In this video Dr. Shereene Idriss, a board‑certified dermatologist, clarifies the summer‑long internet controversy surrounding azelaic acid products. She explains that three distinct forms are marketed: (1) the original free‑form suspended azelaic acid used in early studies and many prescription products, which feels gritty; (2) an ionized (pH‑adjusted) form that dissolves in water, giving a cosmetically elegant serum; and (3) a derivative, potassium azeloyl diglycinate, which is not azelaic acid but is often mislabeled as such. Idriss reviews evidence that the ionized form remains effective, debunks claims that raising pH renders the ingredient useless, and highlights the real issue of mislabeling derivatives as azelaic acid. She discloses her own Reducer Serum, which contains 5 % free azelaic acid plus 5 % the derivative, describing why she combined them for efficacy and texture. The video then addresses common user complaints—itch, perceived barrier damage, “purging,” and variability among prescription manufacturers—explaining which concerns are legitimate and which stem from misuse or other actives. Finally, Idriss provides practical guidance on how to layer azelaic acid with tretinoin or retinol, differentiating application methods for each form (damp skin for free‑form, immediate layering for ionized/derivative), recommending nightly use of azelaic acid (with a patch‑test period) and a gradual, limited schedule for retinoids. The overall message is to demystify product labeling, choose the appropriate form for one’s skin concerns, and integrate azelaic acid into a simple, tolerable routine.
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Azelaic acid has been all over the news this past summer, including an internet drama, because it turns out these 3 products are being sold to you as azelaic acid, but only one of them is from the studies that have been cited over and over again. And I owe you an explanation about my own azelaic acid product, which we'll get into. Who the hell am I? I'm Dr. Shereene Idriss, a board-certified dermatologist. So today we're going to settle the internet drama. We're going to understand the different types of azelaic acid that are currently being marketed so that you can figure out what you have in your vanity. We're going to quickly address the azelaic acid allegations of irritation, purging, inflammation, you name it. And then I want to quickly touch on how you incorporate azelaic acid with your tretinoin or your retinoid, aka your retinol. So without further ado, get your pens and papers out and let's jump in. Back in June, an internet sleuth went through the ingredient list of a very popular Korean azelaic acid serum and noticed that right underneath azelaic acid was sodium hydroxide, also known as lye. And the purpose of putting sodium hydroxide into a formulation is to dissolve the azelaic acid so it doesn't feel like grit when you apply it on your face. And that is why every Korean azelaic acid serum that you've ever tried has been so watery and beautiful and hasn't really pilled, which has been the biggest complaint of mine on my channel when talking about azelaic acid over the years. Now, when this came out, the internet lost its mind because the argument here is if we are adding sodium hydroxide and increasing the pH of a formula, We are now making it less acidic, whereas azelaic acid is an acid. And so if it is less acidic, you're probably making azelaic acid useless. And so you, my friend, have been sold a bunch of bullshit. Now, is that true or not? So this is where you got to grab your pens and papers and get ready to understand the 3 different types of azelaic acid so that you do not get taken for a ride by people on the internet or by beauty companies. All right, so we're going to screenshot this table as I build it out so that you have something that you can easily refer back to once we are done. But the The first type is the free form of azelaic acid. It is the one that is suspended. It is the original. It is the one that the studies have been based off of for years. And this is the one that I have been referring to over the past 5 years when talking about azelaic acid. It's the original one. This is the one that The Ordinary has for $12, and it feels like shit when you apply it because it's quite literally like gritty spackle on your face. The second one is the ionized form of azelaic acid, where the pH of the formulation has been slightly raised. And so what happens is azelaic acid dissolves and you get a much more water-soluble formula that is much more cosmetically elegant, like what you find in Medicube or Anua. I don't know if I mentioned it, but this is the one where the internet has lost their shit. And then you have the third form of azelaic acid, which is actually not an azelaic acid. It is a derivative known as potassium azeloyldiglycinate. And if you're wondering why I've been complaining about azelaic acid for the past 5 years feeling like shit, This one fixes that problem. All right, so screenshot this table. So now you have a framework to work off of. And what exactly then is the verdict of azelaic acid number two? I'm sorry to disappoint a lot of people who wanted more drama, but ionized form is probably fine. So let's look at azelaic acid starting at around a pH of 4.5 to 5.3. It's starts giving up its protons and becoming more ionized, right? And at a pH of 6, most of the azelaic acid is now dissolved in its ionized form. And this is where the internet lost its mind because they said if it's completely ionized, you're not going to get that absorption of azelaic acid. But this is where the vehicle matters. Remember, I've been always saying this— it's not just about an ingredient, it's how it's formulated. So back in 2012, there was a study that was done looking at the ionized form of azelaic acid, and it found that some of azelaic acid is more beneficial when it is dissolved first in a formula. This doesn't mean that the suspended form doesn't work, but it showed that at different vehicles and at different pH and in different formulations, azelaic acid is still effective. So I'm sorry to bust the internet drama further, but ionized azelaic acid does not mean that you have been sold a bunch of bullshit. So now that we have settled that drama, Let us jump into the cousin form of azelaic acid and the one that might be worth arguing about. 3, this is where the outrage should have been directed at. All right, potassium azeloyl diglycinate, because it is not azelaic acid, it is a derivative. But I genuinely do like this derivative. It can help with your skin, it can help with your oil production, your redness. It can help to minimize that, and it can also help to even out your skin tone, in addition to the fact that it is water soluble and it is cosmetically elegant when you use it. But to have a product that labels this derivative as a 10% azelaic acid product is misleading because this is not azelaic acid. All right. And so this is where the outrage should have been spent this summer because a brand quietly changed the name of their azelaic acid product from this to this, meaning that over the past few years you were buying a product that you thought was azelaic acid, but it was in fact the derivative. Now, what the brand did was correct. They at least changed the name, and so they know now that they are not selling something that is misleading. So that I completely applaud. But we need to look back at the past few years and think about: Were we being sold something under the false pretext of what it is because it had no azelaic acid in it in the first place? And that, my friends, is what I believe the internet should have been yelling about, and not whether or not the ionized form of azelaic acid. Is getting into your skin. So just in the spirit of transparency, I am the brand founder of this. I am Dr. Idriss. She is me. And I have an azelaic acid product on the market called the Reducer Serum. And when you look closely at the Reducer Serum, notice that there is no percentage on the box and it doesn't say complex or anything. It just says azelaic acid because this product in fact contains 5% azelaic acid, but it also contains the derivative that I was just interrogating a few moments ago, potassium azelaoyl diglycinate. In fact, it contains both at 5%. So this would technically be an azelaic acid complex at 10%, but I didn't want to be an ingredient story with azelaic acid in terms of percentages. And so I just named the ingredient that is most prominent, that I'm most proud of in this product. Now, why did I include the derivative in this product? Because for the past few years, I have been shouting at you guys that azelaic acid is great. But it is really not cosmetically elegant. So what's the purpose of having a product that peels off your face and rolls into your drawer? You're going to get 0% of 0% and you're going to get no benefit from that product. And so for me, it was important to include azelaic acid in the Reducer Serum because that's what carries the weight of evidence. But I also wanted the derivative in here as well because the derivative makes it more cosmetically elegant. So all of you can actually enjoy the benefits of this product and formulation and layer it into your skincare routine. Which leads me now to why can't we tolerate azelaic acid and what is going on? Now that the internet has been fighting over here, let's look at Reddit and see where you guys have been having drama on your own faces with azelaic acid. Number 1 is the itch. Now you put it on for 10 minutes and you get super itchy. It's normal. So if you look at the prescription insert of azelaic acid, it talks about the itch where the first 10 to 20 minutes of your face are going to be itchy. But this usually goes away after 2 to 3 weeks. If it continues and you have burning, you might want to stop, and maybe you're personally getting irritated. Number 2, it destroyed my skin barrier. Azelaic acid is not an exfoliating acid or a retinoid that is helping to cycle your skin cells better or breaking your skin barrier down. So when I did a little bit of digging into the stories, it turns out a lot of you are using it with another product, and you're attributing the issue to azelaic acid because when you put it on your skin, it burns or it itches. But it could be the other product in your routine, like a retinoid, that is inflaming your skin barrier. Number 3, the purge panic. Half of Reddit thinks that azelaic acid is purging your skin, but azelaic acid cannot purge your skin because it is not a retinoid or an exfoliating acid, and it is not pushing anything to the surface of your skin. So if you're breaking out, it's probably from something else that is irritating you. So go figure out what that is before you try to push through. And number four, my favorite is the prescription drama where a lot of you guys have the same 15% azelaic acid prescription, but you have completely different experiences. So this is something that a lot of you don't recognize. When a pharmacist gives you a generic 15% prescription of azelaic acid, it's made by a certain manufacturer. Could be manufacturer A, B, or C. Each one of these manufacturers are going to cook slightly differently. So the 15% A prescription could be different in terms of the experience from the 15% C prescription. One thing you have the right to ask your pharmacist as a person and as a human and as a patient is, can I get another generic prescription from a different manufacturer? Because maybe it is the way that manufacturer A cooked doesn't sit well for your taste buds and you want manufacturer C's version instead. So that leads me to How do I incorporate azelaic acid into my tretinoin routine? After all the drama, what does it change about pairing azelaic acid with your tretinoin? 3 verdicts, and then I'm going to give you the schedule of how you do it. If we're using the ionized form of azelaic acid, so number 2, or the derivative, which is what's in my product, number 3, you can put it on your face at night. Don't even have to wait. Apply tretinoin or the retinol afterwards and continue with your routine and go live your life or your night. Do whatever you're doing. I don't want to know. Go to sleep, wake up, wash your face, and be happy. If you're using the free form of azelaic acid, the one that's in The Ordinary or the prescription, because it's a suspension and it's a little bit gritty, I would recommend you have it applied on damp skin first, let it sit for a minute or 2, and then use your Tretinoin because you want to get that absorption into your skin. Now, when it comes to the schedule, We're not gonna complicate our lives. Azelaic acid is a gentle ingredient. You can use it every single night. You do not need to earn that. The only thing is everybody has different sensitivities, and I'm talking about true sensitivities. So I would recommend you test azelaic acid on its own without an exfoliating acid, without any sort of retinol, without anything harsh, with a basic moisturizer, even just Vaseline, for a few nights, right? Monday, Tuesday, Wednesday, Thursday, Friday, Saturday. If your skin is totally fine, green light to keep using it every night with or without a retinol. The one that you have to earn in your routine is the tretinoin or the retinol. Most people cannot tolerate that every single night, and you will eventually blast your face off if you try to do that without building up a sort of resistance or a sort of ability to tolerate it. So I would tell you, you're going to use tret like 2 nights a week Tuesday and Thursday, but you're not going to use it every night right off the bat because that will not make your skin or your mental well-being happy. And that's it. That's pretty much it. We do not need to complicate our lives. So azelaic acid, you have the green light to use it every night first before using the retinol or the tretinoin, especially if you are using the free form of azelaic acid, which should be applied on damp skin and just let it sit for a minute or two. before going in with your retinoid. So what do we do now if we're standing in the bathroom and we're like, shoot, I have the wrong bottle of azelaic acid? Nothing. None of the derivatives or the different types of azelaic acid are wasted. They're all going to offer you some sort of benefit. So I would not freak out and I would not waste the product or go out to buy a different product. If you're somebody who has redness, the derivative works beautifully, especially also if you're oily. If you're someone who has pigmentation and really bad melasma, you probably want the prescription because you need a higher percentage of azelaic acid acid, and 15% or higher is usually what's been shown to really help with stubborn pigmentation. And if you're somebody who's breaking out with pustules and really bad inflammation, and the one that you got handed to you from the pharmacist wasn't great, go back and ask if a different manufacturer created one that they could offer you because that formulation did not sit well on your skin. Or better yet, make sure to also go see your dermatologist because maybe you need to be on something systemic and not just topical. And so there you have it. I hope this video was helpful. I hope it helped clarify the drama that was happening over the summer. I hope you have a better understanding of what the different subtypes of azelaic acid is, and I simplified your life in terms of pulling the plug on complicating schedules in terms of how do you incorporate azelaic acid into your skincare routine, especially when you want to be using tretinoin or any sort of retinoid. Have a beautiful Saturday. I'm Dr. Shereene Idriss. Thank you for sticking around, and I will see you guys next week.
