Azelaic Acid Explained (40 Studies): EVERYTHING You Need To Know
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Azelaic Acid, a.k.a “The Unsung Hero.” It wasn’t until a couple years ago that people even started noticing this wonderful ingredient! Now everybody and their mom be like that fish from Spongebob…..
“Hey all you people! Hey all you people! Hey all you people won’t you listen to me? I just found an acid! No ordinary acid! An acid filled with beautifying property!”
Anyhow…. let’s summarize all the science on Azelaic Acid in an easy comprehensive manner! As always, we’ll reviewing every major study done on it, as well as giving product recommendations at the end so we can replicate those studies at home. 😉
Here’s a table of contents in case you want to skip ahead to a section!
Table of Contents
- 1 What is Azelaic Acid?
- 2 What Are the Benefits of Azelaic Acid?
- 3 Side Effects.
- 4 How to Use Azelaic Acid and Tips.
- 5 When will I see results?
- 6 Where can I find Azelaic Acid?
- 7 Want to Subscribe for Updates?
What is Azelaic Acid?
For you natural skincare enthusiasts you’ll be happy to hear it’s a naturally occurring compound found in whole grains, that is also produced by the skin’s microbiome (i.e. the healthy bacteria and yeast that live on our skin). (1, 2)
It’s pH-dependent meaning it has to have the right level of acidity to work. Ideally a product containing azelaic acid will be formulated with a pH of 4.9, which is approximately the same pH of healthy human skin. Any lower and the product won’t be as effective. (3)
Related reading: Why the pH of Skin and Products Are Crucially Important
It’s generally used to treat acne, rosacea, and melasma though one study also found it’s effective against psoriasis too. (4)
What Are the Benefits of Azelaic Acid?
Be prepared for a massive wall of oncoming text explaining its badassery! This acid has been studied extensively and the benefits are plentiful.
When I first discovered it 3 years ago I felt like I found a goldmine no one knew about it. And as you can clearly tell, I stock up and have gone through several tubes of this stuff… ¯\_(ツ)_/¯
Azelaic Acid Treats Acne VERY Effectively!
Let me start off by saying that if you’re using Benzoyl Peroxide to treat your acne, you should really consider opting out for azelaic acid instead.
Don’t get me wrong, Benzoyl Peroxide is a fantastic active ingredient and what kept me clear for many many years, but it has the tendency to be overly irritating and can cause some unwanted side effects longterm.
Let’s start our investigation by comparing azelaic acid to other popular acne medications.
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Azelaic Acid vs. Benzoyl Peroxide.
How does azelaic acid compare against benzoyl peroxide? Pretty damn well. In fact, almost identically. In one study involving 580 people, subjects were either given 15% Azelaic Acid, 5% Benzoyl Peroxide, or 1% Clindamycin (an antibiotic). They were told to apply whatever they got every day for 4 months.
The results….
Clindamycin sucked balls (can you tell I’m not a fan of topical antibiotics?), and azelaic acid proved to be as effective as benzoyl peroxide. Overall, it reduced acne by about 70% on average without the side effects benzoyl peroxide had. (5)
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Azelaic Acid vs. Tretinoin (Retin-A).
Once again azelaic acid compares almost identically. A 6 month study involving 289 people found that 20% Azelaic Acid cream and 0.05% Tretinoin were “equally effective” against acne. Very similarly to the Benzoyl Peroxide study, the Azelaic Acid cream was better tolerated and didn’t cause the side effects seen with Tretinoin. (6)
Studies showing the effectiveness of azelaic acid as an acne treatment, particularly against Benzoyl Peroxide, Tretinoin (Retin-A), and antibiotics have been replicated time and time again, the first as early as 1982. (7, 8, 9, 10, 11, 12) One study even found azelaic acid was effective against adult acne when other treatments were not. (13)
UPDATE 4/19/19: more recent studies have shown the same thing, and it’s becoming increasingly prescribed for adult female acne. (41, 42, 43)
What I find particularly appealing about azelaic acid is that it’s great for inflammatory acne, or the big and painful “under the skin” pimples. To this day I use azelaic acid to spot treat any inflammatory lesions I might get.
Unfortunately many acne treatments like retinoids (e.g. differin a.k.a. adapalene) function as preventative measures because they target comedonal acne. In other words, they stop your pores from getting clogged which eventually reduces acne longterm, but it doesn’t do much for the big cystic pimples that are already there — azelaic acid does!
And I saved the best for last….
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Azelaic Acid vs. effin’ ACCUTANE!
I started fan-girling so hard when I read this study! 😀 This clinical trial involved 85 participants with severe acne who were either given Accutane or 20% Azelaic Acid cream to be used with Minocycline (another lame antibiotic).
After 6 months the Azelaic Acid-antibiotic patients were 100% cleared of cystic acne! They also saw an 88% reduction in whiteheads and papules, and 70% reduction in clogged pores. Pretty unbelievable, if you ask me.
Accutane patients also saw 100% clearing in their cystic acne, and an increased 97% reduction in whiteheads and papules, and 83% in clogged pores. So, overall the Azelaic Acid-antibiotic group didn’t beat Accutane but did comparatively well.
Do note, this is Accutane we’re talking about here: the most powerful acne medication in the world! To do well against it is no small feat. The researchers who conducted this study agreed, and concluded that Azelaic Acid is a highly effective treatment for severe forms of acne, and considered it a valuable alternative to Accutane with fewer risks and better tolerability. (14)
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How does Azelaic Acid work to treat Acne?
Azelaic Acid is antibacterial, anti-inflammatory, and anti-keratinizing (meaning it prevents a build-up of dead skin, which could in turn prevent clogged pores that cause breakouts). (15) If you want to learn more or see a visual of what the keratinization process looks like, watch this video.
Unlike Accutane, it doesn’t change how much sebum your skin produces but decreases the free fatty acid content in skin making it an inhospitable environment for bacterial and fungal overgrowth.
UPDATE 4/11/17: this also means it’s an effective treatment for “fungal acne,” or the skin conditions associated with malassezia like seborrheic dermatitis, pityrosporum folliculitis, dandruff, eczema, and psoriasis. The surface of skin that has been exposed to pathogenic malassezia is abnormally high in free fatty acids.
Source: The Role of Sebaceous Gland Activity and Scalp Microfloral Metabolism in the Etiology of Seborrheic Dermatitis and Dandruff. (41)
One of the mechanisms by which anti-fungals work against all the skin conditions mentioned above, is by regulating the free fatty acid content of skin. Azelaic acid has been shown to do exactly that. In fact, one study found that the levels of free fatty acids were reduced from 15.9% to 10.5%, after 1 month of using azelaic acid. (42)
Azelaic acid also starts accumulating in the follicle after just one application to concentrations high enough to inhibit protein synthesis by Propionibacterium acnes (the bacteria that causes acne) and Staphylococcus epidermidis. (16, 17, 18, 19)
I know that sounds confusing, but think of it like this: a zombie apocalypse strikes and suddenly there’s no food available. Acne is a starving person, and Azelaic Acid is the farmer. Only the farmer tells the starving person to piss off and they promptly die.
Okay, that was a terrible analogy…. But you get the point! Essentially, azelaic acid creates an inhospitable environment that starves acne and malassezia-induced skin conditions to death.
Related reading: Pityrosporum (Malassezia) Folliculitis Treatment: How to Kick Fungal Acne’s Ass
Azelaic Acid Treats Rosacea.
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What is Rosacea?
For the uninitiated, rosacea is a chronic skin condition characterized by erythema, or dilated capillaries (small blood vessels) that give an overall appearance of redness. There are four types of Rosacea (20) but the main two are subtype 1, and subtype 2. (21)
Subtype 1 is strictly limited to superficial facial redness, and often used interchangeably with “couperose skin.” Subtype 2 is known as papulopustular rosacea, and as the name implies includes papules and pustules (i.e. pimples and whiteheads) in addition to the facial redness.
Here are some photos of what that looks like.
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Studies.
Despite how effective Azelaic Acid is against acne, the FDA has approved it as a treatment for Rosacea. In one study, 15% Azelaic gel was shown to control papulopustular rosacea over a period of 6 months by significantly decreasing erythema and inflamed lesions. (22)
Using antibiotics in conjunction with 15% Azelaic Acid gel has been shown to increase the effectiveness of its treatment against papulopustular rosacea. (23, 24).
I’d explain to you how it works against Rosacea, but then I’d have to kill you. Just kidding…..
Truth is, scientist don’t really know yet, but suspect it has something to do with its antimicrobial, antioxidant, and anti-inflammatory properties (no sh*t :p). (25)
Azelaic Acid Treats Hyperpigmentation and Melasma
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What is Melasma?
Really quickly — melasma is a skin condition caused by an overproduction of melanin resulting in brown discolorations on the skin, and looks very characteristically like hyperpigmentation. (26) This condition is worsened through sun exposure. All the more reason you should be using sunscreen! Yes, I’m looking at YOU ma’am and / or sir.
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Azelaic Acid vs. Hydroquinone?
In case you didn’t know, hydroquinone is a standard treatment for hyperpigmentation and melasma that works by inhibiting melanin production. It can be found over the counter up to 2%. Anything higher requires a doctor’s prescription.
There has been some controversy in the past regarding hydroquinone’s longterm safety, namely a 1991 study showing the possibility of it causing tumor growth in mice. (27) But there were a couple problems with this study; for example, mice were fed 0.8% hydroquinone rather than applying it topically.
Despite this, hydroquinone has been banned in South Africa, Japan, Australia, and the European Union. (28) There are some skincare experts and companies that disagree with this assessment, particularly Paula’s Choice and FutureDerm. But I’ll let you make up your mind on this.
However, if you wanna avoid the controversy altogether use Azelaic Acid! Some studies have shown it is more effective than 4% Hydroquinone in treating hyperpigmentation without the unwanted side effects. (29, 30)
One of the largest studies done was 24 weeks long, involved 329 women and found there were “no significant treatment differences” between the two. Better yet, azelaic acid had no severe side effects like exogenous ochronosis or allergic sensitization, which are rare but possible outcomes of prolonged hydroquinone use. (31)
Azelaic Acid is Good For Hair Growth.
The combination of zinc sulphate and azelaic acid has been shown to inhibit DHT, which makes it an effective treatment for hair loss. (32) This is why you’ll often see variations of Rogaine (Minoxidil) products containing azelaic acid.
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Wait, I heard Azelaic Acid causes hair loss?
I’ve seen a few people assert this, but it isn’t entirely true and often results from a misunderstanding behind the mechanisms of hair loss. Let me explain.
Dihydrotestosterone (DHT) is responsible for androgenetic alopecia (better known as male or female pattern baldness). However, that same hormone is what causes facial hair growth in men. In other words, the hormone responsible for balding is the same hormone that causes men to grow beards.
This is why you’ll often see heavily bearded men that are bald. If you haven’t noticed that yet, have fun! 😉
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The takeaway.
Azelaic acid is good for hair loss on the head, but can cause thinning of the beard. Even still, the thinning of facial hair would be very mild and unnoticeable to most people. As far as I know, there has only been one study documenting this and it was a rare exception. (33)
So ladies…. if your concerned about growing a beard it won’t hurt to use some azelaic acid. :p
Summary of the all the benefits.
Azelaic Acid is a highly effective acne treatment comparable to Benzoyl Peroxide, Tretinoin, and even Accutane. It also treats rosacea, melasma, and hyperpigmentation.
It has antibacterial, antioxidant, and anti-keratinizing properties. It prevents dead skin build up, unclogs pores, reduces redness, and most importantly does all this gently without major side effects! Azelaic acid may also be effective for treating hair loss.
Side Effects.
As you’ve probably gathered by now, there really aren’t any major ones. That’s what makes Azelaic Acid so great and versatile. It has numerous functions and treats many skin conditions without the irritation that goes hand in hand with other topical prescriptions and ingredients.
To summarize some of the main points in case you missed them: azelaic acid is associated with very little risk, is non-toxic, or teratogenic (meaning it may cause birth defects. See Accutane). It has excellent tolerability, doesn’t induce bacterial resistance, or photosensitivity (in other words, increasing the adverse effects of sun exposure). (34, 35)
When there are side effects they are very mild in nature and include stinging or burning upon application, and skin dryness. (36) Despite this, Azelaic acid doesn’t actually damage the skin barrier or cause transepidermal water loss (TEWL), which is just a fancy way of saying your skin losing moisture. (37)
How to Use Azelaic Acid and Tips.
Use about a fingertip’s worth of Azelaic Acid for the whole face after cleansing. If you find you are experiencing some irritation from it, try buffering it by applying your moisturizer first. This won’t decrease its effectiveness and is a good way of avoiding unnecessary irritation.
Remember to introduce it slowly and patch test first. More isn’t necessarily better. One study found that applying 20% Azelaic Acid cream once daily was just as effective as applying it two times a day after three months. (38)
If you can, opt out for 15% Azelaic Acid gel instead of cream. The gel has a lower lipid concentration requiring less emulsifiers and unnecessary ingredients that could potentially irritate the skin.
Another benefit of using the gel version is increased penetration. One study involving mice showed it had an 8-fold increase in delivery versus the cream version. (39) In short, the gel is more potent and less irritating.
When will I see results?
Pretty quickly. In a year long study involving 1,200 patients who used 15% Azelaic Acid gel, 81.9% of dermatologist noticed an improvement in acne after 35 days, and that number rose to 93.9% after 73 days. Almost 80% of patients said they were “very satisfied” with their treatment at the end of the study. (40)
Where can I find Azelaic Acid?
Azelaic acid is a prescription drug so it may be a little hard to locate especially if you don’t have a dermatologist. Hoping I don’t get in trouble for saying this, but you can find it on the bay of e…. if you catch my drift.
There are two main brands sold, namely 20% skinoren cream and 15% finacea gel
. Do note that the name skinoren and finacea are used interchangeably: they are the same brand. The only thing that matters is what variation you prefer (cream or gel). If you live in the U.S. it might take a while to receive because it ships overseas.
UPDATE 5/15/2017: It appears that finacea/skinoren azelaic acid is only available on Ebay sometimes. :/
If you don’t like the idea of ordering a prescription drug online, or would rather not wait for long shipping times, there are two AzA products on Amazon. GIGI Bioplasma’s 15% Azelaic Cream, and Ecological Formulas Melazepam Cream which contains 20% Azelaic Acid. There is a third AzA product listed, but it doesn’t have the proper pH to work so don’t waste your time buying it.
UPDATE 10/26/18: Paula’s Choice 10% Azelaic Acid Booster is another option!
UPDATE 11/18/19: Azclear Action Medicated Lotion is another option with a minimal ingredient list, and 100% safe for those with fungal acne! 🙂
Alrighty, that does it folks. Have a lovely day!
Cheers,
—f.c.
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Thanks for writing this informative post, it’s wonderful on educating us on the usage of Azelaic Acid. I’ve been thinking of incoporating Azelaic Acid into my routine as I have acne prone skin. I would your opinion if the Azelaic Acid by The Ordinary is a worthy purchase. It is only 10% though, it seems most of the studies done are at 15% or 20%. Additionally, I also would like your opinion on the Azclear Medicated Lotion, that cream is 20% and is readily available in Australia. It’s also a lot cheaper than the creams you have listed.
Looking forward to your reply. Thanks!
Discovering azelaic acid was a breakthrough for me. It might work slightly less effectively than benzoyl peroxide in clearing acne, but taking into account its gentleness, ability to treat PIH, lack of photosensitisation, and (weak) antioxidant properties, it’s overall the superior ingredient. And if you’re an adult I think there’s no question that you should try it in lieu of the harsher benzoyl peroxide.
In my experience, azelaic acid treats inflammatory acne better than non-inflammatory acne (whiteheads and blackheads). I was still getting a few stubborn whiteheads, so I added adapalene into my routine. My line of reasoning was that adapalene’s strengths are the inverse, in that it’s known to treat whiteheads and blackheads better than inflammatory acne. Also, while Differin, like retinoids in general, is pretty lacklustre as a monotherapy, it enhances the effectiveness of an ingredient used in combination with it (Epiduo, the combination of adapalene and BP, is a good example). So basically I mix my own variation of Epiduo tailored for adult skin, replacing the BP with azelaic acid.
The azelaic acid/adapalene combination works so well that I’m surprised that there isn’t a pre-mixed product available with it already. My guess is that it’s because azelaic acid, for whatever bizarre reason (probably because the FDA is exceedingly broken), isn’t officially approved to use as an acne treatment in the US, unlike in Europe, and Galderma (the manufacturer of Epiduo) won’t invest in developing a drug unless it’s approved in the US.
What are your thoughts on mandelic acid?
Omg this blog has been a great help to me. I have had acne for at least 6 years, im now 18. I now have mild acne, thank good i got over the extreme stage. I am ow looking for something to ditch my PIH, and having African American skin, just makes it harder. I recently started using BHA and AHA from Cosrx and they are truly refining my skin. It looks healthier and less oily, but its doing nothing for my PIH. Im going to try to bring this Acid into my routine slowly and hope it works. I try my best to wear sunscreen even if i dont plan on going out, Im using mostly Korean products now. Even my sunscreen is Korean. I don’t normally commrnt on blogs, but you have helped me so much. I wish evey one here all the luck in the world.
Thank you
Just wanted to spread the word that antibiotics are not good. Try probiotics instead. There are probiotics(good bacteria) designed for skin health and acne etc. Basically when we use the same types of antibiotics over and over, the bad bacteria that causes acne creates a resistance to it. Because of Dr.s prescribing these to people for generations, we have strains of resistant bacteria that is even more serious, and these types are showing up on people’s skin who haven’t even taken antibiotics. Please people. You don’t even have to take my word for it. Feel free to Google it. Hope this helps
Is melazepam malassezia safe? I have rosacea + seb derm combo around my nose and can’t get rid of the seb derm until the rosacea goes away according to my derm. I tried protopic and all it did was irritate the area. Nizoral didnt work and neither did climbazole.
Hi, your blog was more than comprehensive and superb. I started using Azelaic acid from the last 2 weeks but didn’t get any results instead I got more small bumps on my face. I was using a pea size amount of Azelaic acid 10% in the morning from ordinary skincare. Help me please. Thank you ☺
I’ve been using The Ordinary’s Azelaic Acid for about 3 weeks now. I only used about a pea size amount over my entire face at night. But I’ve been starting to have breakouts over the last week and a half or so, white heads with a few cystic acne spots. My skin hasn’t been this bad since I first moved to Korea 2 years ago trying to get used to the climate and polution, and even then I didn’t get cystic acne. I will admit it seemed like it was working ok the first week. I had a little bit of breakouts from suscreen, I’m allergic to most, but have to wear it. But then the weather changed from 14% humidity to almost 90% humidity. And all hell broke loose. Well, my skin decided it didn’t like me anymore
It wasn’t red or itchy really. That’s usually my sign I’m allergic. Just a butt ton of white heads and a few cysts. But I wasn’t sure if it was the weather changing or if I’m allergic to azeliac acid. A few sites online say it’s a form of purging, but I hear conflicting opinions if the skin actually does something like this, especially with azeliac acid. I was also using hyaluronic acid, niacinamide + zinc, and grapeseed oil. I cut everything out for a week but a few drops of grapeseed oil to see if it was the azeliac acid. And I think it might be. A few days ago I slowly reintroduced the niacinamide, and it seems like it’s getting better, but not by much.
I have sensitive, oily, acne prone skin that can get dehydrated, have large pores, and melasma. I clean with straight grapeseed oil or use a sensitive skin oil cleanser to take off makeup, and use Cosrx mildly acidic cleanser as a second step and in the morning.
Fantastic article – thank you so much for sharing your knowledge. I just ordered Azelaic Acid Suspension 10% by The Ordinary and now I am even more excited to try it out!
I love Azelaic acid, but I’m confused. In your guide for treating acne, azelaic acid is behind benzoyl and salycilic as a treatment, but in this article azelaic sounds better than both. Why is that?
I have the one by The ordinary and would like to know if I can use it with my vitamin C ? Just found your post and I’ll be signing up for your newletter very informative
I’m confused about azaelic acid’s RX only (or not) status. It’s easy enough to get from Amazon from the brands you linked, and the Ordinary’s 10% formulation (which I’ve been using but haven’t finished so I’m just not sure about it yet). I thought maybe it was something to do with the strength, but the ones you linked on Amazon are the same strength as prescription only varieties.
Hey just happened to use azclear 20% and my skin is bright and less whiteheads. I also had few litmus paper strips and happened to test it’s pH before I started using it. And the pH is almost same as skin 🙂
Hey F.C.! you absolutely RULE first of all. i’ve been testing if i have FA for a couple months now, and whenever i introduce a non-FA safe product, BAM, little clogs everywhere.
My question on Azelaic Acid is: i recently got prescription strength 15% Finacea gel. The only problematic ingredient is Polysorbate 80. I see in your guide that due to a higher concentration of Azelaic Acid, the ingredient may render inconsequential. But i did want to ask YOU, the master tester, if you personally had setbacks with your prescription strength AzA. ???
I’m nervous to try it because it takes about a week for my FA breakouts to totally go away and i get bad anxiety over breaking out.
Thanks! I love supporting you and your blog!
Hey there, I recently found your blog, your pie vs pih SAVED ME.
Anyway, I love Azeleic Acid, I’m not new to it. I found it out from “Pocketderm” before it became “Curology”
I stopped using this service because honestly, everything in my formulation was available to me over the counter, and I didn’t see the sense in paying $20 a month for products I can buy myself (Niacinamide, Azaleic Acid, Zinc). My dilemma is…I can’t find an Azelaic product that I like…I tried The Ordinary’s product, and my skin yelled at me. It was SO siliconey. Just balled up when you put something over it, and gave me those little bitty white heads that I don’t normally get unless I put silicone on my skin. My skin doesn’t do silicone. Not in makeup primers, not in skin care. Any product suggestions? Thanks in advance!
Hi!
I just wanted to say thank you for your advice! After using Nizoral + Hibiscrub for 4 days, my spots have cleared, so definitely was fungal acne.
Azailic acid + Sebamed gel + Aquaphor has been amazing for my skin and healing too!
THANK YOU ??
First off, great work in your writing and research. You can tell you put a lot of time an effort into writing each piece. I did notice in your results section though a pretty big error. You stated that 81.9% improvement in patients after 34.6 days and a 93.9% improvement after 73.1 days. When I read this I was blown away considering the best research I could find consistently shows around about a 65-70% improvement in patients treated. So curious, I read the article and found that those % refer to the number of clinicians that noticed some improvement by 34 or 73 days. An easy mistake but one I thought you would want to be made aware of. Anyway as I said keep up the great work, you are truly doing so great work that is appreciated by many in the community.
Hey ! Great job on all the info . You’re right . Ya don’t hear about Azelaic acid much . I have seborrheic dermatitis and my pores clog easily like yours . Did Azelaic acid help with your seborrheic dermatitis ? I signed up for Curology in April . My seb derm has gotten worse over time . Started with azelaic acid 4%, Climdamycin 1% , and niacinamide 4% . Didn’t change my skin at all . Moved up in strength to 9%azelaic and added tretinoin .009 % . Still not much change . So next it was 0.02% tretinoin , 5% vitamin c , 4% niacinamide . It got worse than ever with the last one . The seb derm spread and my face felt like sand paper . But luckily , ya can’t see it . It just itches n feels like a film on my face . If ya look close , looks like tiny dead skin flakes or tiny blackheads . I recently got BAD poison oak and had to take a prednisone taper . My skin is like silk , but that will end when the prednisone leaves my system . How did you get rid of your seborrheic dermatitis? Your skin looks amazing now !!! Thanks , Jennifer
Darn it all ! I figured you might have also had the same problem . I’m betting that the sweet almond oil feeds the malassezia and the tretinoin increases irritation . I’m still gonna patch test my new formula with the zinc pyrithione. I used my Curology so slowly , like you did , that I got very minimal irritation from the tret, but it was almost like my scales formed a thicker barrier that protected my face from the tret ( if that makes sense ). I really want Curology to work cuz the doc is the ONLY one to take me seriously. I read your post about tret . I’ve read all of your posts so far .
It’s interesting that my seb derm actually surfaced for th very first time after I stopped using salicylic acid . It started as a small patch on each cheek and slowly took over my face , neck and chest . I shall add salicylic acid back to the mix . I will also ask my Curology Angel to prescribe climbazole . Ketoconazole didn’t do much and the bases I tried clogged my pores . Speaking of clogs ! Have you tried mandelic acid ? Blackheads literally fell outa my damn pores when I used it ! I kid you not !!! I’ve always enjoyed watching a blackhead leave a pore . Esp when I’d wake up to blackheads laying on the side of my nose cuz they’d come out on their own . Vivant Mandelic acid serum 8% is what I used . I might get more . I only stopped to give Curology a shot .
Because of your reviews , I got some Cerave Healing Ointment . I chose it cuz it has the ceramides , but no parabens , and it doesn’t have the big time pore clogger in it . I used the one in the tub years ago and had blackheads galore . Interestingly , since my acne shifter to seb derm , I don’t have as many blackheads . I swear ! I think the malassezia eats up all oils on my face n keeps it from turning to zits or blackheads . I could be wrong , but ya know how ya hear about yeast getting rid of bacteria and vice versa ? I now have no zits and few blackheads, just a thin film of itchy sandpaper ! Lol ! My chin once had blackheads poking out of every pore and I always had at least 3 zits on my chin at a time. But my face was baby butt smooth besides that . Uh ! Speaking of long posts ! Sorry ! I can make a short story long !
I will look up Tom Busby also ! No need to apologize for the long post ! As a matter of fact , thank you for taking the time to answer all my questions ! You’re awesome and I appreciate all your help ! Your skin really does look amazing . Nice work ! Many people will be so grateful for your info . Have an awesome day ???
Hey I was writing a comment here and it got lost somehow, love this post and your blog in general. So I am blessed to have subtype 2 rosacea and hormonal acne that lately comes with nodules and cysts, really big ones, plus I am a big picker. Now I am here with PIH, PIE, rosacea, cysts, etc. My derm prescribed differin 0.1% to help with the whiteheads from rosacea and then Nadixa, a topical antibiotic, for my cysts and nodules, differin helped with some whiteheads but no with the cysts and nadixa is doing almost nothing for my nodules I think. Last month or so I got so desperate that I picked so hard I left marks with my nails, that are now PIH and PIE. then I got desperate again and used hydroquinone, which only helped cause some discoloration around my PIH marks. Now my birthday is approaching so I was considering buying something to help fade my PIH and PIE. Where I live I can get 10% glycolic acid or 20% azelaic acid in a cream base. I am wary about the irritating side of AHA’s in rosacea and worried about the cream base in the azelaic acid, potential clogging ingredients, I asked my derm about glycolic acid and he said that I could use it, when my last cyst heals, but I don’t know if he was listening, he tends to be an ass.
So I am hyped to hear your opinions or product recommendations! Thank you so much 🙂