Azelaic Acid
Also known as Finacea, Skinoren
The quiet all-rounder — acne, rosacea and pigmentation at once, and one of the few actives considered pregnancy-compatible.
OTC 10% around $15–30; prescription 15–20% varies by insurance.
How it works
A dicarboxylic acid with antibacterial action against C. acnes, comedolytic effects, and competitive inhibition of tyrosinase which reduces melanin production. It is also anti-inflammatory, which is why it helps rosacea.
How it's used
10% OTC or 15–20% by prescription, applied once or twice daily. Layers well with most routines and can be combined with retinoids on alternate nights.
Trade-offs
In favour
- Treats acne, rosacea and post-inflammatory hyperpigmentation simultaneously
- Generally considered safe in pregnancy — rare among actives
- Does not cause photosensitivity
- Well tolerated on sensitive skin
Against
- Slower than a retinoid for acne
- Can feel gritty in some formulations
- Higher strengths need a prescription in many countries
Risks and side effects
- Transient stinging or tingling on application
- Rare hypopigmentation on deeper skin tones
How good is the evidence?
Solid randomised evidence for both acne and papulopustular rosacea; supported in dermatology guidelines.
Sources
Sources point to guideline bodies and literature searches rather than single papers, so they stay accurate as the evidence moves.