Azelaic acid may not be a household name yet when it comes to acne therapy, but with a killer combo of strong scientific and anecdotal evidence, it looks like it’s just a matter of time.
Let’s take a deeper look into this rising star and how it can help you get clear.
What is azelaic acid?
Azelaic is a compound that is naturally found in rye, wheat, barley, and can be produced by a special kind of yeast. But don’t let its bakeshop-related origins fool you. This active ingredient has been used for years for skin conditions including rosacea, melasma, and even some forms of skin cancer.
It comes in gels, foams, creams, spot treatments, or serums in concentrations from 10-20%.
With its anti-inflammatory, keratolytic, comedolytic, and anti-bacterial properties, it’s a shoo-in for acne therapy. Azelaic acid is a stable compound so it can be used in combination with other products. Studies show it is well-tolerated by different skin types, making it a good alternative for those who are sensitive to retinoids. With an FDA pregnancy category of B, it is generally considered safe for pregnant or lactating women.
What does it do?
Azelaic acid’s mechanism of action is not yet fully understood. But little by little, we’re getting a better idea of how it works through the results of scientific research.
Lightens hyperpigmentation
When your skin is damaged (either in the process of inflammation or from the harmful but oddly satisfying habit of pimple popping), the melanosomes in your skin cells produce way more melanin that is needed. The result are those brown/black/red spots that lay flat on your skin, where an angry pimple was before. As if dealing with a breakout isn’t bad enough, we’re still left to deal with the aftermath for months or even years later.
That’s where azelaic acid can help you. By inhibiting key enzymes like tyrosinase and thioredoxin reductase, which are heavily involved in the production of melanin, azelaic acid prevents your skin from discoloration.
Curbs inflammation
Acne occurs when the body reacts to clogged pores and bacterial proliferation. The inflammatory process is meant to protect the bodies, with a cascade of reactions that allow our white blood cells to fight against the infection. Unfortunately, when these cellular soldiers are a little too trigger-happy, the result is sensitive skin that overreacts to any stimulus. People who are prone to acne appear to have neutrophils that produce excessive amounts of reactive oxygen species (ROS) that damages not just the invaders, but the skin as well. Acne is also associated with an overblown production of chemical messengers that trigger an immune reaction in the skin. As a result, you see the hallmarks of inflammation: redness, swelling, heat, and pain.
Azelaic acid helps calm our skin down by inhibiting inflammation. It does so by inhibiting the production of reactive oxygen species (ROS) by neutrophils and downregulating the activity of pro-inflammatory agents.
Inhibits bacterial growth
When Propionibacterium acnes proliferates uncontrollably within the favorable conditions of a blocked pore, a pimple isn’t far in the offing. Many acne treatments focus on this part of the pathogenesis, including antibiotics and benzoyl peroxide.
Azelaic acid joins this group as it prevents bacteria from making proteins. Without this, microorganisms cannot grow and reproduce.
Breaks down pore plugs
Every form of acne starts with a blocked pore. It’s usually a plug of excessive sebum, keratin, and dead skin cells. Azelaic acid has a mild comedolytic and keratolytic effect, which means it can loosen up the blockage and allow your skin to breathe.
Conclusion
The popularity of azelaic acid is on the rise. It not only targets active acne through several mechanisms, but also helps lighten hyperpigmentation caused by breakouts past. It is considered safe and well-tolerated for a wide variety of skin types.
With that in mind, azelaic acid is definitely something you can consider incorporating into your acne regimen.
This content is for general information only and is not a substitute for medical advice.
Resources:
Akamatsu, H., & Horio, T. (1998). The possible role of reactive oxygen species generated by neutrophils in mediating acne inflammation. Dermatology (Basel, Switzerland), 196(1), 82–85. https://doi.org/10.1159/000017876
Jones D. A. (2009). Rosacea, reactive oxygen species, and azelaic Acid. The Journal of clinical and aesthetic dermatology, 2(1), 26–30.
Schallreuter, K.U., Wood, J.W. A possible mechanism of action for azelaic acid in the human epidermis. Arch Dermatol Res 282, 168–171 (1990). https://doi.org/10.1007/BF00372617
Worret, W. I., & Fluhr, J. W. (2006). Topische Therapie mit Benzoylperoxid, Antibiotika und Azelainsäure bei der Akne [Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid]. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 4(4), 293–300. https://doi.org/10.1111/j.1610-0387.2006.05931.x
https://practicaldermatology.com/articles/2013-mar/new-insights-into-azelaic-acid/pdf
