Often overshadowed by ingredients with more mainstream recognition, azelaic acid is one of the dark horses of the skincare world due to its ability to hit the holy trifecta of effective, tolerable and versatile. While acting as a multitasker with benefits that include improving the appearance of acne, rosacea and hyperpigmentation, it remains one of the gentler acids. Azelaic acid has been used clinically for decades, with dermatologists lauding its ability to simultaneously treat inflammation and the above concerns, with newer research solidifying its effectiveness, particularly for rosacea.
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There is a major factor right off the bat that separates azelaic acid from the prescription retinoid tretinoin. While the vitamin A-derivative tretinoin is also designed to help with acne and pigmentation, it is far less easily tolerated by the complexion, requiring a period of skin acclimatisation when first introducing it into a skincare routine. It can be irritating but has a wealth of evidence surrounding its efficacy, and that is due to its potency. Unlike retinol, which requires two conversions to get to retinoic acid (the form that can be used by the skin), tretinoin is a biologically active retinoic acid, so it immediately gets to work on cell turnover, collagen production, minimising the appearance of fine lines and improving skin texture, among many other benefits. And as mentioned, the research is strong. In a series of randomised trials in 2025, tretinoin significantly improved wrinkles, and in another proved to be one of the few skincare ingredients that can change photoaged skin.
So which ingredient should you be using – if either? We consulted two experts, Dr Malvina Cunningham, consultant dermatologist at Renew + Me and aesthetic doctor Dr Tego Kirnon-Jackman, to deep dive into both azelaic acid and tretinoin. The answers to our burning questions are below. Top tip: combining them could be the secret to glass skin.
While they are used to treat some of the same concerns, azelaic acid and tretinoin work differently. “Azelaic acid has anti-inflammatory, antimicrobial and anti-pigmentary properties, alongside a mild exfoliating effect,” explains Dr Kirnon-Jackman. “It helps normalise the way skin cells shed, which can help prevent clogged pores and improve texture, while its anti-inflammatory properties make it particularly useful for inflammatory acne and redness.” What’s more, she continues, “it also inhibits tyrosinase, one of the enzymes involved in melanin production, which is why it can be useful for post-inflammatory hyperpigmentation and uneven skin tone.”
On the other hand, tretinoin, Dr Cunningham reveals, “is a prescription-strength retinoid derived directly from vitamin A that works by binding to retinoic acid receptors within skin cells, which accelerates cell turnover, normalises the shedding of dead skin cells, and stimulates fibroblasts to produce collagen and elastin.”
The dermatologist puts it succinctly, “azelaic acid works largely at a surface level to calm and regulate pigment, while tretinoin works more deeply to change the way skin cells behave, regenerate and produce collagen over time.”
Renew + Me Nightly Active Treatment
- Why it’s -approved: If your goal is waking up to skin that looks noticeably fresher, smoother and more rested, Renew + Me’s personalised Nightly Active treatment ticks all the right boxes. Designed to support overnight skin renewal, it combines the gold-standard retinoid – tretinoin – one of the few topical ingredients clinically proven to stimulate collagen production and improve signs of photoageing – with a nourishing base cream packed with barrier-supporting actives – think: peptides, vitamin E, ectoin, and ceramides. The result is a formula that works on multiple levels: encouraging long-term collagen support while simultaneously improving hydration, resilience and skin comfort. Think of it less as an instant plumper and more as a treatment that helps create the optimal conditions for firmer, healthier-looking skin over time.
- Key ingredients: tretinoin, peptides, ectoin, vitamin E, ceramides
- Best azelaic acid for: visible impact on acne and rosacea
- Why it’s -approved: As one of the first skincare brands to extol the benefits of azelaic acid, this Paula’s Choice formula has earned its place on your bathroom shelf. It combines the named ingredient with salicylic acid and plant extracts to combat the impact of sun damage like dark spots, aid in the healing of post-breakout scars, calm redness and boost radiance. Its non-scented formula can be applied to sensitive skin, and it works particularly well for those with acne or rosacea to leave the complexion smooth and soft. There is a reason it has been lauded as a skin saviour.
- Key ingredients: Azelaic acid, salicylic acid and plant extract
- Calms redness
- Speeds up acne healing
- Quite thick for a serum
Azelaic acid is well suited to those concerned with acne, rosacea, pigmentation and melasma. Dr Kirnon-Jackman details, “Azelaic acid is particularly useful for inflammatory acne and rosacea, and I also use it as part of treatment plans for post-inflammatory hyperpigmentation and melasma. It can be especially useful when someone is managing acne and the pigmentation it leaves behind at the same time.” Dr Cunningham adds that it also “has a mild effect on texture thanks to gentle exfoliating properties.”
As for tretinoin, it is prescribed most commonly for acne, “particularly comedonal acne, and it is also very useful for improving skin texture and signs of photoageing such as fine lines and uneven pigmentation,” says Dr Kirnon-Jackman. In fact, Dr Cunningham dubs it “the gold standard for fine lines and wrinkles because of its ability to stimulate collagen.”
With the above in mind, azelaic acid, as a gentler solution, is good for sensitive skin types as well as those with rosacea-prone and reactive skin. It can also be used during pregnancy. Tretinoin is slightly more complicated and cannot be used during pregnancy or while breastfeeding. Dr Cunningham explains, “While most skin types can use it successfully, it needs to be introduced gradually, particularly in those with a compromised barrier or very reactive skin.” This is because irritation, dryness, redness and sensitivity are common when it is first used. Dr Kirnon-Jackman wants to make clear, “Having sensitive skin doesn’t automatically mean you can’t use tretinoin, but the strength, formulation and frequency need to be appropriate for your skin. In the UK, tretinoin is a prescription-only medication and should be prescribed by an appropriate medical professional and used under their guidance.”
She recommends following “low and slow approach,” stressing that “You don’t get better results by irritating your skin, so there’s no prize for using tretinoin every night from day one.”
Azelaic & Kojic Advanced Clarifying Serum
Best azelaic acid for: blemish-prone, irritated skin
There is not just azelaic acid starring in this serum from Allies of Skin. The brand has packed kojic acid in the formula too, as well as retinol-alternative bakuchiol, liquorice and other powerhouse elements that make this a staple for blemish-prone, irritated skin. The azelaic works to fade scars and control sebum, while the kojic calms and brings antioxidant shielding. The rest of the ingredients supercharge these benefits to even out the skin tone, fight acne breakouts and minimise the appearance of pores. Plus, it remains ever gentle, lightweight, easily absorbed and non-greasy.
Why it’s -approved: Without requiring a costly dermatologist appointment, Dermatica offers the opportunity to receive a personalised retinoid-based treatment. Your formula is selected with the assistance of dermatology experts (via the results of a questionnaire) and is an affordable way to combat concerns like acne, fine lines and melasma.
Generally well tolerated, the experts both flag that tingling or stinging can occur when you introduce azelaic acid into your routine, but should go away within a few minutes. Dr Cunningham adds, “Some people notice mild dryness or redness in the first week or two.” But “if you experience severe burning, swelling or blistering, this isn’t normal, and you should stop and speak to a doctor,” she emphasises.
Tretinoin has more common side effects. “An initial period of dryness, flaking, redness and general sensitivity – often referred to as “retinisation” – is expected as the skin adjusts, typically in the first two to six weeks,” the dermatologist continues. “This is different from a true irritant or allergic reaction, which would present as widespread burning, weeping, swelling, or a rash spreading beyond the area you’ve applied the product. That level of reaction means you should stop and seek advice.”
Dr Kirnon-Jackman also spotlights purging: “You can see an initial worsening of acne after starting treatment, but I wouldn’t automatically label every new breakout as a purge. If you’re developing significant inflammation, irritation or breakouts that are very different from your usual acne, it’s worth reassessing your routine rather than assuming you simply need to push through it.”
The biggest mistake when introducing any active ingredient is to do too much, too quickly. The same is true for both azelaic acid and tretinoin. “People will start a new active and simultaneously add an exfoliating acid, a new cleanser and several other products, then have no idea what has irritated their skin,” says Dr Kirnon-Jackman. Dr Cunningham concurs and adds: “The most common mistakes are starting too strong or too frequently, combining either ingredient with other actives too soon, skipping a good moisturiser that supports the skin barrier, and not wearing daily sunscreen. I also see people give up too early, before the skin has had time to adjust and results have had a chance to show, or layer either ingredient with harsh physical scrubs or exfoliating acids, which significantly increases the risk of irritation.”
It is especially important with tretinoin to take a slow and steady, cautious approach. Dr Kirnon-Jackman wants to make clear that “more is definitely not more.” She continues, “A small amount is enough for the whole face, and starting a few nights a week is often much more sensible than immediately trying to use it every night.”
SPF is a daily essential. The derm says, “If you’re trying to treat acne marks, melasma or photoageing, daily sun protection is an important part of the treatment plan regardless of which active you’re using.” It is also counterproductive, if anti-ageing is your mission, not to use it, as sun exposure is responsible for around 80 per cent of visible skin ageing.
Best azelaic acid for: a daily moisturiser
A bestseller in the Skinceuticals collection, the brand has formulated this moisturiser to be used twice daily, both at morning and night, to treat the skin to the benefits of azelaic acid. No matter your skin type, be it sensitive or otherwise, this skin-smoothing treatment brings luminosity and even skin texture without irritation. Rather than a rich, nourishing cream, it sits unobtrusively on the complexion with a lightweight texture.
Whenever I open my TikTok, my algorithm serves me videos of creators waxing lyrical on the benefits of combining the two ingredients for glass skin, but is that just social media hype? The experts say no. “This is actually a combination I use quite frequently,” Dr Kirnon-Jackman tells me. “They complement each other particularly well when someone has acne alongside post-inflammatory hyperpigmentation. Tretinoin can address the acne and abnormal keratinisation, while azelaic acid adds anti-inflammatory and pigment-targeting effects.” Dr Cunningham doubles down on this. “Azelaic acid’s anti-inflammatory, antibacterial and pigment-regulating action complements tretinoin’s ability to boost cell turnover and stimulate collagen, making this a particularly good combination for those dealing with both acne and hyperpigmentation.”
But a cautious approach is even more important when layering the two ingredients. Dr Cunningham advises, “It’s best introduced slowly, for example by alternating which product you use each night to begin with, or using azelaic acid in the morning and tretinoin in the evening, alongside a barrier-supporting moisturiser containing ingredients like ceramides or panthenol to help minimise irritation.”
Why it’s -approved: Skin + Me takes a personalised approach to skincare. Before you have the opportunity to add its products to your basket, you must first complete a questionnaire detailing your concerns and information about your skin type. The final step is a selfie from three angles, and armed with the answers and your photo, the brand’s dermatologists create a customised formula to suit – all without expensive dermatologist fees. Then you wait. In the post, you receive your daily doser, in which one turn is all you need for full-face coverage.
“Using several acids or irritating actives together can cause unnecessary irritation, even if each ingredient is perfectly reasonable individually,” warns Dr Kirnon-Jackman, which is why she recommends looking at your routine holistically. “I’m more cautious when introducing tretinoin alongside exfoliating acids such as AHAs and BHAs because the combination can become unnecessarily irritating. That doesn’t mean those ingredients can never exist in the same skincare routine, but I wouldn’t introduce everything at once.” She says this applies to other acne-fighting ingredients like benzoyl peroxide too, which can even deactivate tretinoin. Vitamin C is another ingredient that may lead to sensitivity, so it is best used in the morning versus tretinoin’s nightly application.
As for what will benefit the application, “Both pair well with hydrating and barrier-supporting ingredients such as hyaluronic acid, ceramides, niacinamide and panthenol, which help buffer the skin and reduce dryness,” suggests Dr Cunningham. And as mentioned above, “A broad-spectrum sunscreen is essential every morning, particularly with tretinoin, as it makes the skin more photosensitive.”
Best azelaic acid for: a targeted spot treatment
Blemish-busting is what this targeted product from Medik8 is all about. Unlike many other spot treatments on the market, it is designed not to dry out your skin, but to support in the appearance of blemishes by reducing redness with a supercharged trio of acne-fighting favourite salicylic acid, skin barrier-protecting and oil-regulating niacinamide and the buzzy azelaic acid to remove bacteria. Blemish SOS fits seamlessly among both AM and PM routines, without pilling under makeup. Only a very small amount is needed.
The best results come from continual use, and for azelaic acid, that can mean you will see the benefits in two to four weeks, agree the dermatologists. “Most people notice an improvement in texture and inflammation within two to four weeks, with visible fading of pigmentation usually taking around eight to twelve weeks, and more significant results after three to four months of consistent use,” details Dr Cunningham.
Tretinoin may yield results for acne and texture in a few months, but there is an adjustment period. Dr Cunningham continues, “Improvements in glow and texture tend to appear from around six to eight weeks, with a more visible reduction in fine lines, pigmentation and acne typically apparent by three to six months. Because it works by stimulating collagen production, the structural benefits continue to build over six to twelve months of consistent use.”
Think long-term with these ingredients. “I always tell patients to think in months rather than days when it comes to prescription skincare,” Dr Kirnon-Jackman stresses. “The temptation is to keep changing products when you don’t see a difference after two weeks, but consistency is often what ultimately makes the biggest difference.”