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Rosacea can be a frustrating and challenging skin condition to manage, but the right skincare ingredients can make a significant difference. Azelaic acid is one such ingredient that has been praised for its effectiveness in treating rosacea.
The 15% Azelaic acid gel called Finacea is the first treatment for rosacea in more than a decade. It has also been approved for the treatment of acne. If you’re wondering how to use azelaic acid for rosacea, this post will provide you with everything you need to know to incorporate it into your skincare routine safely and effectively.
Before we get into that, let us understand what Azelaic acid is, how Azelaic acid works, other treatments for rosacea and over-the-counter products that effectively work for rosacea.
Table of Contents
What Is Azelaic Acid?
Azelaic acid is a naturally occurring dicarboxylic acid found in grains like barley, wheat, and rye. It’s known for its anti-inflammatory, antimicrobial, and antioxidant properties, making it a powerful tool in the fight against rosacea. Unlike some other acids, azelaic acid is gentle on the skin, making it suitable for those with sensitive skin, which is often a concern for individuals with rosacea.
Azelaic acid 15% gel and 20% azelaic acid cream are considered highly effective and well-tolerated. You can only get both strengths on prescription. The gel formulation contains 15% micronized azelaic acid, which enhances drug release into the epidermal and dermal layer of your skin thus making it effective. The gel/cream is devoid of any irritants like fragrance, organic solvent and alcohol, and it is buffered to approximately your skin’s PH (4,8).
Read more on Azelaic acid here: Skincare benefits of azelaic acid
Why is Azelaic Acid Effective for Rosacea?
Rosacea is a chronic inflammatory skin condition characterized by redness, visible blood vessels, and sometimes acne-like breakouts. Azelaic acid addresses several of these symptoms:
- Anti-inflammatory: It reduces inflammation, which helps calm redness and swelling.
- Antimicrobial: It fights the bacteria that can exacerbate rosacea symptoms.
- Reduces redness: Azelaic acid can help diminish the appearance of redness over time.
- Unclogs pores: It gently exfoliates the skin, helping to prevent clogged pores and acne breakouts associated with rosacea.
How Azelaic Acid Work For Rosacea
Azelaic acid works for rosacea partly due to its inhibitory action on reactive oxygen species (ROS) in the neutrophils, leading to a reduction in oxidative tissue injury at the sites of inflammation. Due to this, 15% Azelaic acid has anti-inflammatory, anti-oxidant and anti-microbial properties that improve the inflammatory lesions of rosacea. If you find out that 15% gel irritates you, you can opt for the 15% azelaic acid foam from your dermatologist or start with the listed over-the-counter products below.
How to Use Azelaic Acid for Rosacea
Incorporating azelaic acid into your skincare routine can be straightforward, but it’s essential to use it correctly to avoid irritation. Here’s a step-by-step guide:
1. Start with a Clean Face
Before applying azelaic acid, make sure your face is clean. Use a gentle, sulfate-free cleanser that won’t strip your skin of its natural oils. Pat your skin dry with a soft towel—don’t rub, as this can aggravate rosacea.
2. Patch Test First
If you’re new to azelaic acid, it’s crucial to patch test before using it on your entire face. Apply a small amount to a discreet area of your skin (like behind your ear) and wait 24 hours to see if you experience any irritation or reaction.
3. Apply Azelaic Acid
Once you’ve determined that your skin tolerates azelaic acid, you can begin applying it to your face. Typically, azelaic acid products come in a gel or cream form. Use a pea-sized amount and gently apply it to the areas affected by rosacea. You can use it once or twice a day, depending on your skin’s tolerance.
4. Follow with a Moisturizer
After applying azelaic acid, follow up with a hydrating, non-comedogenic moisturizer to lock in moisture and protect your skin barrier. Look for moisturizers that are free from fragrances and harsh ingredients that could irritate your skin.
5. Always Use Sunscreen
Sunscreen is a must when using azelaic acid, as it can make your skin more sensitive to the sun. Choose a broad-spectrum sunscreen with an SPF of 30 or higher, and make it a part of your daily routine, even on cloudy days.
How Long Does Azelaic Acid Take To Work On Rosacea?
It takes about 12 weeks of consistency for azelaic acid to work on rosacea. Expert Opinion on Pharmacotherapy carried out a study where 15% azelaic acid was administered topically in a 12-week controlled study. At the end of the therapy, Azelaic acid 15% gel showed a reduction in lesions and an improvement in redness than those treated with control in the space of 12 weeks.
What Percentage Of Azelaic Acid Is Good For Rosacea?
15% Azelaic gel or foam or 20% Azelaic acid cream. These percentages can only be gotten on prescription but you can find other products over-the-counter that work effectively. This can be used once or twice daily
If you go to your dermatologist and you are prescribed Azelaic acid, you may be required to start with over-the-counter products to see how your skin reacts before using prescription Azelaic acid.
Safety and Tolerability of 15% Azelaic Acid
No serious adverse effect was reported with the use of 15% Azelaic acid. However, in dark skin, studies showed azelaic acid causing hypopigmentation, meaning loss of skin colour. Overall, side effects are mild and transient and can be managed adequately
Tips for Using Azelaic Acid for Rosacea
- Start Slowly: If you’re new to azelaic acid, begin by using it every other day to allow your skin to adjust. Gradually increase to daily use as your skin builds tolerance.
- Be Patient: It can take several weeks to see noticeable improvements in your rosacea symptoms, so consistency is key.
- Avoid Harsh Products: While using azelaic acid, avoid other potent skincare ingredients like retinoids, AHAs, or BHAs unless directed by your dermatologist. These can increase the risk of irritation.
- Consult a Dermatologist: If you’re unsure how to use azelaic acid or if you have severe rosacea, it’s always best to consult a dermatologist for personalized advice.
Over-the-counter Azelaic Acid Products For Rosacea
The Inkey List 10% Azelaic acid serum is a really lightweight green gel which can be worn under make-up. You can use it twice a day but it is important you start once every other day to build your tolerance. It is also affordable. Making it my number-one pick
SVR AZ Ampoule Flash Sebiaclear contains 15% azelaic acid, and 5% niacinamide – making it great for the skin barrier and helping with managing rosacea symptoms.
SVR products boast in products that reduce redness. Using it once a day is beneficial for your skin
Cos De BAHA 10% Azelaic Acid also contains niacinamide that soothes the skin and protects your skin barrier. It is gentle on the skin and safe for daily use
Other Prescription Rosacea Treatment
Metronidazole
Metronidazole is found in 0.75-1% gel, cream or lotion. The mode of action of topical metronidazole in rosacea is unknown. However, mechanisms that reduce inflammation in rosacea are believed to be involved. Studies compared 15% azelaic acid gel with 0.75% metronidazole gel, both applied twice daily on the face for 15 weeks with patients with moderate papulopustular rosacea. They found out that 15% Azelaic acid was superior in decreasing inflammatory lesions and improved redness.
Ivermectin
Ivermectin is an anti-parasitic drug and it has been approved by the FDA as a 1% cream. A double-blind, controlled study for 12 weeks proved to be highly effective in inflammatory rosacea. The effectiveness could be due to its action against Demodex folliculorum mites or due to its anti-inflammatory properties.
Formulation-Based Treatments For Rosacea
For formulation-based treatment, check Klira Skin Treatment. Klira is a dermatologist-led company where you will need to fill out questionnaires based on your skin and you will be made a formula based on what your skin needs. A highly effective method if you don’t want the trial and error methods on trying out different skincare products.
Also, You may join a community called Galderma Rosacea. It is a global research company where people with rosacea share their struggles and its effect on their mental well-being.
Other Products For Rosacea
You will need moisturizers, and cleansers for your skincare routine. So I have taken time out to tell you about other products that are gentle and safe for this skin condition
CeraVe facial moisturizing lotion is one of my favourite moisturizers. It is gentle on the skin and relatively affordable. It would be a really good choice to add to your routine.
La Roche-Posay Cicaplast Balm B5 is a great choice if your skin is dry and you need a moisturizing balm to come to the rescue, then this is a good choice.
Avene Tolerance Hydra-10 cream is a tolerance hydrating cream for dry to dry-sensitive skin. It is lightweight and great under-makeup. Great daytime moisturizer
La Roche-Posay Micellar Water is a great cleansing water to gently remove dirt easily from the skin. Great for rosacea and sensitive skin types.
Conclusion
Azelaic acid is a gentle yet effective treatment for rosacea, helping to reduce inflammation, calm redness, and prevent breakouts. By incorporating it into your skincare routine, you can manage your rosacea symptoms and achieve clearer, healthier skin. Remember to start slowly, protect your skin with sunscreen, and consult a dermatologist if needed. With time and consistency, azelaic acid can become a valuable part of your rosacea care regimen.
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