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Jasmine says…I am an unfortunate victim of adult acne and I’m being bombarded with different advice from doctors, cosmetologists etc on different creams that all basically do the same thing- mildly exfoliate. I am however using a 20% salicylic acid peel every 10 days to get rid of scars and “unclog my pores”. A relative who is a doctor suggested I try azelaic acid instead- having Indian skin. So my question is: Is there really a difference between these? Do they act on the skin differently? Perhaps molecule size makes a difference?

The Left Brain responds: 

It’s not clear from your question whether or not the doctor you spoke with is a dermatologist. The reason I bring it up is a general practitioner may not have the background required to adequately diagnose your skin condition. Regardless, I would never countermand a doctor’s diagnosis, however I can give you some basic scientific background about the difference between these two active ingredients.

AHAs and acne

Salicylic acid is a beta hydroxy acid which means it’s more lipid or oil soluble so it can penetrate into the “pores” better which makes it effective in treating acne. (So molecule size isn’t the key factor. ).

Azelaic acid is an alpha hydroxide and is also used to treat acne. The mode of action is antibacterial and, according to WebMD, it doesnt work on acne that’s not infected with bacteria. I’m assuming that the sal acid has an advantage here because it can help loosen skin cells that could potentially plug your pores even if there is no bacteria infection.

Azelaic acid also has the ability to reduce inflammation and so can be used to treat rosacea and it used to treat post-inflammatory hyper pigmentation. That makes it a good treatment for post-acne scars.  I couldn’t find any information that indicates it’s suitable for use on Indian skin.

If you’d like to read more, here’s a great reference on the difference between AHAs.

The Beauty Brains bottom line

Unless otherwise indicated by a dermatologist , I suspect that Sal acid is more effective at clearing clogged pores.

References:
Grimes, Pearl E. (2007-07-01). Aesthetics and Cosmetic Surgery for Darker Skin Types. Lippincott Williams & Wilkins. pp. 74–. ISBN 978-0-7817-8403-0.
WebMD

Image credit: cynicsgirl.blogspot.com


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