Azelaic Acid --This quiet overachiever is an absolute hero in the fight against acne
- Oct 5, 2023
- 3 min read
This quiet overachiever is an absolute hero in the fight against acne — in fact, it might be one of the most effective treatments available on the market today and it works during all stages of acne.
It reduces active breakouts, helps clear up the redness and helps hyperpigmentation that acne can cause and keeps bacteria at bay once your skin has healed. It’s also a pro at clearing up rosacea and unlike some other acids, it’s gentle enough to use on sensitive skin.
How does azelaic acid work? The word “acid” is bound to make your eyebrows raise if you’ve never used one on your skin before, but don’t worry, this isn’t going to turn your face bright red. On the contrary, azelaic acid can improve your skin in many ways. So Azelaic acid helps fight against acne and it does so by killing bacteria, preventing follicular keratinization and reducing inflammation.
Bacteria
There are 2 forms of bacteria that contribute to acne: propionibacterium acnes and staphylococcus epidermidis. We’ll call them p. acnes and s. epidermidis for short.
These bacteria are found on everyone’s skin normally but tend to multiply and breed in sebum, meaning that if you have an excess of oil on your skin, you can often end up with acne because the acne-producing bacteria have so much space to reproduce.
Azelaic acid doesn’t stop sebum production, but it does kill the bacteria that multiply in it. It seeks out p. acnes and s. epidermidis and attacks them directly, beginning to inhibit their reproduction.
With repeated use, it continues to kill remaining bacteria and some studies have even suggested that it can kill some antibiotic-resistant bacterial strains as well. By continually doing so, azelaic acid helps prevent acne from recurring.
Follicular keratinization One of the many abilities of azelaic acid is that it can prevent clogged pores. Acne begins with 2 main changes to the sebaceous (hair) follicles on the skin. The first is a process called follicular hyperkeratinization, which is an excessive shedding of skin cells into the hair follicles. The second is caused by excess sebum being produced by the skin, which is usually under the control of hormones. Together, these processes lead to clogged pores, which then are known as comedo or pimples.
Follicular keratinization occurs when the cells that line the inside of our hair follicles stick together. Ordinarily, the cells would shed and be expelled onto the skin’s surface. While it’s not known precisely how azelaic acid stops this, we do know that it does. It normalizes the cells within the follicle and prevents them from sticking to each other, meaning they can be carried out of the follicle by the sebum without issue.
Inflammation Azelaic acid works as an acne treatment by reducing inflammation, and it can do the same for rosacea as well. While rosacea isn’t related to acne, it can look similar, as those experiencing it will often see a reddening of the face and some papules and pustules as well.
Within acne, inflammation looks like redness and swelling around the affected areas. These symptoms can often last after the pimples themselves have healed, which is why it is important to keep treating acne even as it becomes less apparent. Azelaic acid does just that, and while there are a few theories as to exactly how, it has been suggested that this ingredient has antioxidant properties. Just like niacinamide, azelaic acid is capable of tackling free radicals and preventing the effect of oxidative stress that they have on the skin.
But that’s not all...
Azelaic acid is a great treatment for acne because it doesn’t only stop it, it assists with the healing process as well. There are 2 main types of damage you might notice on your skin post-acne: scars from the pimples and acne lesions themselves and damage done to the skin by picking or popping pimples.
As tempting as it might be to pick on a pimple, the resulting trauma caused to the skin around it can lead to broken capillaries and redness even after the pimple itself has healed.
Another thing you may notice is hyperpigmentation: dark spots and patches on the skin. This occurs when damage to the skin causes the release of inflammatory cells, which then lead to the release of pigment cells that darken the skin. While hyperpigmentation and scarring aren’t necessarily harmful, it’s common to want to get rid of them and azelaic acid’s anti-inflammatory properties help manage skin texture and tone issues.
Who can use azelaic acid?
Azelaic acid is suitable for practically everyone. It’s ideal for anyone with sensitive skin and may be a good choice for anyone whose skin is not compatible with stronger anti-acne treatments.
