Azelaic Acid

What is azelaic acid and what does it do?

Azelaic acid is a dicarboxylic acid produced naturally by the yeast Malassezia and made synthetically for skincare and medicines. It reduces the growth of acne bacteria, normalises how cells line the pore, and calms inflammation, which is why it is used in acne and in the papules and pustules of rosacea. It also inhibits tyrosinase and preferentially affects overactive melanocytes, so it can lighten melasma and post-inflammatory hyperpigmentation without bleaching normal skin. It does not increase sun sensitivity in the way retinoids can, and it does not contribute to antibiotic resistance. Mild tingling on first use is common and usually settles. [1]

What does the evidence show?

A Cochrane systematic review found azelaic acid more effective than placebo for acne, though the certainty of evidence was low to moderate. Randomised trials support 15% gel for papulopustular rosacea, and comparative trials in melasma suggest 20% azelaic acid performs similarly to 4% hydroquinone in several studies, with variable quality. Reviews describe a favourable safety profile, with stinging and itching as the main side effects.

Who should avoid azelaic acid?

People with a known allergy to azelaic acid or the product's base should avoid it. Those with very sensitive skin or active eczema may find the tingling uncomfortable. Rarely, lightening of skin in darker skin types has been reported, so watch for patchy change. Pregnancy use should be discussed with a doctor, although it is often considered a lower-risk option.

Is azelaic acid available in Singapore?

It depends on strength and product. Medicated azelaic acid creams and gels at 15–20% are regulated as medicines in Singapore and are generally obtained through a doctor or pharmacy. Lower-strength azelaic acid or its derivatives appear in some cosmetic products. Check with a doctor or pharmacist which category a product belongs to.

If a dark patch, breakout or irritation is not responding to what you are using, the next step is a diagnosis rather than another product. See the Skin A–Z library for related ingredients.