Does azelaic acid help closed comedones?

What does azelaic acid do for closed comedones?

A comedone is a plug of skin oil and keratin, a protein in skin cells, inside a hair follicle. Closed comedones are the noninflamed whitehead form of acne. Azelaic acid reduces both noninflamed acne lesions and inflamed spots, so its usefulness is not limited to red pimples.234

Azelaic acid also works on acne causing bacteria, reduces acne inflammation and treats dark spots left after acne clears. That makes it a useful option when whiteheads occur alongside pimples or lingering dark marks. It is also an established topical treatment for mild acne.13

How should you use azelaic acid?

Azelaic acid 20% is an established option for comedonal acne. General guidance for treatments that clear comedones is a thin layer over the entire affected area once or twice daily; follow your particular product's directions or prescription rather than treating that schedule as universal.2

1. 1Wash with a mild cleanser and water. General comedonal acne care includes washing twice daily.
2. 2Apply a thin layer across the acne prone area, not just individual whiteheads. Treating the area addresses existing acne and helps prevent the next breakout.
3. 3Use the product consistently as directed. Let its instructions determine whether you apply it in the morning, evening or both.
4. 4For an initial home treatment trial, use one acne treatment for 6 to 8 weeks without adding another active treatment.

A one product trial leaves the rest of the acne aisle waiting for its audition. Choose oil free cosmetics, because oily cosmetics can aggravate comedonal acne. If you already have prescribed acne medication, follow that treatment plan rather than replacing it with a home trial.12

How long does it take to work?

For acne treatment generally, fewer breakouts can appear after 4 to 8 weeks, with clearing around 16 weeks when treatment works. Those are general acne timelines, not a fixed azelaic acid deadline. Comedonal acne can take several months to improve significantly. Look for fewer new whiteheads and a gradual reduction in existing ones, rather than expecting immediate clearing.25

Who should be careful or see a dermatologist?

Azelaic acid can cause itching, burning, stinging and redness. Sensitive skin still needs attention to tolerability; azelaic acid is not automatically irritation free. If irritation makes treatment difficult to tolerate, get advice about how to proceed rather than pushing through it.6

If you are pregnant or trying to become pregnant, consult a dermatologist before treating acne yourself. Seek treatment sooner for large, painful spots deep in the skin or acne that leaves scars. Persistent whiteheads despite consistent treatment also warrant a dermatologist appointment, particularly if you are not seeing clearer skin within a few months.25

Does salicylic acid help closed comedones?

Yes. Salicylic acid unclogs pores and exfoliates skin, and works particularly well for whiteheads and blackheads. It is available in different strengths and formats, including cleansers and moisturizers. The bottle format is not the treatment decision, however much shelf space it occupies. Choose one suitable acne treatment first instead of starting salicylic acid and azelaic acid together.15

Azelaic acid is not the only option if whiteheads persist. Topical retinoids such as adapalene and tretinoin also treat open and closed comedones. A dermatologist can help select a different treatment or a combination based on the types of acne present and how well your skin tolerates treatment.14