Azelaic acid Hyperpigmentation

Azelaic Acid

July 24, 2021

In this post, I discuss my experience with azelaic acid.

  • What is azelaic acid good for?

During my visits with my dermatologists, if my skin didn’t tolerate hydroquinone, he was going to write me an azelaic acid prescription for my dark spots. Azelaic acid is generally well tolerated, even on sensitive skin. Azelaic acid works by reducing melanin production in hyperactive areas. This makes It great at treating melasma. It has also been used to improve the appearance of acne, rosacea, uneven skin texture, and large pores.


  • How effective is azelaic acid for hyperpigmentation

Generally, the results produced by azelaic acid have been shown to be comparable to those of HQ. Here are three studies to consider:

  1.  Three hundred twenty-nine women with melasma were treated with either 20% azelaic acid or 4% hydroquinone. Both creams were applied twice daily- 65% of patients using azelaic acid had good to excellent results compared with 73% of patients using 4% hydroquinone. 
  2. In another study, involving 155 melasma patients, 20% azelaic acid was superior to 2% hydroquinone in clearing melasma.
  3. In a third study that compared the combination of azelaic acid and tretinoin to azelaic acid alone, the combination was found to be more effective. Here, 50 Asian patients were treated with either a double combination or a 20% azelaic acid cream over a 6 month period. Both treatments yielded approximately 73% good to excellent results. However, the double combination cream showed a faster response and a more pronounced improvement during the first 3 months and had a higher rate of excellent results at the end of 6 months.


  • How  to use azelaic acid

Azelaic acid can be used once or twice daily. 

Once for people who may find it intolerable

Twice a day if you want to see fast results.

For an added effect, consider using it with a retinoid at nighttime or an exfoliant.

  • Azelaic acid routine



Vitamin c (optional)

Azelaic acid 







Azelaic acid 



  • Results

It can take anywhere from 1-3 months to see results on the face. On the body, give it about 3- 6 months


  • Important things to know
  1. According to Sheth and Pandya (2011) Side effects are generally mild: Short term Stinging, burning, scaling, mild erythema, and pruritus
  2. It can be combined with retinoids for an added benefit
  3. Unlike hydroquinone and arbutin, azelaic acid is safe for pregnant women and nursing mothers
  4. Azelaic acid can also be combined with other pigment lighteners for best results. For example, a dermatologist could write you a prescription for both hydroquinone and azelaic acid. Then ask you to use azelaic acid in the morning and hydroquinone at night; this typically yields faster results than azelaic acid alone.


  • Products to try
  1. Aziderm 20%  azelaic acid cream and gel 
  2. Melazapem 20% azelaic acid (available on Amazon
  3. The ordinary (not very effective. Will take longer to show results)
  4. Finacea foam and gel
  5. Skinoren 20% azelaic acid 
  6. Ezanic azelaic acid gel


Products Mentioned in Video

▶ Azelaic acid

I. Aziderm http://thepigmentedlife.com/product-links/

II. Melazapem https://amzn.to/2VODnoL

III. The Ordinary azelaic acid suspension https://amzn.to/3iupfsn

▶ Retinoids

I. Tretinoin http://thepigmentedlife.com/product-links/

II. Differin https://amzn.to/3hQ0V5t

III. Retinol https://amzn.to/3Bn3zr5

▶ Hydroquinone http://thepigmentedlife.com/product-links/



Do you have azelaic acid in your skincare routine? Would you like to try it?


To be added shortly


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