Azelaic Acid for Reducing Acne Scars and Skin Discoloration
Acne scars and dark spots don’t just stick around because you had a bad breakout-they linger because your skin’s natural repair process gets stuck. That uneven texture or stubborn brown patch? It’s not laziness. It’s inflammation. And azelaic acid is one of the few ingredients that actually targets both the cause and the look of these marks without burning your skin alive.
What azelaic acid actually does to your skin
Azelaic acid is a naturally occurring dicarboxylic acid found in grains like barley and wheat. But the version you use on your face? It’s lab-made to be pure, stable, and strong enough to work. It’s not a chemical peel. It’s not a retinoid. It’s something quieter, smarter: a multitasking agent that calms inflammation, kills acne bacteria, and gently slows down overactive pigment cells.
When you get a pimple, your skin sends out inflammatory signals. That’s normal. But sometimes, those signals don’t shut off. They keep telling pigment-producing cells (melanocytes) to dump out extra melanin. That’s how a red bump turns into a dark spot that lasts for months. Azelaic acid interrupts that signal. It doesn’t bleach your skin-it tells the melanocytes to behave.
Studies show it reduces post-inflammatory hyperpigmentation (PIH) by up to 50% in 12 weeks. That’s not magic. That’s science. A 2023 trial published in the Journal of Clinical and Aesthetic Dermatology found that 20% azelaic acid cream improved skin tone evenness in 78% of participants with mild to moderate acne scarring after 16 weeks.
How it compares to other acne scar treatments
You’ve probably heard of hydroquinone, vitamin C, niacinamide, or chemical peels for dark spots. Each has pros and cons. Hydroquinone works fast but can irritate sensitive skin and is banned in some countries. Vitamin C brightens but doesn’t touch inflammation. Niacinamide is gentle but slower. Azelaic acid sits in the middle: effective enough to compete, gentle enough for daily use.
Here’s how it stacks up:
| Treatment | Targets Inflammation | Reduces Pigmentation | Safe for Sensitive Skin | Time to See Results |
|---|---|---|---|---|
| Azelaic Acid (15-20%) | Yes | Yes | Yes | 6-16 weeks |
| Hydroquinone (2-4%) | No | Yes | No | 4-8 weeks |
| Vitamin C (10-20%) | Mild | Yes | Usually | 8-12 weeks |
| Niacinamide (5%) | Yes | Moderate | Yes | 8-12 weeks |
| Glycolic Acid Peel (30%) | No | Yes | No | 4-6 weeks |
Azelaic acid wins on safety and dual action. It doesn’t just fade color-it stops new scars from forming. That’s why dermatologists often recommend it for people with rosacea and acne at the same time. It’s one of the few ingredients that treats both conditions without making one worse.
How to use azelaic acid for best results
Not all azelaic acid products are the same. Over-the-counter versions usually contain 10-15%. Prescription strength is 15-20%. For acne scars and discoloration, you want at least 15%. If you’re using the 10% version, you’ll need to be patient-it might take 4-6 months to see real change.
Here’s how to use it right:
- Start slow. Use it every other night for the first week. Some people get mild stinging or redness at first. That’s normal. If it burns or flares up, stop for a few days and try again.
- Apply to clean, dry skin. Use a pea-sized amount for your whole face. Don’t rub it in like lotion-pat it gently.
- Wait 15-20 minutes before applying moisturizer. This lets it absorb fully.
- Use sunscreen every morning. Azelaic acid doesn’t make you sun-sensitive, but your skin is healing. Sun exposure makes discoloration worse.
- Stick with it. Don’t quit after two weeks. It takes time to reset your skin’s pigment production.
Pair it with a simple moisturizer containing ceramides or squalane. Avoid strong exfoliants like retinoids or AHAs on the same night. You don’t need to layer everything. Less is more when you’re repairing.
Who should avoid azelaic acid
It’s one of the gentlest options out there, but not for everyone.
- If you have extremely sensitive skin or active eczema flare-ups, test it on a small patch first.
- Don’t use it on broken skin or open wounds. It can sting.
- Pregnant or breastfeeding? It’s considered safe. The FDA classifies it as Category B. But talk to your doctor if you’re unsure.
- If you’ve had allergic reactions to other topical acids, try a sample size first.
It’s safe for all skin tones. Unlike hydroquinone, it doesn’t cause ochronosis (a rare but serious darkening of the skin in darker complexions). That’s why it’s a top pick for people with brown or Black skin who struggle with post-acne marks.
Real results: what to expect after 4, 8, and 12 weeks
Here’s what most people actually see:
- Week 4: Less redness around old pimples. Skin feels calmer. Some dark spots might look slightly lighter.
- Week 8: Noticeable fading of brown marks. Texture feels smoother. New breakouts are fewer.
- Week 12: Acne scars appear less defined. Skin tone is more even. Many users say their skin looks "healthier," not just clearer.
It won’t erase deep, pitted scars. That needs lasers or microneedling. But for flat, discolored marks-the kind that make you feel like you still have acne even when you don’t? Azelaic acid clears them.
Top brands and where to find them
You don’t need to spend a fortune. Here are a few reliable options:
- Finacea (15%) - Prescription gel. Popular in the U.S. and Europe. Often covered by insurance.
- The Ordinary Azelaic Acid Suspension 10% - Affordable, effective for maintenance. Best paired with other actives.
- Paula’s Choice 10% Azelaic Acid Booster - Lightweight, blends well under makeup.
- Skinoren (20%) - Prescription cream available in Canada and parts of Europe. Stronger, faster results.
Generic versions exist too. Look for "azelaic acid 15%" or "20%" in the ingredients list. Avoid products with added fragrance or alcohol-they’ll undo the calming benefits.
Why this isn’t a quick fix-but it’s worth it
There’s no magic potion for acne scars. Lasers cost hundreds. Chemical peels need downtime. Azelaic acid doesn’t promise overnight results. But it’s one of the few treatments that actually changes your skin’s behavior over time. It doesn’t just cover up the problem. It fixes the root cause: inflammation and rogue pigment cells.
Think of it like training your skin to heal better. Every night you use it, you’re rewiring how your skin responds to damage. That’s why people who stick with it for six months often say their skin never goes back to how it was before.
It’s not glamorous. No viral TikTok trends. No before-and-after filters. But if you’ve spent years chasing quick fixes that left your skin raw and your wallet empty-this is the quiet, steady solution you’ve been waiting for.
Can azelaic acid remove deep acne scars?
No, azelaic acid won’t fix deep, pitted, or ice-pick scars. Those require procedures like microneedling, laser resurfacing, or subcision. But azelaic acid is excellent for reducing the redness and dark discoloration around those scars, making them look less noticeable.
How long does azelaic acid take to fade dark spots?
Most people see visible improvement in 6-8 weeks, with full results around 12-16 weeks. Consistency matters more than strength. Using it daily, even at lower concentrations, beats sporadic use of higher doses.
Can I use azelaic acid with vitamin C or niacinamide?
Yes, but not at the same time. Use azelaic acid at night and vitamin C in the morning. Niacinamide can be used in the same routine, but space them out by 30 minutes to avoid irritation. Avoid mixing with strong acids like glycolic or lactic acid.
Does azelaic acid make your skin peel?
Mild flaking can happen in the first two weeks, especially with higher concentrations. This is normal as your skin adjusts. If peeling is severe or painful, reduce frequency or switch to a lower strength. Moisturizing helps.
Is azelaic acid safe for long-term use?
Yes. Unlike hydroquinone, azelaic acid doesn’t lose effectiveness over time and has no known long-term side effects. Many dermatologists recommend it as a maintenance treatment for chronic acne or recurring discoloration.
Next steps if it’s not working
If you’ve used azelaic acid daily for 16 weeks and see no change, it’s time to reassess. Are you using enough? The 10% version might be too weak. Consider switching to 15% or 20%. Are you using sunscreen? UV exposure can undo progress. Are you still breaking out? New acne creates new scars. You might need to treat active acne first.
If you’re doing everything right and still stuck, talk to a dermatologist. They can check for other causes of discoloration-like melasma or fungal infections-and recommend stronger options like tranexamic acid or low-dose laser therapy.
Azelaic acid isn’t the only answer-but for most people, it’s the best starting point. It’s safe, effective, and doesn’t cost a fortune. And if you give it six months? Your skin might surprise you.