Rx · prescription onlyAcid
Azelaic Acid
From $25
★ 4.6 community rating
A prescription acid that reduces inflammation, kills bacteria, and fades dark spots.
How it works
- Answer a short set of medical questions and share photos.
- A licensed provider reviews your case — usually within a day.
- If prescribed, your treatment ships directly to you.
Not available in your state yet
Online visits for prescription treatments are currently offered in 12 states. We're working on more — in the meantime, browse community-ranked skincare.
Requires a consultation with a licensed provider. Available in Arizona, Delaware, Florida, Georgia, Illinois, New Jersey, New York, North Carolina, Pennsylvania, Tennessee, Texas, and Washington. You're only charged if your case is reviewed; a prescription is never guaranteed.
How and why it works
Azelaic acid is a naturally occurring dicarboxylic acid with a uniquely versatile mechanism of action. It inhibits tyrosinase (the enzyme responsible for melanin production), making it effective against hyperpigmentation and melasma. It exhibits bacteriostatic activity against C. acnes and Staphylococcus epidermidis. It normalizes keratinization, preventing follicular plugging. It also has anti-inflammatory properties by scavenging reactive oxygen species and inhibiting neutrophil-generated free radicals. This multi-modal action makes it effective for acne, rosacea, and PIH simultaneously.
How to use
Apply a thin layer to affected areas twice daily (morning and/or evening) on clean skin. Azelaic acid is one of the few prescription actives that is safe during pregnancy (Category B). Initial tingling or mild stinging is normal and typically subsides within 2–4 weeks. Unlike retinoids, it does not increase photosensitivity, but SPF is still recommended. Results for acne appear in 4 weeks; pigmentation improvements at 8–16 weeks.
Formulations
A prescription-strength azelaic acid gel with an aqueous base optimized for even distribution and rapid penetration into the epidermis. The formulation balances efficacy with cosmetic elegance—lightweight, non-comedogenic, and suitable for sensitive skin types including rosacea-prone skin. Stabilizing agents maintain the active ingredient at therapeutic levels over the product shelf life.
Pairs well with
Tretinoin or adapalene (azelaic acid in the morning, retinoid at night—complementary mechanisms without excessive irritation), niacinamide (both address pigmentation and inflammation), vitamin C (morning use for antioxidant layering), hyaluronic acid, and gentle cleansers. Safe to combine with most actives. Avoid layering with strong AHAs at the same time to prevent over-exfoliation.
From the community
★★★★★
“Game changer for my rosacea and dark spots. Gentle enough for my sensitive skin but effective. My hyperpigmentation has faded significantly in 8 weeks.”
★★★★★
“I switched from tretinoin because my skin was too sensitive. Azelaic acid is so much gentler and my PIH is fading beautifully. Wish I found it sooner.”