What does Azelaic acid do for the skin?

Azelaic acid can counter or neutralize free radicals that cause inflammation. It has significant skin-calming effects and helps to improve redness. It decreases pigmentation, inhibiting an enzyme called tyrosinase that leads to hyperpigmentation or dark patches of skin. In addition, it could boost skin turnover to unclog pores, reduce inflammation, and diminish discolouration, possibly making it effective in treating rosacea, hyperpigmentation melasma, and acne. More importantly, it’s safe to use azelaic acid every day. Some prescription-strength products are designed to be used two times per day. To decrease the risk of irritation, start two or three times per week and then work up to daily use.

Azelaic acid is effective in treating acne because it is active against all of these factors. Azelaic acid is a competitive inhibitor of mitochondrial oxidoreductases and 5 alpha-reductase, inhibiting the conversion of testosterone to 5-dehydrotestosterone. It also possesses bacteriostatic activity for both aerobic and anaerobic bacteria, including Propionibacterium acnes. This acid is an anti-keratinizing agent, displaying antiproliferative cytostatic effects on keratinocytes and modulating epidermal differentiation's early and terminal phases.