Episode Details

Can you use azelaic acid with tretinoin or another topical retinoid? Dermatologist Dr. Dray explains how these two skincare ingredients can work together for acne, rosacea, post-inflammatory hyperpigmentation, and other common skin concerns.

Azelaic acid has anti-inflammatory, antimicrobial, and pigment-modulating properties, making it useful for acne, rosacea, and dark marks left behind after breakouts. Tretinoin and other topical retinoids work differently by helping normalize skin cell turnover, prevent clogged pores, treat acne, and improve signs of photoaging.

Dr. Dray explains why combining azelaic acid and tretinoin can be particularly useful for people dealing with acne and hyperpigmentation, how to introduce both ingredients without unnecessarily irritating the skin, and whether azelaic acid really needs to be used twice a day.

The video also explores the evidence for once-daily vs. twice-daily azelaic acid for papulopustular rosacea, why once-daily treatment may be a reasonable option for some people, and how individual skin tolerance should guide your skincare routine.

Dr. Dray also discusses using azelaic acid with adapalene, tazarotene, or trifarotene, whether retinoids can be used with rosacea, and why adding more active ingredients does not necessarily mean better results.

In this video:

• Can you use azelaic acid with tretinoin?
• How azelaic acid works for acne and hyperpigmentation
• How tretinoin works for acne and photoaging
• Why azelaic acid and retinoids can complement each other
• Does azelaic acid need to be used twice a day?
• Once-daily vs. twice-daily azelaic acid for rosacea
• Azelaic acid for post-inflammatory hyperpigmentation
• Using azelaic acid with adapalene, tazarotene, and trifarotene
• Can you use tretinoin if you have rosacea?
• Azelaic acid and tretinoin for anti-aging
• How to reduce irritation from combining active ingredients
• Why more skincare actives are not always better
• How to build a simple azelaic acid and retinoid routine

Timestamps

0:00 Introduction
0:37 What Does Azelaic Acid Do?
2:17 What Does Tretinoin Do?
3:22 Why Combine Azelaic Acid and Tretinoin?
4:13 Do You Need Azelaic Acid Twice a Day?
7:07 When Would You Use It Twice a Day?
7:51 How to Combine Azelaic Acid With a Retinoid
11:04 What If You Use Adapalene or Tazarotene?
11:28 Acne Plus Dark Marks
11:59 What About Rosacea?
12:39 What About Photoaging?
13:16 The Biggest Issue: Irritation
15:53 My Bottom Line

The key takeaway is that twice-daily azelaic acid is not automatically better than once-daily treatment. Prescription azelaic acid 15% gel is labeled for twice-daily use for rosacea, but clinical research has found comparable improvement with once-daily application for papulopustular rosacea. The ideal frequency depends on the specific product, condition being treated, tolerability, and consistency.

For many people, a simple routine of azelaic acid in the morning, tretinoin at night, moisturizer, and daily sunscreen can be an effective approach. The goal is not to use the maximum number of skincare actives, but to find a routine that provides benefits without excessive irritation.

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FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links.

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