic acid? Here are some of the most popular ones:

  • inflammation
  • dryness
  • sensitive skin
  • stinging
  • tingling

There are also others like itching, fever, pain, rashes, skin flaking, swelling, and changes in skin color. However, these are super rare and I’m only mentioning them for information exhaustiveness.

Azelaic acid side effects

Who should avoid using azelaic acid?

Azelaic acid is a certain no-no for people allergic to the ingredient or to propylene glycol.

I also highly recommend speaking to your doctor and informing them if you are pregnant, have had asthma, or if you breastfeed. Although azelaic acid is not forbidden in these cases, its applications to your routine will likely be different to ensure your safety.

Does azelaic acid cause purging?

Yes, azelaic acid can cause purging as it’s an acid with exfoliating properties.

If some of you are not sure about what purging means, it’s simply a bout of acne that usually comes your way after implementing a new product into your routine. Don’t worry, it’s just a phase that quickly comes to pass.

Azelaic acid works its magic by tackling clogged pores on a deep level. The debris, dirt, and oils usually rise to the surface of the skin before they can be removed and cleared out. In addition, skin cell turnover is boosted, which can cause a bit of acne before the area is purified.

So how long does azelaic acid cause purging? How long does it take for azelaic acid to stop purging?

The azelaic acid purging phase usually lasts between 6 to 8 weeks after starting your treatment. However, I must add that it could also take anywhere between 12 and 24 weeks for some people to notice improvement.

When I was reading about the ingredient and saw that a lot of users experience purging, the first question I had was whether azelaic acid can cause a breakout. The answer is no, as azelaic acid literally kills bacteria that cause breakouts. However, due to increased skin turnover, it’s possible to see some acne that has been in the making inside your skin before you’ve started to use the ingredient.

Does azelaic acid make acne worse before it gets better?

Yes, this is what essentially azelaic acid does. It tends to make your skin look worse before you start seeing an overall improvement in your skin condition. Remember that this is only temporary and it’s the path towards cleaner and healthier skin.

Purging vs. breaking out

People often confuse what’s purging and what’s breakouts. However, there are clear signs that can help you tell them apart.

First, purging usually only lasts for a couple of weeks up to two months and you will gradually start to see improvement. If the problem stays for longer, it’s most likely a product-induced breakout.

Second, if acne is in new places on your face and not your general problem zones, it is always a sign of a breakout, not a purge.

Breakouts are normally triggered by the use of products containing comedogenic ingredients. Heavy ingredients can also lead to the same results as they will block your pores and stop your skin’s exfoliation process.

What ingredients to avoid if you use azelaic acid

So considering that azelaic acid could be a risky treatment, one big question comes to mind – What should not be used with azelaic acid?

There are three things that you don’t want to use in combination with azelaic acid are:

  1. Alcohol-based toners and cleaners
  2. Other acids
  3. Deep cleansing or exfoliation products

A mix of azelaic acid and the mentioned above types of products can result in skin irritation.

I’d also say it’s best to stay away from harsh soaps or any products infused with lime, astringents, or spices to prevent further irritation and discomfort.

On the positive side, it’s safe to use azelaic acid with almost any ingredient included in most skincare products, like Benzoyl peroxide (which removes bacteria that leads to acne and dehydrates pimples and blackheads) and salicylic acid (which gently exfoliates and evens the skin tone when combined with azelaic acid) and even with retinol!

How to ensure safe use of azelaic acid

Azelaic acid can quickly and easily be incorporated into your normal skincare routine.

However, I’d highly advise speaking to a dermatologist before trying this ingredient, even if it’s in the under 10% concentration. A professional can guide you towards the right uses, how often to use, and more.

Here is my suggestion for using this superb ingredient.

Start off by cleaning your face with a cleansing lotion, apply a thin azelaic acid gel or cream layer, and finish the routine by using a gentle moisturizer.

I’ve received a lot of questions regarding the use of azelaic acid before or after moisturizer. I’d recommend using it before as this makes it more potent. When applying it after moisturizer, the effects are reduced as it can’t easily penetrate the skin.

Remember to always do a patch test on a small skin area to see how the ingredient will react with your skin. It’s normal to feel a slight tingling that usually goes away in a few minutes.

How long does it take to see results from azelaic acid?

Although there is no certain answer to this question, from experience and research, I’d say it takes between 4 and 6 weeks before you can see any results.

How long it will take depends on a range of factors like your skin condition, your skin type, your skincare routine, how you’re using azelaic acid, and more.

Wrap up

Azelaic acid is definitely a solution for people with acne-prone skin, especially those who are patient enough to wait for the storm to pass and welcome the calmness (let’s say our storm is the purging in this case).

As long as you use it as prescribed and with caution, the results should not take too long to show.

Do you have any experience with azelaic acid? I’d love to hear your thoughts and stories! If you have gone through azelaic acid treatment or have used it as part of a product in your skincare routine, you can share your feedback in the comments section below.

Until next time!