Azelaic Acid and Salicylic Acid Together – Safe To Mix?

They’re two ingredients that are often recommended for acne-prone skin, but is it ok to use azelaic acid and salicylic acid together?

Here’s everything you need to know…

Azelaic Acid

Azelaic acid is a dicarboxylic acid found in grains like wheat and barley. It’s suitable for even the most sensitive, rosacea prone skin and offers a wide-variety of benefits.

• It reduces inflammation
• It improves redness and rosacea
• It removes dirt, bacteria, and oil from pores
• It’s antibacterial
• It can improve the appearance of acne and acne marks (post-inflammatory erythema/hyperpigmentation)
• It prevents melanin synthesis which helps brighten skin and reduce dark marks/hyperpigmentation
• It reduces skin sensitivity
• It improves skin texture

It also provides a gentle exfoliating effect that is well tolerated by sensitive skin but may cause an initial worsening of breakouts (purging).

Salicylic Acid

Salicylic acid is a chemical exfoliant that’s often used to treat acne. 

Chemical exfoliants increase the rate that your skin naturally exfoliates itself by breaking down the bonds that hold your dead skin cells together which makes it easier for them to be shed from the surface of your skin.

There are three main types of chemical exfoliant; alpha-hydroxy acids (AHAs), beta-hydroxy acids (BHAs), and polyhydroxy acids (PHAs).

Salicylic acid is the most well-known BHA and is derived from willow bark. It’s oil-soluble which means that it can easily get into your oil glands and help control the amount of oil your skin produces.

The main benefit of using salicylic acid for acne over other chemical exfoliants is its ability to penetrate and exfoliate your pores due to its oil-solubility. This means it’s also able to get into your oil glands and control the production of oil.

Other ways that salicylic acid benefit your skin are by:

• Reducing inflammation and soothing skin.
• Offering some protection from UV radiation.
• Preventing the growth of bacteria (due to its acidic pH).
• Increases collagen production to improve fine lines and wrinkles.

As it is very effective at reducing oil production, it can be quite drying and may not be suitable for dry skin.

Can You Use Azelaic Acid and Salicylic Acid Together?

If you can’t decide which ingredient you want to use, the good news is you don’t have to choose! You can use azelaic acid and salicylic acid together! However, it’s not really necessary and may increase the risk of skin irritation.

One clinical study found that the combination of azelaic acid and salicylic acid was effective at treating inflammatory acne but there was no comparison to either ingredient used alone. However, azelaic acid does appear to enhance the effects of other common acne treatments, including benzoyl peroxide and retinoids, which suggests that it may also enhance the effects of salicylic acid.

They’re also effective at similar pH levels, with azelaic acid being most effective at a pH of 4.0-5.0 and salicylic acid originally thought to be most effective at a pH of less than 3.5.

However, research suggests that there isn’t much of an increase in the effectiveness of salicylic acid when used at low pHs, just an increase in irritation and skin barrier damage.

Even if they were ideally used at different pH levels, your skin’s natural surface pH is around 5.0 – 6.0 so they would have to adjust to your skin’s natural pH anyway.

How To Use Azelaic Acid and Salicylic Acid Together

There are many different ways that you can combine azelaic acid and salicylic acid together but it depends on the type of product you’re using as to which is best.

Chemical exfoliators, such as salicylic acid, should only be used 1-3x per week in order to reduce the risk of over-exfoliation and skin barrier damage. However, this is typically OK if it’s in a multi-active serum or cleanser.

Multi-active products are usually tested for irritation potential and designed to be used daily while cleansers are rinsed off which acts as short-contact therapy. 

Although azelaic acid has a gentle exfoliating effect, it can be used 1-2x daily with most clinical research studies using it twice-daily. However, other research has shown that azelaic acid is equally as effective when used only once a day.

While a multi-active product is probably the best way to combine the two ingredients, you can also combine azelaic acid and salicylic acid together in the following ways:

• Salicylic acid cleanser, azelaic acid serum, moisturizer, (sunscreen if AM)
• Cleanser, salicylic acid serum 1-3x a week and azelaic acid cream on the other days, moisturizer, (sunscreen if AM)
• Cleanser, salicylic acid serum (1-3x a week) AM/ azelaic acid PM, moisturizer, (sunscreen if AM)

If using both azelaic acid and salicylic acid as serums it doesn’t really matter which way round you use them. However, you should only introduce them one at a time. This will help identify if your skin reacts negatively to one of the ingredients as well as help prevent skin barrier damage.

Summary – Azelaic Acid and Salicylic Acid Together

Both azelaic acid and salicylic acid are great options for treating acne. If you’re after a more tried-and-tested option or if you have oily skin, then salicylic acid is probably the better choice for you. However, if you have sensitive skin, azelaic acid would be the better option.

If you’re skin isn’t particularly sensitive, you may be able to combine azelaic acid and salicylic acid together, although there isn’t much evidence to suggest that the two in combination is more effective than either used alone