Azelaic acid, explained
A gentle multitasker for redness, dark spots and breakouts. Why it suits menopausal and sensitive skin, and what strength actually works.
Good evidence
What it does
Azelaic acid calms redness, helps fade dark patches by slowing pigment production, and clears pores. It’s gentler than many acids and doesn’t make skin sensitive to the sun.
Why it suits skin over 40
It works on several common 40+ concerns at once: rosacea-type redness, melasma and age spots, and adult breakouts around menopause. It’s often suggested when skin can’t tolerate stronger actives.
What strength?
15 to 20%
The strengths used in most studies. In the UK these are prescription treatments, so ask your GP or pharmacist about rosacea or melasma.
Up to about 10%
Found in over-the-counter serums, including Korean ones. Gentler, with less research behind them.
How to use it
- Once or twice a day, after cleansing.
- A mild tingle at first is common and usually settles.
- Fine with niacinamide and retinoids, and generally considered suitable in pregnancy, but check with your GP or midwife.
- Use with daily sunscreen for dark spots.
What the research shows
In a 24-week, double-blind study of 329 women with melasma, 20% azelaic acid cream was compared with 4% hydroquinone, both used with a broad-spectrum sunscreen. Azelaic acid worked about as well, and severe side effects such as allergic reactions were not seen with it.
Baliña and Graupe, International Journal of Dermatology, 1991 [1]
Good to know
Is azelaic acid good for menopausal skin?
It can help with redness, breakouts and dark patches, which are common around menopause, and it’s gentle enough for sensitive skin.
Can I use azelaic acid with retinol?
Yes, many people do. Start slowly with one, then add the other.
Is azelaic acid an exfoliant?
It has a mild smoothing effect, but it’s much gentler than AHAs or BHAs.
Sources
This page is general information, not medical advice. Last updated 30 October 2026.