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What the science says about Azelaic Acid

Peer-reviewed research on Azelaic Acid, summarised in plain language. Every study links to its record on PubMed so you can read it yourself.

Azelaic Acid for acne

Strong evidence for acne
  • It usually cleared acne better than a placebo
  • 30 studies back this, including several large reviews
  • It often worked about as well as tretinoin, and results versus benzoyl peroxide were mixed
  • It could work better when used together with other acne ingredients
  • The most common side effects were dryness, scaling, and other moderate skin irritation

32 studies

  1. Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne.

    The Cochrane database of systematic reviews2020Meta-analysis3,880 participantsMixed

    In a large review of 3880 people with acne, azelaic acid worked about as well as tretinoin but cleared acne less well than benzoyl peroxide.

    PubMed 32356369DOI

  2. Guidelines of care for the management of acne vulgaris.

    Journal of the American Academy of Dermatology2024Systematic reviewPositive

    Expert guidelines recommend azelaic acid for acne, but this abstract does not say how much it helped.

    PubMed 38300170DOI

  3. A systematic review to evaluate the efficacy of azelaic acid in the management of acne, rosacea, melasma and skin aging.

    Journal of cosmetic dermatology2023Systematic review20%Positive

    A large review found that azelaic acid helped clear acne better than a placebo, and 20% azelaic acid outperformed erythromycin gel in some studies.

    PubMed 37550898DOI

  4. Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review.

    Journal of evidence-based medicine2020Systematic review3,880 participantsMixed

    In a review of 3880 people with acne, azelaic acid worked less well than benzoyl peroxide but about the same as tretinoin.

    PubMed 33034949DOI

  5. Acne vulgaris.

    BMJ clinical evidence2011Systematic reviewNeutral

    This large review looked at acne treatments, including azelaic acid, but the abstract does not report a clear result for azelaic acid itself.

    PubMed 21477388

  6. Acne vulgaris.

    BMJ clinical evidence2008Systematic reviewNeutral

    This large review included azelaic acid for acne, but the abstract does not report how well it cleared acne on its own.

    PubMed 19450306

  7. A randomized controlled double-blinded split-face prospective clinical trial to assess the efficacy, safety, and tolerability of a novel 3-step routine compared to benzoyl peroxide for the treatment of mild to moderate acne vulgaris.

    Archives of dermatological research2024RCT21 participantsPositive

    In a 12-week study of 21 adults with acne, an azelaic acid routine cleared pimples about as well as benzoyl peroxide and people preferred it more.

    PubMed 38787441DOI

  8. The usefulness of a dermocosmetic containing Myrtus communis extract and azelaic acid for maintenance phase of adult female acne: Results from a randomized exploratory investigator-blinded comparative study.

    Journal of the European Academy of Dermatology and Venereology : JEADV2023RCT53 participantsPositive

    In a 16-week trial of 53 women with acne, a skin care product with azelaic acid was linked to fewer relapses than a light moisturizing cream.

    PubMed 36729399DOI

Research context, not treatment advice. Studies are about the ingredient, not any one product.

Products with Azelaic Acid

Products we have confirmed contain Azelaic Acid, from their ingredient lists.

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