Azelaic Acid: A Soothing Ingredient for Clear & Even-Toned Skin

Azelaic acid in liquid, powder, and cream form to be used in skincare

Azelaic acid is an often overlooked yet incredibly effective ingredient in the world of skincare. It is a versatile addition to any routine, with a wide range of impressive benefits, even when up against some of the skin’s most challenging battles.

This week’s ingredient spotlight delves into Azelaic acid: what it is, how it works, its various uses in skincare, and the numerous skin benefits you can experience by incorporating this must-have ingredient in your beauty regimen.

What is Azelaic Acid?

Azelaic acid is a naturally occurring acid found in grains like barley, wheat, and rye, and is synthetically produced for stability and efficacy.

Azelaic acid is known for its anti-inflammatory, antibacterial, and exfoliating properties, and has many characteristics that make it an ideal ingredient for treating stubborn skin conditions, including acne, rosacea, and hyperpigmentation.

When applied to the skin, Azelaic acid is generally well-tolerated by all skin types and beneficial to all skin tones for its help with skin discoloration issues, like Melasma and post-inflammatory hyperpigmentation.

How is Azelaic Acid Used in Skincare?

Azelaic acid has become a skincare powerhouse, effectively addressing some of skin’s most challenging issues.

But how exactly does Azelaic acid work?

The answers lie in its potent properties and remarkable effectiveness, making this underrated ingredient essential for achieving clear, smooth, and even-toned skin.

  • Anti-inflammatory Properties: Azelaic acid reduces redness and inflammation, which helps to calm and soothe the skin. This is particularly beneficial for conditions like acne and rosacea, where inflammation plays a significant role.

  • Antibacterial Action: Azelaic acid also inhibits the growth of bacteria that can contribute to acne. This anti-bacterial property proves valuable for managing breakouts and preventing the formation of new acne lesions.

  • Exfoliation Effects: Azelaic acid promotes the removal of dead skin cells through a Keratolytic effect, leaving you with a smoother, more radiant appearance. This exfoliating action also helps prevent clogged pores that lead to acne, while also brightening the skin's surface for a natural glow.

  • Regulating Melanin Production: Azelaic acid interferes with melanin production, which is what’s responsible for dark spots and hyperpigmentation. It helps to lighten dark spots by targeting hyperactive/abnormal melanocyte function and inhibiting the enzyme tyrosinase, key players in melanin production. Regular use of Azelaic acid can result in a more even skin tone.

What are the Skin Benefits of Incorporating Azelaic Acid into Your Routine?

Azelaic acid offers a multitude of skin benefits that address a range of skin concerns–from hyperpigmentation and breakouts to inflammatory skin conditions and overall skin texture. 

Let's explore how incorporating Azelaic acid into your daily regimen can help transform your skin.


Safe Option for Sensitive Skin

One of the standout benefits of Azelaic acid is its suitability for sensitive skin. In fact, Azelaic acid can serve as a compelling alternative to Retinol if you are pregnant or nursing, and is considered to have few risks, even for those with reactive skin.  

It can actually help to soothe redness and calm the skin, mitigate breakouts rather than causing them, and is less aggressive than other potent ingredients, like retinoids or high-concentration alpha hydroxy acids (AHAs), making it an excellent ally for individuals who want to address their skin issues without risking irritation.


Acne Treatment

Azelaic acid is highly effective in treating mild to moderate acne. Its antibacterial properties target specific bacteria, and has been proven to be effective in treating both comedonal acne (blackheads and whiteheads) and inflammatory acne (red pimples, nodules, and cysts).

Unlike other acne treatments, Azelaic acid is generally well-tolerated and less likely to cause dryness or irritation. Studies have shown that Azelaic acid is as equally as effective as other acne treatments like Tretinoin, when used at full strength, with fewer side effects than retinoids.


Hyperpigmentation Reduction

Dark patches that appear on the skin due to excess melanin, like sun spots, melasma, and post-inflammatory hyperpigmentation, can be frustrating and challenging to treat.

However, consistent use of Azelaic acid ensures a continuous reduction in melanin production, gradually fading dark spots and evening skin tone. Over time, you’ll notice a significant improvement in the appearance of hyperpigmentation, but it requires patience and regular application.


Rosacea Management

For those suffering from rosacea, Azelaic acid can be a game-changer. It helps to reduce the inflammation and redness associated with rosacea, providing significant relief for sufferers. Azelaic acid’s gentle nature means it can be used long-term to manage the condition without causing further irritation.


Smoothing Skin Texture

By promoting cell turnover and exfoliating the skin, Azelaic acid helps to reveal a brighter, smoother complexion. This same exfoliating action keeps pores in a constant state of renewal, gradually reducing the frequency and severity of breakouts. It can improve your skin texture to feel softer and appear more even, making it an excellent option for those looking to enhance their skin’s overall appearance. 


Antioxidant Protection

Azelaic acid also offers antioxidant benefits, helping to protect the skin from environmental damage caused by free radicals. Antioxidants contribute to a more youthful appearance and prevent premature aging.

Incorporating Azelaic Acid into Your Skincare Routine: Trifecta + Polish Exfoliator

At KaramMD, we use Azelaic acid in our Polish Enzymatic Exfoliator, which is a supplemental skincare solution that can be added to your Trifecta routine to amplify its benefits. 

Polish gives your skin a deep clean, eliminating dirt, bacteria, and impurities to clear congested pores. This exfoliation process removes dead, dull skin, and prepares it for active ingredients, improving skin texrture, tone, and long-term health of the skin.

To maximize the benefits of Azelaic acid, here are some fun facts to know about incorporating this ingredient into your routine:

It Has Synergistic Benefits Alongside Other Active Ingredients: 

No need to worry about the risk of integrating Azalaic Acid into your routine. It is known for its compatibility with other active ingredients and treatments without causing irritation.

Azlelaic acid works synergistically with Vitamins A,B, C to enhance overall effectiveness, and compliments other botanical brighteners in Trifecta, like Vitamin C & E, Licorice root, Green Tea, Bromelian, and Willowherb to reduce dark spots, balance skin tone, and boost clarity, while also providing its hydrating and soothing effects on the skin.

Easy Routine Integration with Polish: 

Azelaic acid should be applied after cleansing and before moisturizing. This ensures that the active ingredient can penetrate the skin effectively. 

The Azelaic acid in Polish, is perfectly sandwiched between our Rinse Daily Cleanser and followed post-exfoliation by Quench Vitamin C Serum and Illuminate Anti-Aging Cream. This sequence ensures that the Azelaic acid can integrate effciently with the other products to maximize your skin’s benefits.

Provides Gentle, Yet Efficient Exfoliation: 

Azelaic acid is a gentle approach to exfoliation as it helps to remove dead skin by breaking down the outer layer of the cells.

Regular use of Azelaic acid can lead to clear pores and reduced breakouts, a more even skin texture, and a brighter complexion.

Unlike stronger chemical exfoliants, you can use Azelaic acid regularly without the risk of irritation. This made it the perfect complement to the natural enzymes and ultra-fine powders we use in our Polish, crafting an approachable exfoliating option, even for those with vulnerable skin conditions. 

Always Remember, Consistency is Key: 

Like with any skincare ingredient, consistency is going to make the biggest difference in your end result. To fully appreciate the benefits of Azelaic acid, it’s important to understand that consistent use is crucial. 

Unlike some skincare ingredients that provide immediate results, Azelaic acid works gradually, making regular application pivotal for achieving and maintaining its full range of benefits.

Don't Forget Your Sun Protection: 

Always use sunscreen during the day, as Azelaic acid, like most exfoliators, can make your skin more sensitive to the sun.

You should be applying sun protection daily, backed up by antioxidants, and also wear protective clothing, like hats and sunglasses. 

This also helps prevent further pigmentation issues that can undo all of your hard work.

Azelaic Acid: Your Solution for Clearer Skin

Azelaic acid is a versatile and effective skincare ingredient that addresses a range of skin concerns, and can be a powerful tool in achieving healthier, clearer, more radiant skin. 

By understanding how to incorporate Azelaic acid into your skincare routine and using it consistently, you can unlock its full potential and enjoy its numerous skin benefits.

Whether you’re dealing with stubborn acne, struggling with rosacea, or looking to even out your skin tone, Azelaic acid might just be the solution you’ve been searching for.




Polish Exfoliator with Azelaic Acid

Polish is a dynamic exfoliator that offers an effective at-home treatment to renew and revitalize your complexion.

Featuring Azelaic acid's exfoliating properties, Polish helps to remove dry skin, clear pores to prevent breakouts, and remove the top layer of pigmented cells, while also working deeply to reduce dark spots and even skin tone with brightening boost.

An exfoliation habit is key to ensure you continue to receive the maximum benefits from your anti-aging skincare routine, making Polish the perfect complement to your Trifecta routine.

Amir Karam MD

Board Certified Facial Plastic Surgeon
Founder / Creator of KaramMD Skin

Dr. Amir Karam is a renowned facial cosmetic surgeon and an authority in his field. With over two decades of experience helping patients achieve a younger, refreshed appearance. In addition to surgical procedures that sculpt a youthfully-defined facial shape, Dr. Karam takes the quality of the skin into account.


Adele Casamassima

Hi Dr Karamm, quick question on using energy devices like CO2 for skin resurfacing ( tackling brown spot/ pigmentation, fine lines and overall skin appearance ). I am 58 and in good skin state but I am starting to step up intervention . I was advised to do a CO2 laser( I am aware this is ablative and quite strong treatment) and for improving a bit firmness to do software / ultherapy. I think I am 1 year away from wanting to do a face lift , just trying to hold on another little bit. For the rest I do standard micro needling with peptide too up (no ppatketvplasma ) and religiously use all the products you suggest( thinking to try trifecta next time I am in San Diego likely one of the ASH conferences as I am
Not sure I can order it from UK. For instance my friend d from Italia said they would block it at custom in Italy). Long story short, what is your perspective on CO2 laser? Too aggressive? When would that be really required?
KaramMD Skin replied:
Hi Adele—Great question. Make sure you are subscribed to Dr. Karam’s YouTube channel and the Journal newsletter so you can be notified when he covers this topic in the future! So far it sounds like you’ve been doing all the right things when it comes to skin care treatments. If you have a provider that you trust, and they know your skin and are suggesting CO2 laser, then it could be a good fit for you. Trust your instincts, trust your medical professionals, and most importantly, stay committed to a daily skincare routine in between treatments. If you are interested in Trifecta, it is available in the UK and will have no problem going through customs. If you have any other questions about international shipping, reach out to <>. And in the meantime, keep an eye out for future blogs about CO2 coming your way!

Ana Laura

Wonderful! I ordered Trifecta and I will wait for the sunscreen to be available soon, but also would like to know if considering Trifecta travel kit or a smaller presentation. Thank you!
KaramMD Skin replied:
Hi Ana—We’re thrilled that you ordered Trifecta! The EltaMD sunscreen is only available in the US, but if you are located in another country, Dr. Karam has written some other articles about selecting a sunscreen (just type “sun protection” in the search bar and you will see a few pop up). Hopefully you can find a sunscreen that works for you! As for a travel size, we currently don’t have a smaller option, but we really appreciate your interest and feedback about that, and will definitely keep it in mind for the future. Thank you for your support, and enjoy your new products!


Ive been told i have acetic keratosis,will it help w/ this
KaramMD Skin replied:
Hi Kelly—Azelaic acid isn’t typically used to treat actinic keratosis. It’s more commonly used for acne and rosacea. For actinic keratosis, treatments like topical creams, cryotherapy, or laser therapy are usually recommended. It’s best to consult your dermatologist for the most suitable treatment. Hope that helps!

Elizabeth Wajnberg

I began to get redness and tiny pimples on upper lip after I started using the Trifecta. I also have the Polish. Is there a way to get azelaic acid without the other exfoliants?

My skin is thin and transparent after years of taking prednisone for inflammatory bowel disease, so perhaps I am over-exfoliating?
KaramMD Skin replied:
Hi Elzabeth—Thank you for reaching out, and we’re sorry to hear about your experience with breakouts. Don’t worry, our skin is always changing, and with a little persistence, and maybe some trial and error, you will be able to figure it out. To answer your questions: Yes, you can get Azelaic Acid by itself if you’re interested. Lower doses are available over the counter, or we recommend seeing a dermatologist for higher percentages. A skincare professional might also be able to give you more specific insight and advice on what is causing the bumps and how to proceed since that is not a typical reaction we hear about with Trifecta. Regarding over-exfoliating, if you have thin, sensitive skin, try spreading out your Polish usage. Maybe try once a week and slowly work your way up to more frequently, or if you are still having a reaction, try spacing it out more. I hope that helps, and best of luck with your skincare journey. You can always reach out to <> if you have more questions.



Hello Dr. Karam! Trifecta is sold out, elta, enrich & polish as well, when will they be available again?
KaramMD Skin replied:
Hi Ana—I am sorry everything appeared to be sold out when you were trying to shop, that must have been a glitch because we are fully stocked and ready for your order! Go ahead and try again. If you run into any other issues, contact <> and we will help you sort it out. Take care!

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