Azelaic Acid in Skincare: What It Does and Who It Suits
Azelaic acid is a well-known dermatology ingredient, and in Australia the version you can buy depends on how the product is positioned. Our take: it's worth a chat with your pharmacist or doctor rather than a guess from a label. We don't currently use azelaic acid in any Dope Skin Co product, so this is general education only.
What is azelaic acid?
Azelaic acid is a saturated dicarboxylic acid, also known by its chemical name nonanedioic acid. A 2024 review describes it as having antibacterial, anti-keratinising, antimelanogenic, antioxidant and anti-inflammatory activity in laboratory and clinical research (Feng et al., Clin Cosmet Investig Dermatol 2024).
It's used in dermatology, and it's also sold in cosmetic products overseas. If you're searching for azelaic acid skincare in Australia, the key question is which version you can actually buy here.
What does azelaic acid do for skin?
Most of what's known comes from medical research, not cosmetic testing. The authors of one review say it reversibly inhibits tyrosinase in vitro and slows keratinocyte proliferation (Feng et al., 2024).
Another review reports activity against skin microorganisms in laboratory models (Schulte, Wu and Rosen. J Drugs Dermatol 2015;14(9):964-968). These are mechanism findings, not evidence about any product we sell.
Who is azelaic acid good for?
Because it can be a prescription or pharmacy-only medicine in Australia, the right person to ask is a doctor, dermatologist or pharmacist. Skin that's sensitive, broken or reactive should meet any new active with care.
The US prescribing information for a 20% cream lists itching, burning, stinging and tingling as the most common reactions in trials, and notes rare reports of worsening asthma (FDA label, Azelex, revised 02/2024). If you are pregnant, breastfeeding or planning a pregnancy, speak to your doctor or pharmacist.
How do you use it?
Follow the directions on the product or from your prescriber. Patch test first, and our guide shows how to patch test skincare properly. Strength matters here, and strengths vary widely between cosmetic and medical products, so don't guess.
What does it pair with?
A sensible general approach: add one active at a time, and go carefully when stacking it with other exfoliating acids or retinoids until you know how your skin responds. Our guide to AHAs vs BHAs vs PHAs explains how different acids behave, and what retinol is covers another active people ask about.
What does the research say?
The short version: well covered in medical research, with less on cosmetic-strength products.
Reviews describe the most common strengths in medical use as 15% and 20%, and say cosmetic products typically contain lower concentrations (Feng et al., 2024). The same review reports mainly mild, transient stinging, burning or itching, and low skin absorption.
Studies in people with acne, rosacea and melasma are discussed in that literature, but we don't make claims about those conditions. That research is not evidence about any product we sell, and prescription-strength use is a medical matter for your doctor.
Safety and regulation
Australia, Poisons Standard. The Poisons Standard sets who can sell a substance. In an interim decision, the TGA delegate did not adopt a proposal to make topical azelaic acid at 10% or less unscheduled, saying the evidence for a 10% cut-off was insufficient (TGA, interim decision notice).
The final decision notice says azelaic acid for dermal human therapeutic use sits in Schedule 2 (pharmacy medicine), other therapeutic use sits in Schedule 4 (prescription only), and a new Schedule 5 entry covers azelaic acid when it is not in Schedules 2 or 4, which captures non-therapeutic uses such as cosmetics. The implementation date was 1 October 2024 (TGA, final decision notice; Explanatory Statement, Poisons Standard October 2024). The schedules can change, so check the current Poisons Standard on legislation.gov.au before relying on this.
Australia, AICIS. AICIS's 2021 evaluation statement covers nonanedioic acid (CAS 123-99-9) and notes the common name azelaic acid.
It says topical therapeutic use is excluded from the assessment and that overseas cosmetic uses were not assessed. It also recommends amending the Poisons Standard entry, partly because the then-current scheduling limited concentration to under 1% even where dermal use was not intended (AICIS evaluation statement EVA00010, 2021).
US and EU. The CIR (Cosmetic Ingredient Review) published a 2012 safety assessment of dicarboxylic acids, salts and esters, concluding the named ingredients are safe in the present practices of use and concentration (Int J Toxicol 2012;31(4_suppl):5S-76S).
That assessment does not name azelaic acid, so it shouldn't be read as covering it. In the US, a 20% azelaic acid cream is an FDA-approved prescription product, and its label says the exact mechanism of action is not known (FDA label).
Azelaic acid in Dope Skin Co products
We don't currently use azelaic acid in any Dope Skin Co product, and our products don't replace it or imitate it. If you're unsure what suits your skin, take our skincare quiz or browse the dark spots and pigmentation collection.
Frequently asked questions
Is azelaic acid available over the counter in Australia?
It depends on the product. Under the Poisons Standard, dermal preparations for human therapeutic use are Schedule 2 (pharmacy medicine), and other therapeutic use is Schedule 4. A pharmacist can tell you what's available.
Is azelaic acid the same as salicylic acid or glycolic acid?
No. Salicylic acid is a beta hydroxy acid and glycolic acid is an alpha hydroxy acid, while azelaic acid is a dicarboxylic acid. Read our guides to salicylic acid and glycolic acid.
Can I use azelaic acid while pregnant?
Speak to your doctor or pharmacist.
Does azelaic acid cause irritation?
Reviews and the US label report stinging, burning and itching in some people. A patch test helps, but it doesn't guarantee a reaction-free outcome.
Do you sell azelaic acid?
No. We don't currently use it in any product.
How is azelaic acid different from kojic acid or arbutin?
They are different ingredients with different chemistry and different regulatory positions. Read our guides to kojic acid and alpha arbutin.
Another brightening ingredient people ask about is thiamidol, which our thiamidol guide explains.
Related ingredients
Sources
- Feng X, Shang J, Gu Z, Gong J, Chen Y, Liu Y. Azelaic Acid: Mechanisms of Action and Clinical Applications. Clin Cosmet Investig Dermatol 2024;17:2359-2371. Link
- Schulte BC, Wu W, Rosen T. Azelaic Acid: Evidence-based Update on Mechanism of Action and Clinical Application. J Drugs Dermatol 2015;14(9):964-968. Link
- US FDA. Azelex (azelaic acid) cream 20% prescribing information, revised 02/2024. Link
- TGA. Interim decision on azelaic acid (Poisons Standard scheduling). Link
- TGA. Notice of final decision to amend or not amend the current Poisons Standard, ACMS #41 / ACCS #36 / Joint ACMS-ACCS #33. Link
- Australian Government. Explanatory Statement, Therapeutic Goods (Poisons Standard-October 2024) Instrument 2024. Link
- AICIS. Evaluation Statement EVA00010, nonanedioic acid. 14 September 2021. Link
- Cosmetic Ingredient Review Expert Panel. Safety Assessment of Dicarboxylic Acids, Salts, and Esters as Used in Cosmetics. Int J Toxicol 2012;31(4_suppl):5S-76S. Link
