Kathy Morell LE, LC, LMT

I initially looked into azelaic acid as a treatment for acne, but it turns out it can also be helpful in smoothing skin–and so much more. Found in grains like wheat, rye, and barley , Azelaic Acid is produced naturally by yeast that lives on normal skin. It brightens the skin tone while visibly improving the evenness of skin texture and reducing the look of blemishes. It is a multi-functional support ingredient for all skin types and also acts as an effective antioxidant.

Azelaic acid is most frequently prescribed for rosacea sufferers, because it’s crazy-effective at decreasing the inflammation that causes Rosacea’s trademark redness. The ingredient is also antibacterial, making it helpful for decreasing acne. It has the same efficacy for acne as Benzoyl Peroxide and Tretinoin without the dreaded effects of Benzoyl Peroxide.(http://www.ncbi.nlm.nih.gov/pubmed/1712709, http://www.ncbi.nlm.nih.gov/pubmed/17456913.)

Azelaic acid acts in part by inhibiting the growth of acne-causing bacteria. It also works on the cells that line the  pores by changing the way they mature and proliferate, which decreases clogging and helps prevent blackheads, whiteheads, and inflamed acne lesions. Basically, azelaic helps regulate the production of skin cells, so they don’t build up and clog your pores. It also helps fade the dark spots acne leaves behind.

In cases of hyper-pigmentation, Azelaic acid  is a recommended alternative for those sensitive to using hydroquinone for the treatment of hyperpigmentation or melasma. Azelaic acid appears to selectively target hyperactive pigment-producing cells, while having little effect on normal acting ones. For this reason it is a treatment of choice for hyper-pigmentation in clients of all skin types, particularly useful for darker skinned patients whose acne spots leave persistent brown marks (post-inflammatory pigmentation) or who have melasma.

Azelaic acid is safe for long-term use and for women who are pregnant, but women who are breastfeeding may be discouraged from using these products. Those with sensitive skin or pre-existing skin conditions like eczema may find it difficult to use this type of product due its irritating properties. However, irritation caused by azelaic acid can be treated with an anti-inflammatory agent. Azelaic acid is most effective when used in combination with other active ingredients such as retinoids, alpha hydroxy acids, and vitamin C.

Some popular name brand azelaic acid skin creams are Azelex and Finacea, are  available by prescription only. Azelex is a 20% concentration, whereas Finacea contains 15% concentration in a gel form. There are mixed reviews on the efficacy of both Azelex and Finacea. Some people claim they work great, but the side effects (itching and stinging) can be difficult to tolerate. Others state that they became more prone to acne breakouts, but did see marked improvement in post-inflammatory hyperpigmentation afterward.

Cosmetic skincare products usually contain less than 1% azelaic acid and are available over-the-counter. However, lower concentrations of Azelaic acid seem to be most effective when used in combination with other topical products such as retinoids, which provide proper exfoliation of the pore lining, thus reducing the occurrence of acne. It may take some experimenting to find the right combination that works best for individual’s skin. Consulting with an esthetician trained in Advanced Skin Analysis and Cosmetic Chemistry can help individuals select the correct products to treat their specific concerns and get results.

If you are having challenges with Acne, Rosacea or inflammatory breakouts, we can help! To make an appointment for an Advanced Skin Analysis please call 716.631.0964 or click here.

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