Azelaic Acid + Retinol Is The Skincare Combination That Has Everyone Talking. But Does It Work?

Everything you need to know about TikTok’s latest skincare craze (including whether it works and for whom). One of the best parts of my job is surveying what’s trending in skincare. Lately, there’s been one skincare combination that’s pervaded my social media algorithm. Enter the buzziest new skincare TikTok users have widely praised this duo in their pursuit of “glass skin”, making claims about its combined efficacy at clearing acne, smoothing texture and fading dark spots. But what does the science say? We asked three skin experts (including a consultant dermatologist and dermatologic surgeon) to share their thoughts on whether you should incorporate these ingredients into your skincare routine. What is azelaic acid and how does it work?Nandika Singh, founder of Auckland-based skin clinic Skin Atelier, says azelaic acid can be useful for acne as well as the pigmentation that can follow it, because it has antimicrobial, anti-inflammatory and other properties.Tyrosinase is an enzyme responsible for the production of melanin, or what makes pigment in the skin. Singh says azelaic acid can help reduce the pigmentation left behind after acne heals, also known as post-inflammatory hyperpigmentation. Consultant dermatologist and dermatologic surgeon Dr Monique Mackenzie says azelaic acid is good for treating hyperpigmentation and melasma as well as acne and rosacea.It’s commonly used to bring down redness, or to alleviate symptoms of perioral dermatitis – a red, bumpy inflammatory rash that crops up around the nose or mouth. I’ve used azelaic acid many times to treat my bouts of perioral dermatitis, clearing it within days.What is retinol?Vitamin A derivatives (including retinol) speed up cell turnover and boost collagen to treat the visible signs of ageing and acne. These derivatives differ in strength depending on how many steps they need to convert into retinoic acid (the most potent form of vitamin A). The scale starts with milder forms: retinyl esters, which are generally well-tolerated by beginners and sensitive skin types, then retinol (the most popular in traditional skincare), intermediate option retinaldehyde, and ending with retinoic acid like tretinoin, a prescription-only, clinical-strength active. Medical skin therapist Lauren Harding says there are many benefits of incorporating vitamin A into your skincare routine.“[Vitamin A] covers so many different cell functions. It will stimulate the fibroblast [essential cells in the dermis layer of skin] to cause your skin cells to produce collagen,” Harding says. “Because it’s stimulating collagen, your pores start to become more refined because it’s tightening up the skin around it; it’s helping address fine lines and wrinkles, and texture.” This maintains healthy cell turnover, Harding says, giving an element of exfoliation and keeping the skin clear.Tretinoin is the most potent retinoid, but it’s not Harding’s pick of the bunch. “Tretinoin causes a lot of irritation and disrupts the lipid barrier. I could tell you how to introduce it gently but I prefer to use a retinal or retinol,” Harding says. Singh agrees that while vitamin A can be valuable in treating skin conditions such as acne, tretinoin is not necessarily the right jump-off point for every skin type. “Tretinoin is prescription retinoic acid, so it acts directly on the retinoid receptors in the skin. Because of its potency, if the skin isn’t ready for it, it can cause significant irritation and compromise the skin barrier,” Singh says. Retinyl palmitate or acetate offer “slower conversion pathways to retinoic acid (three steps)”, Singh says, which means the skin can better adapt to vitamin A with less potential for irritation. Are azelaic acid and retinol effective together?Azelaic acid and retinoids are cornerstones in acne treatment, but for different reasons. Retinoids prevent clogged pores and acne formation, while azelaic acid soothes inflamed acne, redness or post-acne marks. Many TikTok users, including content creator Natalie O’Neill, have sung the praises of using this combination in pursuit of a clearer complexion, but Mackenzie warns not to believe everything you see on social media. “Several studies have been undertaken on the accuracy of skin care advice on social media,” Mackenzie says. “The findings showed around half of the information was incorrect. Not every trend that you see is suitable for your skin. “I certainly wouldn’t recommend starting using retinol and azelaic acid at the same time for everybody.”One of the primary reasons is that both ingredients can be irritating and drying, especially if you haven’t built up a tolerance. Singh says while this combination can be appropriate for some people, introducing multiple actives into skin that isn’t ready for them can create “significant irritation and inflammation, which can ultimately set the skin back rather than move it forward”.“It’s much more important to assess the condition of the skin first and introduce ingredients progressively, rather than assuming that more active ingredients will give you better results,” she says. What’s the best approach for this trend?Master the skincare basics (gentle cleanser, moisturiser and sun protection) before venturing into active ingredient territory, Mackenzie says. Her recommendation for those with more mature skin is to layer in retinol on alternate evenings – starting with over-the-counter options that can be less potent than prescription retinol. “Start there, go low, start slow,” she says. “Azelaic acid can then be added [into your routine] if your skin is not showing any signs of distress, but [that] is really more dependent on your skin’s needs and tolerability.”Harding says how you incorporate both ingredients into your routine boils down to which formulas you use, when you use them and what your skin type is.“[Formulas] are rarely azelaic on its own. [They’re] lots of different things, and usually if it’s a formula that’s helping with pigmentation, you’ll use it in the morning,” Harding says. Harding recommends not using azelaic acid formulated with AHAs with your retinoids at night; instead, use it on alternate nights. Again, it all depends on what type of retinoid you’re on and how your skin is reacting to it.But if you’ve built up your tolerance to both and are planning to layer them, use them at night, starting with the azelaic acid formula first. Concentrations matter. Azelaic acid varies in strength but most over-the-counter options sit at 10% to 15%. Retinoids range in strength from 0.01% to 1%, depending on type. What are the side effects?Mackenzie says she’s recently had several patients complain of irritant contact dermatitis after being too heavy-handed with active ingredients including azelaic acid. “Without prior assessment of your skin type or need for these products, you can risk damaging the skin barrier,” she says. “Initially, the skin might feel tighter and smoother by limiting the older, more robust skin cells from forming (stratum corneum), but with continued use and without this protective layer, the skin becomes more vulnerable, especially in cooler months when we have cooler drier air.”Signs your skin is becoming distressed vary from increased sensitivity and redness to inflammation and skin peeling. Such symptoms can lead to other things such as irritant contact dermatitis, acne cosmetica (a type of breakout caused or worsened by pore-clogging makeup and skincare) and skin infections, which Mackenzie says she’s been seeing more in-clinic. Our experts agree that while these ingredients have their merits, it’s best to check in with the pros before you introduce this new combo to your routine. “Both products have significant skin benefits but are not appropriate for all skin types, so seek dermatologist advice if you are unsure,” Mackenzie says. “Caring for your skin is a marathon, not a race, and rewards consistency.” Add To CartOur experts agree it’s best to proceed with caution when it comes to combining azelaic acid and retinol, so consult your skin therapist or dermatologist first. If you’re ready to try these ingredients separately, check our top product picks below. Azelaic AcidRetinol More beauty and wellnessThe top beauty trends that emerged from the NZFW runway; experts share their go-to products to use backstage; wellness rituals to combat burnout and how to achieve great eyebrows.