If you’ve spent any time on skincare social media recently, you may have noticed two ingredients appearing again and again: azelaic acid and retinoids. We’re increasingly being asked about this combination in consultations at Shape Clinic. Should you be using both? Which one goes first? Can sensitive skin tolerate them? And, perhaps most importantly, does everyone actually need them?
At Shape Clinic, neither ingredient is new to us. Azelaic acid and topical retinoids have been used in for many years. They can both be useful ingredients, but as with most skincare trends, what works for one person’s skin may be completely wrong for another. The goal shouldn’t be to fit as many active ingredients as possible into your routine. The goal is to find a routine that your skin can tolerate consistently.
First, what is Azelaic Acid?
Despite having the word acid in its name, azelaic acid is quite different from the exfoliating acids many people associate with skincare. Alpha hydroxy acids (AHAs), such as glycolic acid, and beta hydroxy acids (BHAs), such as salicylic acid, can be useful ingredients, but some people, particularly those with sensitive or reactive skin find frequent exfoliating acids difficult to tolerate.
Azelaic acid can offer another option. It has anti-inflammatory and antimicrobial properties and can influence abnormal keratinisation and pigmentation pathways within the skin. For this reason, azelaic acid has been used in the management of concerns including acne, rosacea and certain forms of hyperpigmentation. It can be particularly useful when we’re dealing with skin that seems to have several concerns happening at once. For example, acne accompanied by redness and the post-inflammatory pigmentation left behind after breakouts.
Does Azelaic Acid help pigmentation?
Yes, it can. This is another reason we’re such fans of azelaic acid. Pigmentation is rarely as simple as trying to ‘fade dark spots.’ Conditions such as melasma and post-inflammatory hyperpigmentation involve complex pathways within the skin. Azelaic acid can influence tyrosinase, an enzyme involved in melanin production, which is one reason it has been studied in pigmentation disorders including melasma. Depending on the individual skin, azelaic acid can also be combined with many different ingredients such as vitamin C, Niacinamide or topical Tranexamic Acid.
Can those with sensitive skin use Azelaic Acid?
Often, yes, but ‘sensitive skin’ isn’t one universal skin type.
One of the reasons we frequently consider azelaic acid is that it may be tolerated by people who struggle with some other active ingredients. That doesn’t mean irritation is impossible. Any active skincare ingredient can cause sensitivity in some people, particularly when introduced alongside multiple other actives.
And, what about Retinoids?
This is where the social media conversation can become a little more complicated…
What are Retinoids?
‘Retinoid’ is an umbrella term for a family of vitamin A derivatives. Different forms are available in cosmetic skincare, while some retinoids are prescription only medicines.
The important thing to note is that they aren’t all interchangeable. Retinoids have been extensively studied in dermatology. But there is an important catch: your skin has to tolerate them! The strongest one isn’t necessarily the best product for your skin.
Are Retinoids safe?
Yes, is the short answer. But, as with all skincare, it’s important to know how treatment may effect you.
Very often, a patient tells us they’re using a very strong retinoid. When we ask how frequently they’re using it, the answer is:‘Maybe once to twice a week, because otherwise my skin peels, is red and stingy. I just can’t tolerate any more than that.”
That’s when we need to reconsider what we’re trying to achieve. Retinoids can cause dryness, redness, peeling, stinging and irritation, particularly when first introduced. For some people these effects improve as their skin adjusts. For others, persistent irritation means the particular product, strength, frequency or formulation simply isn’t right for their skin.
Speak to your skincare practitioner to help understand what is the right routine for you if you’re having issues!
Can Azelaic Acid and a Retinoid be used together?
For some people, yes.
Rather than layering everything at once, a routine may separate active ingredients across the day. For example, using azelaic acid as part of a morning routine and a suitable retinoid at night.
That doesn’t mean this should automatically become everyone’s routine. The right combination depends on what we’re treating and the other products being used.
Remember, managing acne and photo-damaged skin will likely need a very different routine from someone managing rosacea, melasma or post-inflammatory hyperpigmentation.
This is when copying someone else’s skincare routine, that has not been prescribed for your skin, can be problematic.
So, do you need Azelaic Acid and a Retinoid?
Maybe.
At Shape Clinic, we’re not interested in building skincare routines around what’s trending that month. We’re interested in understanding the skin in front of us. If your skin is inflamed, sensitised or struggling with a damaged barrier, adding another active ingredient may not be the answer.
The important part is choosing them for a reason.
Skincare should never become a constant trade-off between efficacy and maintaining a healthy skin barrier.
A theoretically powerful ingredient isn’t particularly useful if your skin becomes so irritated that you can barely use it. Sometimes a different formulation, a less intensive retinoid, a slower introduction or simply a different skincare strategy altogether is more appropriate.
Shape Clinic’s approach to Retinoids and Azelaic Acid
Good skincare needs to be appropriate for your skin, address the concerns that actually matter to you and be something you can use consistently without continually disrupting your skin barrier.
Azelaic acid and retinoids aren’t exciting because they’re suddenly trending on social media. They’re exciting because they are established ingredients with legitimate roles in skin management.
But the most important thing to remember when the next skincare trend appears on your feed is not, ‘should I be using this because everyone else is’? But rather, ‘does my skin actually need it’?
Our range of Skin Treatments
Here at Shape Clinic, we have a range of skin treatments for all types of conditions and concerns.
