Our site is reader-supported. When you buy a product via our links, we may earn a small commission, at no extra cost to you. Read full disclosure here.
Table of Contents
Who said a perfect skin doesn’t get imperfect? That’s a lie, sometimes it does. Our regular daily activities in conjunction with change of diet can change the skin from good to bad, especially if prevention measures wasn’t taken.
In my own case, i had some ugly-looking minor acne breakouts. I had some on my right cheek, some on my left cheek and one on my forehead.
So, I decided it’s a good time to put tretinoin and azelaic acid together into the test, to see how really effective these duo-actives are in tackling superficial acne, because I have been longing to use these two active ingredients to test their efficacy.
Although previously, I have practically tested niacinamide and azelaic acid together on their efficacy in treating acne, and the result was mind-blowing. Therefore the usage of tretinoin and azelaic acid together shouldn’t be any different right? Well, we shall know about that.
In this experimental review, I used tretinoin 0.1% gel and azelaic acid 20% gel every-other-day for three (3) weeks, at night-time only. Ouch!, That’s a hell of a high concentration right? Well, I’ve been a long-time acid-user, (even though I have a sensitive skin), I technically know my way around acids and how to properly use them to avoid inflammatory-irritation. So, if you want to use this combination, I strongly advise you should start from lower concentration for the sake of your skin’s moisture-barrier, (example: 0.05% tretinoin and 10% azelaic acid).
After using these duo-actives every-other-day for three (3) weeks, at night time only, I’ve come to share my honest experience with these acids, but before I plunge into that, let’s know what these ingredients are and what they do for the skin.
What Is Tretinoin?
Tretinoin also known as (Retin-a) is a vitamin A derivative and also a medicine, topically used to treat acne, melasma and minimize skin aging-signs such as wrinkles and fine lines by accelerating collagen production and encouraging cell turnover and regeneration process which in turn boost skin cell renewal for a healthier and brighter-looking skin.
Tretinoin usually comes in 3 strengths – 0.025% – mildest-strength, 0.05% – medium-strength and 0.1% – strongest-strength. Tretinoin is usually issued on prescription by dermatologists and they always advice to start from the lowest concentration, so as to allow your skin build tolerance to tretinoin, before moving ahead slowly to higher strength (if need be).
What Is Azelaic Acid?
Azelaic acid is a naturally occurring acid found in grains such as barley, wheat, and rye. It’s rich in anti-microbial and anti-inflammatory properties which makes it an effective treatment for acne and rosacea. Similar to tretinoin and retinol, azelaic acid puts a stop to future outbreaks as it kills acne-causing bacteria and clean bacteria from your pores that causes acne. It also mildly exfoliates the skin, curtails redness and reduces the appearance of hyperpigmentation.
Similar to niacinamide, azelaic acid is a multi-functional skincare ingredient, as it tackles different kinds of skin issues and fix imperfections such as acne, rosacea, redness, hyperpigmentation, melasma and shrink large pores.
And oh, don’t let the word “acid” fool you, azelaic acid isn’t a hard-hitter ingredient, or the kind that sensitizes the skin like retinoids, AHAs and BHA. Azelaic acid exfoliates the skin more gently than glycolic, lactic, and salicylic acid does.
According to Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital, “Unlike other acids, azelaic acid does not make you sensitive to the sun.”
But that shouldn’t mean you should not always wear your sunscreen, for Christ’s sake do wear your sunscreen always (during the day) before stepping outside.
My Honest Experience With The Combination Of Tretinoin and Azelaic Acid.
Effect On Acne.
Holy Jeezz!, It was a bomb!. I applied these acids in a pea-size amount on my whole face (I didn’t spot-treat),…….. and you know what? All my acne-breakouts were all gone!. You can see for yourself in the pictures below:
And what actually baffled me was that, the result was rapid, I swear I could see my acne gradually healing at day-3 of treatment. This encouraged me, I had to keep up with the treatment religiously till the second week (week 2), boom!! — It was a sweep-off. All acne breakouts wiped-off without a trace. I kept on using these duo-actives despite not having any active acne on my face till week 3. This is to enable me give a precise review about the combination of these two acids.
The result I got from the combination of tretinoin and azelaic acid was very impressive, and like I mentioned earlier, it was similar to the result I got with the combination of niacinamide and azelaic acid, but the combination of tretinoin and azelaic acid was more effective and rapid.
Effect On Skin Texture.
While using these duo-actives, my skin was not only acne-free, but super-smooth, firm and plump.
Personally tretinoin takes a little longer to get rid of my acne, but does great to improve my skin texture and elasticity.
Azelaic acid on the other hand does the work faster when it comes to getting rid of my acnes and preventing scarring. This was what prompted me to combine these two actives together, because I needed something that will quickly get rid of my acne breakouts, prevent scarring and improve skin texture.
Tretinoin accelerates skin cell turnover and stimulate collagen production, as a result of that help plump the skin, which reduces the looks of wrinkles and fine lines and also treat acne as a result of skin cell turnover and regeneration process.
Azelaic acid is well known to be a hater of acne, it kills acne causing bacteria (P. acnes) and cleanses the pores of pore-clogging impurities, all thanks to its mild exfoliating potentials.
Can Tretinoin And Azelaic Acid Be Used Together?
If you’re wondering if tretinoin and azelaic acid can be used together, then the answer is yes, a research study which involves azelaic acid with the combination of topical medications such as benzoyl peroxide 4% gel, clindamycin 1% gel, tretinoin 0.025% cream, and erythromycin 3%, proved enhanced efficacy in treating acne.
Another research study with the combination of 20% azelaic acid and tretinoin on patients with melasma showed that azelaic acid is superior to 4% hydroquinone, as tretinoin enhanced the skin lightening effect of azelaic acid on melasma within three (3) months of treatment on patients.
From my experimental review with the usage of tretinoin and azelaic acid together, I have come to the conclusion that both acids are effective individually, but more effective when combined together in treating acne breakouts (especially cystic and hormonal acne) and improving skin texture and complexion. A redditor also attested to the efficacy of both acids. While other redditors followed suit.
Also if you have a sensitive skin and concerned about using these two actives together, I’ll recommend you use them apart or in separate times. By this I mean, use azelaic acid in the morning, while you use tretinoin at night — but still maintain the every-other-day application method.
Possible Questions & Answers.
Q: How did you apply or layer tretinoin and azelaic acid together?
A: I eased my way into this routine. I apply only a pea-size amount of both actives on my skin.
- Step 1: After cleansing (with CeraVe Hydrating Cleanser), while my skin is slightly damp, I hydrate (with Hada Lobo hyaluronic acid serum).
- Step 2: I move ahead to apply a lightweight moisturizer (Simple Hydrating Light Moisturiser).
- Step 3: Then I wait for 5-6 minutes for my skin to dry before I apply a pea-size amount of tretinoin, while i wait for 1 minute (to allow it absorb), then I move ahead to apply a pea-size amount of azelaic acid, I massage gently till fully absorb.
- Step 4: Then I apply a thicker moisturizer to seal in moisture (The Ordinary Natural Moisturizing Factors + HA).
This method is called the sandwich technique. (Moisturize, tretinoin & azelaic acid, moisturize again). This is to prevent these acids from hitting your skin directly as not to incur inflammation-irritation in the course of treatment which can disrupt your moisture-barrier. And of course this technique will not reduce tretinoin and azelaic acid’s potency, it just reduces the intensity at which both actives hits the skin.
Also, I don’t use these acids every day, I use them every-other-day. Example: I use them on Monday, I skip Tuesday and use them again on Wednesday, just like that. This is another way to enjoy the benefits of these acid combos without irritation.
If you should make the mistake of applying azelaic acid cream or gel on a damp or moist skin, It will increase product penetration or absorption which can lead to stinging or itchiness. This is because, azelaic acid (being a mild acid and exfoliant) can tend to cause skin-irritation when applied on moist skin as a result of increased absorption. After hydrating and applying a lightweight moisturizer, allow skin to dry before applying tretinoin and azelaic acid.
Also don’t forget to wear your sunscreen during the day to protect your skin from UVA and UVB exposure as tretinoin tends to increase skin’s sensitivity to the sun, and when appropriate protection-measures isn’t taken, your skin remains vulnerable to sun damage.
Q: Can I use tretinoin and azelaic acid together both morning and night?
A: While azelaic acid can be used both morning and night – because it is a mild acid, tretinoin shouldn’t. Reason is because due to tretinoin’s potentials in skin cell turnover and regeneration can increase skin sensitization or sensitivity which leaves the skin vulnerable to the sun’s UV rays attack. So, for the sake of your skin, limit tretinoin use at night-time only.
In this experimental review, I used tretinoin and azelaic acid every-other-day, for three (3) weeks, at night-time only.
Q: Did the combination purge your skin?
A: I didn’t experience purging, this is because I’m a longtime acid user. As aforementioned, I’m not new to acids, I know my way around acids.
However if you’re a new acid-user and want to give these two actives a shot, please do well to contact your board-certified dermatologist first (for advice whether or not to use them).
However, if you must use them, endeavor to follow the technique I used, by using the buffer or sandwich method, and using every-other-day (resist the urge of applying these acids daily) for the sake of your moisture-barrier.
Also it’s very important to start from a low concentration, especially if you have a sensitive skin. You can start from 0.025 or 0.05% tretinoin and 5 or 10% azelaic acid to ease your way into these acids and to allow your skin gradually build tolerance or get accustomed to them. You can read my experimental-comparison review between The Ordinary & Paula’s Choice azelaic acid 10%.
Q: Did the combination irritate your skin?
A: While using tretinoin and azelaic acid together, I had no irritation, this is because I played smart. I don’t use them everyday (but every-other-day) and also i hydrate and moisturize my skin before layering the actives. And Oh, don’t mind the high concentration I used, my skin has built tolerance to tretinoin 0.1% and azelaic acid 20%, as I have previously used them individually.
Q: Can I use azelaic acid and retinol together instead of tretinoin?
A: If you’re an individual with super-senstive skin, and wish to go for retinol instead of tretinoin (which is the most potent of all retinoids), then you’re definitely on the right track. So, the answer is Yes, you can definitely use azelaic acid and retinol together and still achieve same result (but not as effective as the combination of tretinoin and azelaic acid together). But that doesn’t matter, as long as result is achieved without compromising skin barrier or incurring inflammatory-irritation.
Also as regards to your super-senstive skin, I’ll recommend you use them apart or in separate times. By this I mean, use azelaic acid in the morning, while you use retinol at night — but still maintain the every-other-day application method.
Retinol is a weaker retinoid as compared to tretinoin, which is an advantage to sensitive skin individuals. So, instead of combining azelaic acid and tretinoin together which may increase irritation on your super-senstive skin, using retinol instead will be a smart move. But still endeavor to maintain the every-other-day application technique and not everyday.
Don’t forget to start from lower concentration and build your way up (if need be). Example: 10% azelaic acid and 0.5% retinol. This is to ease your way into these acids and to allow your skin gradually build tolerance or get accustomed to them. And also endeavor to hydrate and moisturize with a lightweight moisturizer before applying/layering these acids (as to protect your moisture-barrier).
Disclaimer: This is a personal experience with the combination of Tretinoin and azelaic acid, you may have a whole different experience as skin type differs so as result differs too.