Can You Use Azelaic Acid With Tretinoin?
Many people with skin concerns like acne, rosacea, and melasma have found success using prescription retinoids like tretinoin. However, tretinoin can cause irritation, redness, peeling, and increased sun sensitivity in some users. This has led many to wonder if azelaic acid can be safely paired with tretinoin to help offset these side effects.
What is Azelaic Acid?
Azelaic acid is a naturally occurring acid found in grains like wheat, rye, and barley. It has antimicrobial and anti-inflammatory properties that make it effective in treating common skin concerns like rosacea, acne, and melasma. Some key facts about azelaic acid include:
- Helps kill acne-causing bacteria on the skin
- Reduces skin inflammation and redness
- Helps fade post-acne marks and melasma
- Evens skin tone and improves skin texture
When applied to the skin, azelaic acid works within the cells to limit melanin production. This helps with conditions like melasma and post-acne marks where unwanted pigmentation is an issue. It also decreases keratin production which helps open and clear clogged pores.
What is Tretinoin?
Tretinoin is a topical, prescription-strength retinoid. It is considered the gold standard retinoid treatment for acne, melasma, fine lines, and other skin concerns involving cell turnover. Some key facts about tretinoin include:
- Speeds up cell turnover and clears acne
- Stimulates collagen production which reduces fine lines
- Brightens skin and fades dark spots/melasma
- Opens clogged pores to prevent new breakouts
Tretinoin works by increasing cell turnover. This helps clear away discoloration and stimulates collagen. However, the increased cell turnover and exfoliation can also cause significant irritation and flaking.
Can You Layer Azelaic Acid with Tretinoin?
Azelaic acid and tretinoin work differently and can offer complementary benefits. Azelaic acid calms the inflammation that tretinoin often causes, while tretinoin speeds up the cell turnover that reveals fresher skin. Additionally, their ability to brighten discoloration and even skin tone is enhanced when the two ingredients are paired together.
That being said, there are some precautions to take when layering azelaic acid with tretinoin:
Start Slowly
When first starting out with azelaic acid and tretinoin, go slowly so your skin can adjust without excessive dryness, peeling, redness or irritation. Start by applying azelaic acid and tretinoin on alternating mornings or nights, not together. See how your skin responds for a few weeks before trying them as part of the same skincare routine.
Use Gentle Products
Using azelaic acid and tretinoin together will increase your skins sensitivity and vulnerability to irritation. Stick with a gentle cleanser, alcohol-free toner, lightweight serums and an unscented moisturizer while adjusting to reduce the chances of redness or peeling.
Pay Attention to Reactions
Keep an eye out for excessive dryness, flaking, redness, burning or itching when using azelaic acid and tretinoin. If you experience any concerning reactions, pull back usage of one or both ingredients until your skin calms down. Then you can reintroduce them more slowly.
Avoid Other Actives
Using azelaic acid and tretinoin together provides plenty of treatment already so additional active ingredients like alpha hydroxy acids (AHAs), vitamin C, benzoyl peroxide or retinoids are generally unnecessary. Stick to a simple routine to avoid overwhelming your skin.
Prioritize SPF
Both azelaic acid and tretinoin can make your skin more photosensitive. Its critical to apply, reapply and wear broad spectrum SPF 30+ sunscreen daily to protect your skin from their increased UV vulnerability.
How to Layer Azelaic Acid and Tretinoin
If your skin can tolerate using azelaic acid and tretinoin together, here is an effective way to layer them in your routine:
AM Routine
Cleanse skin with a gentle, non-foaming cleanser, rinse then pat dry. Apply azelaic acid and allow it to fully absorb. Follow with a lightweight moisturizer and SPF 30+ broad spectrum sunscreen. You can follow with makeup if desired.
PM Routine
Cleanse skin to remove sunscreen, makeup and debris from the day. Pat dry then apply a pea size amount of tretinoin cream or gel. Allow it to absorb fully before following with your night cream or moisturizer. Your PM routine should not include azelaic acid to avoid excess irritation.
How Often to Use Azelaic Acid and Tretinoin
When starting with new ingredients like azelaic acid and tretinoin, begin applying them two to three times a week and gradually increase frequency based on your skins tolerance. Over time, aim to work up to applying azelaic acid once daily in the morning and tretinoin every other evening. Avoid using tretinoin in the morning or applying azelaic acid more than once a day to avoid excess irritation.
Things to Remember
Have reasonable expectations - Consistent use over months is needed to experience the full smoothing, brightening and tone evening benefits of using azelaic acid and tretinoin together. Stick with it!
Take note of timing - Azelaic acid and tretinoin can interact so aim to space them apart as indicated or alternate mornings and evenings when first starting out.
Be gentle - Using both may increase dryness or peeling so stick to a simple routine with hydrating and nourishing products while your skin adjusts.
The Bottom Line
Using azelaic acid and tretinoin together can help amplify their ability to improve acne, rosacea, melasma and more. However, caution must be taken because they make skin more reactive and sensitive to irritation. Go slowly when first starting out and adjust based on your skins tolerance.
Layering azelaic acid and tretinoin properly alongside adequate hydration and sun protection can increase your chances of achieving clearer, calmer and more even toned skin over time.
FAQs
Can I use azelaic acid and tretinoin at the same time?
It's generally recommended to use azelaic acid and tretinoin at different times of day when first starting out, such as azelaic acid in the morning and tretinoin at night. This helps avoid excess irritation. Once your skin adjusts, you may be able to layer them by applying azelaic acid first followed by tretinoin.
Should I apply azelaic acid before or after tretinoin?
If layering them, it's best to apply azelaic acid first since it helps calm the potential irritation from tretinoin. Let the azelaic acid fully absorb before applying tretinoin.
Can I use azelaic acid twice a day?
It's usually recommended to only use azelaic acid once a day, typically in the morning. Using it twice daily may cause too much irritation when paired with tretinoin.
How long does it take to see results?
It can take several months of consistent use to see significant results from combining azelaic acid and tretinoin. Have reasonable expectations and stick to your routine.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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