Azelaic acid is a skincare ingredient used to address various skin concerns. It is a naturally occurring dicarboxylic acid found in grains like wheat, barley, and rye, and it is also produced by certain yeasts that live naturally on human skin. In skincare products, azelaic acid is typically created synthetically to ensure its stability and effectiveness. It has gained recognition for its role in managing acne and its lingering effects on the skin.
Types of Acne Scars Azelaic Acid Addresses
Acne can leave behind different types of marks on the skin, and azelaic acid primarily helps with specific forms of discoloration. It is effective for post-inflammatory hyperpigmentation (PIH) and post-inflammatory erythema (PIE). PIH appears as flat, dark spots, ranging from brown to black or gray, which result from an overproduction of melanin in response to skin inflammation or injury. PIE, on the other hand, presents as red or pink patches, caused by damaged or dilated blood vessels underneath the skin after an inflammatory breakout.
Azelaic acid targets these color changes, improving skin tone uniformity. Azelaic acid generally does not improve textural acne scars. These include indented scars like ice pick, boxcar, or rolling scars, which involve changes in the skin’s collagen and elastin structure. Such textural scars usually require different types of dermatological treatments.
How Azelaic Acid Works for Scar Improvement
Azelaic acid offers multiple mechanisms that contribute to improving skin discoloration from acne. Its anti-inflammatory properties reduce redness associated with post-inflammatory erythema (PIE) by calming irritated skin and lessening visible redness.
The ingredient also works to fade dark spots, or post-inflammatory hyperpigmentation (PIH), by inhibiting tyrosinase. Tyrosinase is an enzyme essential for melanin production, and by interfering with its activity, azelaic acid helps to decrease the synthesis of pigment in the skin. This selective inhibition targets overactive pigment-producing cells without affecting normal skin pigmentation. Additionally, azelaic acid has antioxidant capabilities, which protect the skin from damage caused by free radicals and contribute to overall skin health and clarity. It can also promote cell turnover, which aids in the skin’s healing process and helps to minimize the appearance of scars.
Using Azelaic Acid for Scar Treatment
Incorporating azelaic acid into a skincare routine for scar improvement requires consistent application. It is available in various concentrations, with over-the-counter formulations typically containing up to 10%, while prescription-strength products can range from 15% to 20%. These products come in different forms, such as creams, gels, or foams.
For application, a small amount, often pea-sized, should be applied evenly to clean, dry skin once or twice daily. It is advisable to start with a lower concentration or apply less frequently to allow the skin to adjust. Following application, use a hydrating moisturizer. Daily use of broad-spectrum sunscreen with an SPF of 30 or higher is important to protect the skin and prevent further discoloration.
Expected Outcomes and Important Considerations
Users can anticipate gradual improvement in skin discoloration when using azelaic acid for acne scars. Initial changes, like reduced redness and calmer skin, may be noticeable within 2 to 4 weeks. More significant fading of hyperpigmentation and clearer skin often appear after 2 to 4 months of consistent use. Full benefits can take 6 months or more.
Some individuals may experience mild side effects, particularly during the initial weeks of use. These can include a temporary sensation of itching, burning, stinging, or redness, as well as dryness or scaling at the application site. These effects are typically mild and subside as the skin adjusts. If irritation is severe or persistent, reduce frequency or temporarily discontinue use.
While azelaic acid does not significantly increase sun sensitivity, daily sunscreen use is recommended to protect treated skin and prevent worsening discoloration. If no noticeable improvement occurs after several months of consistent use, or if side effects are concerning, consult a dermatologist for personalized guidance and other treatment options.