Azelaic Acid for Rosacea

By Dr Magnus Lynch
MA(Cantab) DPhil(Oxon) MRCS FRCP
Consultant Dermatologist & Dermatological Surgeon

Azelaic acid is a an effective topical treatment for rosacea and can reduce redness, inflammation, and bumps. Unlike many other treatments it is considered safe during pregnancy.

Is azelaic acid worth trying for rosacea?

Yes. Azelaic acid is effective for many patients with mild to moderate rosacea. It works by calming inflammation and helping normalise skin cell turnover. Many patients notice improvement in redness and pustules after 6–8 weeks of consistent use.

What strength of azelaic acid should I use?

Azelaic acid comes in two main strengths for rosacea:

15% gel – generally well tolerated and often the starting choice.
20% cream – slightly stronger, good for resistant areas.

Start with once-daily application on a small area to check that it does not irritate your skin. You can apply to a wider area after this.

How can I stop azelaic acid from burning or itching?

Burning or itching is common initially but usually improves with consistent use. Tips to reduce irritation:

Moisturise first: Apply a gentle, water-based moisturiser such as Cetaphil or Cerave 5–10 minutes before azelaic acid.
Use a small quantity: A pea-sized amount for the entire face is usually enough at first then build up.
Avoid broken skin: Do not apply to areas of active inflammation or open wounds.

How long until I see results?

Improvement is usually seen after 6–8 weeks, but some patients notice gradual benefits earlier.

Products

I do not have financial ties to any brands, but patients often find these helpful:

Finacea 15% gel
Skinoren 20% cream

Both are suitable for rosacea and generally well tolerated when introduced gradually.

What alternative topical treatments are available?

Another good option is topical ivermectin (e.g. Soolantra). I generally find this to be the most effective treatment for inflammatory rosacea. It can also be combined with azelaic acid.

Dr. Magnus Lynch, Consultant Dermatologist

About Dr Magnus Lynch

I am a London-based Consultant Dermatologist and Dermatological Surgeon. I am highly experienced in skin cancer diagnosis, Mohs micrographic surgery, acne, rosacea, acne scarring and laser treatments. I studied at the Universities of Cambridge and Oxford, and completed my dermatology training and Mohs fellowship at the prestigious St John’s Institute of Dermatology. I graduated from medical school in 2003 and have worked exclusively in Dermatology since 2012.

I lead a research team at King’s College London investigating the molecular biology of skin cancer. In recent years I have been involved in Media Appearances, including the Channel 5 series 'Skin A&E', where I perform skin surgeries and treat various skin conditions. Filming for the next series has recently completed and the series will be released later in 2025.

My NHS practice is at Guy's Hospital. I consult with private patients at the London Bridge Hospital, OneWelbeck (near to Bond Street station) and on Harley Street. A new consultation is £250. Book A Consultation.

I am the founder of Revessa Health which provides online consultations for acne and rosacea across the UK (see below).