Can I use The Ordinary Azelaic Acid with tretinoin?

Why can the ingredients work together?

Both topical retinoids and azelaic acid are acne treatment options. Tretinoin helps clear pore blockages and reduces inflammation. Azelaic acid is useful for acne and the darker marks that can remain after inflammation. Azelaic acid has also been effective in combination with tretinoin cream in acne treatment. That makes a clinician directed combination a reasonable possibility, rather than a pairing that is always forbidden.13

Acne care can combine topical treatments that work in different ways. Retinoids or azelaic acid are also used for maintenance to suppress the tiny developing pore blockages that precede acne lesions. The useful goal is a treatment plan for acne, not a bathroom shelf that looks like a stockroom.34

What is different about The Ordinary's product?

The Ordinary Azelaic Acid Suspension 10% is a creamlike suspension marketed for uneven tone and texture, which gives the tube a more specific job than 'fix everything.' The Spanish and Portuguese product pages both advise avoiding retinoids, strong acids and peptides with the suspension. Those product directions matter even though azelaic acid and tretinoin have roles together in medical acne care.25

Can I use azelaic acid in the morning instead?

The Ordinary allows the suspension in a morning or evening routine, but does not give a separate morning and evening exception to its advice to avoid retinoids. Do not assume that moving the suspension to breakfast automatically resolves the combination question. Ask your prescriber whether to add azelaic acid at all, which formulation to use, and whether the products should be used at separate times. Keep your prescribed tretinoin schedule rather than changing it to accommodate an extra cosmetic.2

How do I apply the suspension if it is approved?

1. 1Patch test first. Apply a small amount to clean skin on the upper forearm, keep the area dry, and rinse after 24 hours. Do not use the product if redness, burning, itching, blisters or irritation develop.
2. 2At the time agreed with your prescriber, apply a small amount to intact facial skin. Avoid the eye area and contact with the eyes or mouth.
3. 3Place the suspension after water based products and before heavier treatments. This is its usual routine position, not an instruction to put it above or below tretinoin.
4. 4Use sunscreen during the day. The Ordinary recommends sun protection even though azelaic acid does not significantly increase sun sensitivity.

What should I watch for?

Irritation is a major reason people struggle to continue topical retinoids. Azelaic acid treatments can also cause burning or stinging. Sensitive skin is a reason to take the suspension's patch test seriously, even though The Ordinary describes it as generally well tolerated. If the suspension causes irritation, rinse it off, stop using it and consult a doctor. Do not push through irritation simply because both ingredients are used for acne.15