Azelaic acid

Fatty-acidDicarboxylic acid

What is it

Azelaic acid is a nine-carbon dicarboxylic acid found in small amounts in whole grains. It is best known as a topical prescription medication for acne and rosacea. Its role as a dietary supplement is limited.

Evidence for 3 uses

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

Acne (topical)

Strong Evidence

Topical azelaic acid is FDA-approved and well established for treating mild to moderate acne, with multiple randomized trials supporting efficacy.

Rosacea (topical)

Strong Evidence

Topical 15% azelaic acid is FDA-approved for inflammatory rosacea, with consistent evidence of reduction in papules, pustules, and redness.

Oral supplementation

Mixed Evidence

No human evidence supports a clinical use of oral azelaic acid supplements.

How it works

Topically, azelaic acid reduces the growth of acne-related bacteria, normalizes pore lining cells, and reduces inflammation. It also inhibits tyrosinase, which gives it a role in hyperpigmentation treatment. Orally, azelaic acid is largely metabolized by liver beta-oxidation and excreted, with no established systemic clinical benefit from oral intake. It is not a recognized essential dietary component.

Dosage

Topical prescription strengths are 15% (gel) or 20% (cream), applied twice daily. There is no established oral supplemental dose; oral azelaic acid is not a clinically validated approach for any condition.

When and how to take it

Topical: apply twice daily after cleansing. Oral supplements are not validated.

1 commercial form

Compare the main delivery options and what they’re best suited for.

Topical azelaic acid (15% gel, 20% cream)

FDA-approved prescription form.

Topical absorption is limited; effects are local.

Safety

Topical azelaic acid is generally well tolerated, with mild burning, stinging, or itching as the most common side effects. Oral azelaic acid in food amounts is safe; concentrated oral supplements have no established benefit and limited safety data.

Who should be cautious

Generally safe topically in pregnancy at FDA category B classification (older labeling), but discuss with a clinician. Apply only to clean skin; avoid eye contact.

Interactions

Topical azelaic acid does not produce meaningful systemic interactions. Oral high-dose use has not been characterized for interactions.

Food sources

Whole grains (small amounts)

Amount
Variable
%DV
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Frequently asked questions

Can I take azelaic acid by mouth for acne?⌄

There is no established oral use. Topical azelaic acid is the form proven to help acne.

Is azelaic acid safe in pregnancy?⌄

Topical use is generally considered acceptable in pregnancy, but discuss any prescription or supplement with your clinician.

References

Azelaic acid on Wikidata — Wikidata link

Azelaic acid (ChEBI:48131) — ChEBI link

Azelaic acid (PubChem CID 2266) — PubChem link

Azelaic acid on NIH DSLD (US supplement label database) — NIH Dietary Supplement Label Database link

Research on Azelaic acid (PubMed search) — PubMed link

Track Azelaic acid with Pilora

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Evidence-based·How we grade evidence

Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.