Azelaic Acid vs Benzoyl Peroxide – Which Is Better For Acne?
They’re two ingredients that are often recommended for acne-prone skin, but how do they compare? Is there much difference between azelaic acid vs benzoyl peroxide?
If you’re torn between the two ingredients, this article will help you decide which one is the better choice for your skin. As well as discussing whether you can use both azelaic acid and benzoyl peroxide together.
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).
Benzoyl Peroxide
Benzoyl peroxide is an acne medication that can be found over-the-counter or by prescription. When you apply it to your skin, it breaks down into benzoyl radicals and benzoic acid.
Benzoyl radicals are a type of free radical that create oxygen in your skin. The bacteria that cause acne (c.acne) prefer an oxygen free environment (which is why they only really become an issue when your pores are clogged).
No oxygen = Increased c.acnes growth
By releasing free oxygen radicals in this way, benzoyl peroxide is able to kill the acne-causing bacteria in your skin.
Benzoic acid is thought to work in a similar way to salicylic acid and helps to exfoliate and unclog your pores.
Benzoyl peroxide may also target the inflammatory immune cells in your skin which prevents them from releasing the inflammatory molecules that can make acne look red and angry and sometimes feel painful.
Overall, benzoyl peroxide is:
- Anti-inflammatory
- Exfoliating
- Oil controlling
However, it’s generally considered to be less effective at treating acne than retinoids and salicylic acid unless it’s combined with other ingredients.
Because it produces free radicals, benzoyl peroxide has been shown to deplete your skin levels of vitamin E, so using it alongside an antioxidant serum or moisturizer is recommended.
(Note that there is no evidence to suggest that the free radicals produced by benzoyl peroxide contribute to skin aging – there is also no evidence that they don’t but the anti-inflammatory effect of benzoyl peroxide may have anti-aging benefits)
Azelaic Acid vs Benzoyl Peroxide
Both azelaic acid and benzoyl peroxide have similar benefits when it comes to treating acne and may even enhance each other’s effects.
They’re both anti-inflammatory, antibacterial, and have a mild exfoliating effect. However, azelaic acid is usually less irritating than benzoyl peroxide and is better suited to sensitive skin. It’s also able to treat a wider variety of skin conditions than benzoyl peroxide and can help treat hyperpigmentation and rosacea.
One clinical study found that azelaic acid was equally as effective at treating inflammatory acne (papules and pustules) as benzoyl peroxide but caused less irritation and was better tolerated. However, other research suggests that it may be less effective.
Azelaic acid can also have an antioxidant effect unlike benzoyl peroxide which is a pro-oxidant and can deplete your skin’s natural levels of antioxidants.
Some research suggests that azelaic acid may increase oil production which may make it less suitable if you have oily-acne prone skin but is an added bonus if you have dry acne-prone skin.
Benzoyl peroxide was shown to increase surface oil but not as a result of increasing oil production. Instead, benzoyl peroxide promotes the free flow of oil from your pores to the surface of your skin – likely due to its pore-unblocking effects.
If you’re looking for a more tried-and-tested acne treatment, then benzoyl peroxide is probably the best option as there is a lot more research to support it over azelaic acid. However, if you have sensitive, rosacea-prone skin, then your skin may struggle to tolerate benzoyl peroxide and you may be better suited to azelaic acid.
Can You Use Azelaic Acid and Benzoyl Peroxide Together?
If you still can’t decide between azelaic acid vs benzoyl peroxide, the good news is that you don’t necessarily have to.
In fact, when it comes to treating acne, the two ingredients may actually complement each other’s effects. For example, research suggests that the combination of azelaic acid and benzoyl peroxide was more effective than using benzoyl peroxide alone. In addition, the people in the study found that the combination of ingredients was much more convenient too.
One of the downsides of benzoyl peroxide is that it can reduce your skin’s levels of antioxidants which makes it more prone to free radical damage. Azelaic acid has antioxidant properties which can help protect your skin while you’re using benzoyl peroxide.
Unlike ingredients like vitamin C and retinol, azelaic acid isn’t easily oxidized which means that benzoyl peroxide is unlikely to make it ineffective.
How To Use Azelaic Acid vs Benzoyl Peroxide
Both azelaic acid and benzoyl peroxide can be used once or twice a day and are available in a range of products like creams, gels, serums, and facial washes. It’s usually easier to use multiple active ingredients if you’re only using each one once a day
If you’re using benzoyl peroxide in a leave-on product, like a gel or a cream, be aware that it can bleach clothing, pillow cases, and towels. To prevent this, allow it to dry completely before getting dressed or getting into bed at night.
When introducing new skincare ingredients into your routine, it’s best to introduce one ingredient at a time so that if you have a reaction it’s easier to identify which ingredient was the culprit.
Benzoyl peroxide can increase your skin’s sensitivity to the sun which increases your risk of sunburn and premature skin aging. Azelaic acid has a protective effect on your skin but it’s still important to wear sunscreen everyday.
Some skincare products or prescription products already contain this combination of ingredients for you which is the easiest way to use azelaic acid and benzoyl peroxide together. However, you can use them in separate products too.
If using the ingredients in separate products, it’s usually best to apply your products in order of thinnest to thickest, for example, applying a serum before a moisturizer. This is because products with a thinner consistency usually penetrate your skin quicker than those with thicker consistencies.
If you’re planning to layer them together and wondering which goes first – azelaic acid vs benzoyl peroxide, it’s probably better to apply benzoyl peroxide first and then, once it has absorbed into your skin, follow with azelaic acid. This way the azelaic acid can also help provide antioxidant protection to your vitamin e depleted skin.
However, it’s important to only introduce one new active ingredient into your skincare routine 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.
Be aware that, although research suggests that using azelaic acid and benzoyl peroxide together is effective at treating acne, it also has the potential to cause skin irritation.
To lower your risk of irritation when using azelaic acid and benzoyl peroxide together:
- Avoid using other active ingredients until you are sure your skin can handle it
- Stick with a gentle cleanser (your skin should not feel tight and dry after cleansing)
- Use plenty of moisturizer
The Bottom Line – Azelaic Acid vs Benzoyl Peroxide
Both azelaic acid and benzoyl peroxide are useful skincare ingredients for treating acne. If you’re looking for a more tried-and-tested treatment, you’re probably better off using benzoyl peroxide. However, if you have sensitive skin or skin that’s easily irritated, azelaic acid is the safer bet.
If your skin can tolerate it, you may get even better results using both ingredients together but you should only introduce one ingredient at a time and keep the rest of your skin routine simple in order to reduce the risk of irritation.
You may also find that the following skincare ingredient combinations are more effective:
