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Azelaic Acid for Acne and Skin Health 

Azelaic Acid (AzA) is one of the frontrunners in acne-treating ingredients for popular skincare products, due to its powerful effects in the inhibition of acne production within the epidermis. It has been proven to work on a variety of other conditions as well, and has made its way into dermatological treatments due to its multifunctionality in positively impacting multiple skin disorders simultaneously and safely.  

What is Azelaic Acid and how does it work? 

Azelaic Acid is produced from a type of yeast found in rye, barley, and wheat called malassezia furfur1 and has been found to have the ability to inhibit unhealthy protein development, prevent excessive bacteria/cell-growth, and target malignant melanocytes (skin-cells which produce unhealthy amounts of pigment) within the skin.2 AzA is well-known in cosmetics due to its ability to penetrate deep into the dermis and prevent the formation of multiple types of fungi, bacteria, and proteins that result in common conditions such as acne vulgaris.

AzA has been proven through clinical studies to be efficacious in the prevention of reproduction of certain proteins within the skin, which can buildup and lead to small lumps commonly associated with acne.3 Within the tissue of the dermis, it has also been observed to exert cytotoxicity (the destruction of cells) on malignant melanocytes, the most common reason for hyperpigmentation, and manages to do so without any effect on undamaged normal skin4 -- meaning it only kills the negative cells within the skin and leaves the healthy areas intact.

The antibacterial property of Azelaic Acid allows it to prevent negative bacteria, such as: propionibacterium2 (a principle cause of acne) and pityriasis versicolor1 (a fungal infection resulting in skin discoloration), with incredible efficacy -- mitigating and repairing areas suffering from common bacterial issues. It accomplishes this while also reducing inflammation in the skin (preventing further infection from the bacteria) and assisting with acne, pigment, and texture. 

Benefits of Glycolic Acid for Your Skin

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What conditions does Azelaic Acid help to treat? 

Acne vulgaris (more commonly known as just ‘acne’) is a chronic infection/inflammation (often resulting from the aforementioned propionibacterium) of the sebaceous follicle within the skin that results in increased sebum secretion.3 The sebaceous glands which produce sebum are generally stimulated in response to stress-related hormones,5 but can also be affected by certain oils used for the hair, scalp, and skin.6 Due to its antimicrobial properties, AzA’s ability to reduce the production of the harmful bacteria that infects the skin’s glands and follicles allows high levels of clinical efficacy when used for acne vulgaris.

Azelaic Acid is also able to treat other forms of acne, such as blackheads (comedones), elevated pus-filled pimples (papulopustular), and chest/back acne (nodulocystic) due to its highly-penetrative properties. By targeting the bacteria within the follicles, which causes these eruptions within the epidermis, it is able to effectively reduce the noticeability and recurrence of all forms of acne.7

Discoloration within the skin can be caused by a variety of reasons and AzA serves as an effective tool for pigment-restoration. One of the causes of discoloration is pityriasis versicolor, a fungus that results in pigment changes and dry/scaly skin, that AzA treats directly with its antibacterial properties.1 A second common type of pigment disorder, called post-inflammatory hyperpigmentation (PIH), can be associated with any type of inflammation to the skin (often resulting from persistent acne and UV damage). Azelaic Acid is able to treat this type of pigment damage effectively through its inhibition of the enzyme that produces melanin through melanogenesis (the formation of melanocytes), and thereby serves not just as a way to treat current inflammatory issues but also the resultant aftereffects.5

Other issues such as rosacea are treated as well through the very same antibacterial, protein-resistant, and anti-inflammatory properties that help to define AzA’s use for treating skin disorders. Three-to-four months of regular treatment has been proven to help reduce rosacea,4 and thus has been clinically approved for addressing redness within the skin.1

Studies have indicated that Azelaic Acid should be used for acne as early as possible in order to minimize hyperpigmentation and acne-scarring.8

What are the results and how long do they take? 

Topically applied AzA is one of the most efficacious options for acne within the cosmetic industry and many studies work to set realistic expectations for the timeline of acne-related treatments. Demonstrable improvement and restoration of acne-affected areas was observed to be most noticeable for 85% patients after 16 weeks,8 but many study participants were able to see observable results within the three-month mark.9

For other conditions, such as: hyperpigmentation, rosacea, and other skin disorders, a study in 2016 found that acne-prone patients, suffering from skin-texture and pigment issues, found their skin to be much smoother following the application of Azelaic Acid.1 Observed pigmentary lesions within the skin were found to have had a significant decrease, improving the overall appearance of the skin-tone and texture.9

For a timeline, it is best advised to follow the instructions and to set reasonable expectations dependent on the severity of the condition it is being used to treat. The amount of time can vary heavily based on the concentration of Azelaic Acid, the mode of application, and the type of skin disorder.

Azelaic Acid has a long history of positive results, and has been employed by the skincare industry for good reason. Clinical trials have repeatedly demonstrated its capacity as an anti-acne ingredient, and due to its overall safety and efficacy is recommended to be used as a common treatment, either over-the-counter or by prescription.  

References