Can I Use Azelaic Acid and Rosacea Cream Together?

Usage of Rosacea Cream

Hello, doctor.
I would like to ask if I can use a 20% azelaic acid cream purchased from the pharmacy to lighten acne scars while also using a prescription cream for rosacea.
Can these two creams be used simultaneously, or should I wait a few hours in between applications? Or would it be better to alternate them daily? Thank you.

Xuan, 30~39 year old female. Ask Date: 2021/06/06

Dr. Wu Yuxin reply Dermatology

You can use Lifu ointment during the day and azelaic acid ointment at night.

Reply Date: 2021/06/06

More Info

When considering the simultaneous use of azelaic acid and a rosacea cream, it is essential to understand the properties and mechanisms of action of both treatments. Azelaic acid is a dicarboxylic acid that is effective in treating acne and rosacea due to its anti-inflammatory, antibacterial, and keratolytic properties. It helps to reduce redness, swelling, and the appearance of post-acne marks. On the other hand, rosacea creams, which often contain ingredients like metronidazole or ivermectin, are specifically formulated to address the symptoms of rosacea, such as redness and flushing.

1. Can They Be Used Together?
Yes, azelaic acid and rosacea cream can generally be used together, but it is crucial to monitor your skin's response. Both treatments can complement each other, as azelaic acid can help with the underlying acne that may accompany rosacea, while the rosacea cream can specifically target the symptoms of rosacea. However, combining these treatments may increase the risk of skin irritation, especially if you have sensitive skin.

2. Timing and Application
If you choose to use both products, it is advisable to apply them at different times of the day to minimize potential irritation. For example, you could apply azelaic acid in the morning and the rosacea cream in the evening. Alternatively, if you prefer to use them both in the evening, you could apply one product first, wait for about 20-30 minutes to allow it to absorb, and then apply the second product. This approach can help reduce the likelihood of irritation and allow each product to work effectively.

3. Skin Tolerance
Before starting this combination, it is wise to conduct a patch test with both products to assess your skin's tolerance. If you experience any redness, burning, or excessive dryness, it may be best to use them on alternate days or to consult with a dermatologist for personalized advice.

4. Potential Side Effects
Using both treatments may lead to increased dryness, peeling, or irritation, particularly if your skin is not accustomed to these active ingredients. If you notice any adverse reactions, consider reducing the frequency of application or consulting a healthcare professional for guidance.

5. General Recommendations
When using topical treatments, it is essential to maintain a gentle skincare routine. Use a mild cleanser and a good moisturizer to help maintain your skin barrier. Additionally, sunscreen is crucial, especially when using products like azelaic acid, which can increase your skin's sensitivity to the sun.

In summary, while azelaic acid and rosacea cream can be used together, it is essential to approach this combination with caution. Monitor your skin's response, consider timing your applications to minimize irritation, and maintain a gentle skincare routine. If you have any concerns or experience significant irritation, consulting a dermatologist would be beneficial for tailored advice and treatment options.

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