THE AZELAIC ACID BOOM

Azelaic Acid has actually been around for quite a long time, lurking quietly in the depths of the beauty world as somewhat of an unglorified hero pretty much up until the recent past. Now however, this quiet achiever is getting a lot of attention from skincare companies and consumers alike, but what is so special about it and why should you care?

Azelaic acid (AzA), has been widely used as a therapeutic agent in dermatology for quite some time now for various reasons, but is most well-known for the treatment of acne prone skin. Specifically, it has been shown to be highly effective against the Propionibacterium acnes and Staphylococcus epidermidis, which are acnegenic microbes that are stimulated by trapped comedones and initiate inflammatory responses that you end up seeing as red bumps on your skin. AzA is a way to not treat the symptoms of acne (which a lot of anti-acne skincare does), but it actually aims to treat the cause by robbing those microbes of their function to initiate and stimulate acne, just to name one property of AzA! It’s a naturally occurring acid found in whole grains like rye and wheat, and it’s also naturally produced by yeast in our skin’s microbiome. 

Anti-inflammatory, anti-bacterial, anti-keratinising. These are just some of the words you can use to describe the properties of AzA. without going into too much nerdy details (and to save the length of this post), I’ll just very briefly state the what, why and how of each.

AZELAIC ACID AS AN ANTI-INFLAMMATORY

One of the earliest studies of AzA as a topical application at 20% found that AzA reduced the number of lesions (comedones) in people with acne both in immediate and long term time spans. These results seem to pretty much replicate through numerous further studies and on the whole, show that AzA can suppress some of the immune responses (the release of interleukins to be specific, clap your hands if your familiar!) that cause inflammation of the clogged follicle or pore. It’s also demonstrated to participate in another pathway that is implicated in people with rosacea, so it’s also been used to treat this skin condition too! Interestingly, it also has the ability to scavenge free radicals so it can be likened to antioxidants used in skin care.

AZELAIC ACID AS AN ANTI-BACTERIAL

What makes me really excited about AzA as an anti-bacterial agent is that is does not present the same concerns of using antibiotics to treat acne in the sense that there is no real risk of developing antibiotic resistance. Which is of course, a huge concern for modern medicine these days and I choose to steer clear from antibiotics wherever I can. Not only that, it’s also been found to be effective on some of those antibiotic resistant bugs! So far I’ve read eleven studies that show AzA has inhibited the growth of acnegenic bacteria both in vitro and in vivo, and both of the surface and follicular populations of bacteria and I’m sure there is many more. I think it’s important to note here that optimal activity appears to occur after at least one month of treatment. The supposed mechanism of action of AzA is it’s ability to affect the intracellular pH of bacterial cells, leaving them unable to perform their functions and hence, reduced acne!

AZELAIC ACID AND SKIN KERATINISATION

AzA has also has the potential to normalise keratinisation of our skin, which basically means it can help to keep your stratum corner (outer) layer of your skin in optimum condition by maintaining a healthy thickness of this layer. This action mirrors the property of Retinol to normalise skin keratinisation and has shown to be just as effective as Retinol. This action of AzA has also shown to inhibit the generation of comedones, both in frequency and in size of comedones. AzA also assists in healthy filaggrin distribution in the outer layer. The filaggrin protein helps to ensure healthy epidermal barrier function and to prevent transdermal water loss. It is believed that this can help to control oil since it helps to maintain moisture in your skin so that it doesn’t feel the need to produce as much sebum.

PUTTING AZELAIC ACID TO THE TEST

So after reading up the effects of Azelaic Acid, I was way too excited to start getting into using it. It seemed like it had everything going for it. I’ve had some hormonal issues and recently also had to stop my current form of contraception which just happened to be keeping my acne at bay as well. So I was needing to find alternative acne solutions fast. But I struck a problem, where can you actually get AzA? Azelaic Acid is not something easy to find over the counter in Australia, but you’ll be able to source them from dermatologists via a prescription should your skin require this sort of treatment. Be aware of the strength of this though, the topical prescriptions you can get are on average at 20% which is actually pretty strong and intense for your skin based on what I have read. You’ll have to eliminate all other active acids and avoid using it daily if it’s too much for you. For me though, I prefer something a little more gentle for daily use and luckily the products that don’t require a script from a practitioner are those that are less in concentration. Yay! There has been a well-known skincare brand that has also released its own version of Azelaic Acid in a 10% concentration and this was no doubt the fuel for raising the popularity of Azelaic Acid in recent times, but good luck getting it if you’re in Australia (sold out woes).

Neutriderm AzA lotion

I was recently offered the opportunity to try AzA for myself however, through a little company called Neutriderm. The product, called the Oil Regulator Lotion, has a 5% concentration of Azelaic Acid, 2% salicylic acid and chamomile extract, and is my first introduction to AzA. Using AzA is a little interesting because it does exist commonly in formulations with a silicone (dimethicone) carrier. I only use it at night for this reason, and despite it being an active ingredient I do choose to use it after all my serums because of the dimethicone which could inhibit the penetration of other skincare products. But then there is the argument that if you’re using hydrators and occlusives than that could be inhibiting the penetration of AzA. What comes first, the chicken or the egg? There is an ongoing debate about how best to use AzA suspended in silicone to get the maximum benefit, so if you use it in your routine I’d love to hear how you use it! I wait around 20-30mins after applying my usual skincare products and then just spray 3 pumps onto a cotton pad before swiping it over my face. A gentle swipe is all that is needed to avoid any product pilling. It does lend itself to an oily, slippery type of feel on your skin owing to the silicone in it but this doesn’t bother me. It may bother some people though. There was no real scent to the product that I noticed either.

Neutriderm Azelaic Acid

At the time of publishing this post it has been 6 weeks of use, but I must admit I haven’t used it daily like I thought I would. Nonetheless, I didn’t really need to because I am still getting great results with my less frequent use. Now, disclaimer: in the middle of the 6 week period I did have a cosmeceutical peel (you can read up on it here) which could have influenced the results. But four weeks later my skin is still loving the Oil Regulator Lotion. As I mentioned, my recent hormonal changes and going off the contraceptive pill has in the recent weeks caused my skin to have more pimples than normal. And I honestly think that if it weren’t for stepping it up with my skincare including this AzA lotion, my skin would be a lot worse considering how bad my skin got when I had to go off the pill last year. Any new pimples that were starting to inhabit my face didn’t seem to be so large and aggressive as ones I got beforehand.

Something I wasn’t expecting from this was a brightening effect. It seemed to heal and reduce the signs of blemish scars and disclouration from recent pimples, giving me a more even and radiant complexion. With the advent of new pimples, the redness seemed to subside much quicker for these than normal after using the lotion although it took me a few weeks to notice that. Considering my skin has been really good up until recently, my anti-acne skincare product arsenal was quite limited because it was generally not something I had to really address for years. But when I think back to acne skincare that I used to use when I did have constant acne, I don’t remember anything working quite as quickly for my pimples as the Neutriderm lotion, but that could be due to quite a few different factors which may have changed since then (e.g. lifestyle factors etc) so it’s hard to compare. Also, while this is marketed as an Oil Regulator Lotion, to me that wasn’t the biggest improvement in my skin. While it may have reduced sebum production slightly (I say ‘may’ because it’s not that much of a difference where I can confidently say that it really did help), the most noticeable improvement for me was reducing the aggression of my pimples and the evening out of my skin.

Overall I’ve had a really positive experience using the Neutriderm Oil Regulator Lotion and I think it’s a really good alternative for those wanting an ‘entry-level’ Azelaic Acid product. AzA does seem to be one of skincare’s unsung heroes based on the literature I’ve read and I am surprised more people aren’t talking about it! If you want to try this lotion for yourself, you can purchase it off the UAS Pharma website, or on Amazon Australia.

Have you used Azelaic Acid before? Or heard of it at least? Let me know in the comments below! I’d really like to hear the experiences of others who have used it.

Further Reading:

Mayer-da-Silva, A., Gollnick, H., Detmar, M., Gassmuller, J., Parry, A., Muller, R., Orfanos, C.E. 1989. Effects of azelaic acid on sebaceous gland, sebum excretion rate and keratinization pattern in human skin. An in vivo and in vitro study. Acta Derm Venereol Suppl. 143:20-30.

Thiboutot, D. 2008. Versatility of azelaic acid 15% gel in treatment of inflammatory acne vulgaris. J Drugs Dermatol. 7:13-16.

Bojar, R.A., Holland, K.T., Leeming, J.P., Cunliffe, W.J. 1988. Azelaic acid: its uptake and mode of action in Staphylococcus epidermidis. J Appl Bacteriol. 64:497-504.

Holland, K.T., Bojar, R.A. 1989. The interaction of azelaic acid with Propionibacterium acnes. J Invest Dermatol. 92:446A.

Mastrofrancesco, A., Ottaviani, M., Aspite, N., Cardinali, G., Izzo, E., Graupe, K., Zouboulis, C.C., Camera, E., Picardo, M. 2010. Azelaic acid modulates the inflammatory response in normal human keratinocytes through PPARγ activation. Exp Dermatol. 19:813-820.

Nazzaro-Porro, M., Passi, S., Picardo, M., Breathnach, A., Clayton, R., Zina, G. 1983. Beneficial effect of 15% azelaic acid cream on acne vulgaris. Br J Dermatol. 109:45-48.

*This is a sponsored post. While compensation has been provided all views, experiences and opinions are genuine and my own. The Beauty & the Geek AU is no expert so please do not substitute my opinions for professional advice. 

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12 Comments

    1. Based on what I know from your skin posts, I think it would be something beneficial for you to explore as well. It’s been used since the 80’s from what I can see. So many studies and clinical trials on it and it really has such a proven history of working for problem skin, it’s quite strange it’s not considered a staple in skincare.

    1. You’re not the only one, it’s so under-represented in skincare! I myself didn’t hear about it up until last year. The more I read on it the more impressed I become!

    1. Your skin is absolutely beautiful right now, so I’m not sure you even need it! But if you encounter some problems in the future it might be something you want to take a look at 🙂

    1. It’s a little bit of a secret in the skincare world it seems, it’s refreshing to hear of an ingredient you haven’t read of before though!

    1. Oh yes, that does seem to be a common problem. If you do end up trying it, I’d really love to know how it goes with you.

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