Azelaic Acid and Tretinoin Cream: OK to Use Together?

You must have heard these two skincare actives: azelaic acid and tretinoin. But do you understand what these two activities are about? And what are their benefits for the skin? Some actives can be too harsh on the skin used alone, let alone used together in the same routine.Therefore, what can possibly happen to your skin if you use it together in your skincare routine? In my previous post, I talked about my experience with tretinoin and how it helped with my acne. Let’s learn more about azelaic acid and tretinoin cream, and the use in skincare.

What is Azelaic Acid and Tretinoin?

Azelaic acid is a naturally occurring chemical in the skin. According to research papers, Malassezia furfur, a type of fungus normally found on human skin, produces azelaic acid. Azelaic acid has an anti-inflammatory effect and it also is effective against acne by stopping the growth of acne-causing bacteria (P.acne). Other than being anti-inflammatory and anti-bacterial, an added bonus is its effect on pigmentation. It helps to reduce hyperpigmentation and therefore can be used to treat melasma as well as to even out skin tone for acne prone skin. Azelaic acid is also exfoliating, it promotes faster skin cell turnover.

Tretinoin is another skincare active that is popular as acne treatment as well as anti-aging solution. It is basically Vitamin A that you can apply topically on the skin. Tretinoin promotes cell turnover, helps to unclog pores hence prevent acne, and also boosts collagen production. 

Mixing Azelaic Acid with Tretinoin

Seeing those benefits laid out above, you might think that it’s a good idea to mix azelaic acid and tretinoin together. Both azelaic acid and tretinoin help with acne in different ways. So you will think using both will enhance the benefits for acne even more, right?

You might be right. However, you should do this with precaution. Both azelaic acid and tretinoin cream will increase the cell turnover of the skin. Therefore, a side effect of using both together in the same routine might be dryness, flakey skin or irritated skin. Simply put, both azelaic acid and tretinoin cream when used together can cause over exfoliation that leads to skin irritation. However, for skin that is already well accustomed to these actives, you may not face this irritation anymore. But please be careful when you start incorporating these actives in your routine, start slowly.

How to Use Azelaic Acid and Tretinoin Cream in Skincare Routine?

I am currently trying to use both actives in my skincare routine and let me tell you what works for me. Rather than using azelaic acid and tretinoin cream in the same routine (for e.g. night routine), I split the use of each in the morning and at night. 

In the morning, I use my hydrating toner, then Vitamin C serum before putting on Azelaic Acid. After that I put on moisturizer and lastly, sunscreen. It is important to always put sunscreen (and ample amount of them) on your skin if you use exfoliants in your skincare routine. In my case, I use azelaic acid and tretinoin cream in my routine, so sunscreen SPF 50 is imperative. 

At night, I use the same hydrating toner, hydrating serum, followed by thicker night time moisturizer. And then I carefully slug under eye areas, creases near the nose and corners of my mouth using Vaseline. Then I put my tretinoin cream on my skin. 

azelaic acid and tretinoin cream

Should You Use Azelaic Acid and Tretinoin Cream Together?

In summary, azelaic acid and tretinoin can be used together in your skincare routine. If your skin is not too sensitive and can handle it, you can layer the two in the same routine. However, if you are worried of over exfoliation or overly dry skin, you can use azelaic acid in the morning routine and tretinoin at night. The result that I have from using both actives has been incredible. My skin is so soft and supple, and you can really see the glow. And people actually commented that my skin looks very nice and healthy.

tretinoin before and after_january 2023

Tretinoin Before and After: Own Experience

There are so many questions from everyone about tretinoin and the benefits it has on the skin. People widely associate tretinoin as vitamin A for the skin. There are so many names for this chemical, you might also have heard the name Retin-A. They are basically the same thing. Actually, Retin-A is a brand of a tretinoin that somehow got associated with the chemical substance itself. However, now you know that when someone refers to Retin-A, they are actually referring to tretinoin. 

Tretinoin effect on the skin

Why do people use tretinoin? People use this chemical because of the benefits that it gives to the skin. It helps to increase the rate of cell turnover on the skin, also it can help to improve the overall texture and chemistry of the skin, and regulate the oil glands. Other than these benefits, it can also stimulate the production of collagen, hence it helps with wrinkles. Many people got to know about this chemical substance because of the acne problem. And then they realise after that the benefits from tretinoin is not only clearing their acne, but also helping to keep their skin young. 

Personally, I started my journey on tretinoin because of my acne concerns. I wrote a lot about pimples and acne in this blog as well, due to my struggle with them.

Tretinoin ideal candidate

As mentioned earlier, if you have acne and you want to clear your skin, tretinoin is one of the best options out there for your skin. However, some people with more sensitive skin might get irritated by tretinoin. Don’t fret, there is an alternative to tretinoin that is as good as tretinoin but less irritating i.e. adapalene (popular brand for this is Differin).

Another group of people who are interested in tretinoin are those looking for anti-aging skincare products. There are many scientific and clinical proofs that tretinoin does help to reverse ageing or at least preserve your skin’s youthfulness. There are so many people out there who are living proof of tretinoin’s effectiveness as an anti-aging skincare product.

Skin improvements from tretinoin

I started using tretinoin because my dermatologist prescribed me one (I need to thank her!). Back in October 2021, I had maskne around my nose and mouth area. I used tretinoin for 4-5 months but I was not consistent, because my skin was peeling so badly back then. I did see a huge improvement in my skin texture and how clear and soft my skin has become though. However, starting March 2022, I made a point to do it consistently after seeing so many women in their senior years having very good skin thanks to tretinoin.

tretinoin before and after_oct 2021

This is my skin in October 2021. Many spots and clogged pores around the mask area especially. Texture of the skin was also not smooth.

A few months after, my acne became much more under control. I was still struggling with the dryness and flakey skin. But I just focused on moisturising my skin more. You can see that my skin is dry in the photo below and there are some flakey area. 

tretinoin before and after_march 2022

This is my skin in January 2023 (see photo below). I’ve been using tretinoin for more than 1 year at this point. With consistent fortnightly use of tretinoin, now my skin has tolerated it better and it does not flake as badly as before. And starting a few weeks ago, I just started to amp up the frequency of my tretinoin from every other night to every night. And if you see some redness there, I did have mini purging in the past few weeks due to the increased tretinoin frequency.

tretinoin before and after_january 2023
tretinoin before and after_january 2023_2

Am I satisfied with the result from tretinoin?

Yes, I am satisfied with my tretinoin before and after. It was a journey and I did not expect instant results. You need to be patient with tretinoin. The more you are impatient with it and put too much, it will backfire on you.

Tretinoin, based on a lot of scientific studies, can change the chemistry of your skin and I can see how my skin improves so far. The frequency of acne/pimple has reduced so much. I don’t get cystic acne anymore except 1 or 2 in the past year. My skin texture due to acne scar has improved as well. I can get glowing skin when I moisturise my skin well now that my texture has improved. This is something that I couldn’t achieve before. Overall, I feel more confident in my own skin and I only wear SPF (and not foundation) when I go out now. I am excited to see how my skin will further improve from here.

Chemical Peel for Back Acne (and Scars)

Back acne can affect your confidence, especially when you want to bare your back. It can be when you are going to the beach and want to wear your bikini, or if you want to attend an event and wear a backless dress. Whatever it is, back acne can happen to anyone and you need to learn how to manage it. We have covered the topic of back facial for back acne and whether that works, so make sure to check it out. Now we will cover the topic of chemical peel for back acne and whether that works!

chemical peel for back acne_backless dress

Chemical peel for back acne

A lot of beauty centers offer chemical peel for back acne. Have you ever felt tempted to try this hoping that it will stop your back acne from occurring? How does chemical peel for back acne work? 

Chemical peel for any kind of acne is normally using the typical acids that are good for skin. It can be lactic acid (AHA) or salicylic acid (BHA) in higher concentration than what you find in normal skincare products. Therefore, it needs to be administered by professionals in beauty centers. Moreover, the application is only for a short period of time (several minutes). This is in contrast to the home application of these acids via skincare products that you can leave overnight on your skin. 

It does help with acne including back acne as it will remove the dead skin layer and help to surface the younger, newer skin underneath. If you have clogged pores due to dead skin cells which lead to acne on your back, chemical peel can also help to mitigate the issue. The chemical peel will help to reduce the occurrence of blackheads and whiteheads too. Since blackheads and whiteheads can lead to acne, this will improve acne condition.

However, having said that, you will still need to take care of your back acne. Take precautions like wear a breathable fabric and maintain your hygiene well. Please follow all the best practices to keep your back clear from acne, as what we mentioned in our article on Sweat/Back Pimples. 

Is it effective to get rid of back acne scars?

Chemical peels cannot get rid of deep acne scars on the skin unfortunately. It will not help with the texture of the skin significantly. However, what chemical peels can do for you is to lighten hyperpigmentation. A lot of people with back acne scars see darkened back acne scars which can take a long time to recover. Chemical peel for back acne scars can help fasten the recovery process of this hyperpigmentation.

What will happen after chemical peel?

As the name of the treatment suggests, the chemical peel treatment will peel the skin. It may not happen immediately after your do the treatment, but this can happen a few days after. What you can see visually is your skin flaking away. When that happens, do not pick your skin. Let it flake at its own pace. You can also refrain from going out when this happens because you might see a lot of skin flakes from your back.

With the newer skin coming to the surface, your skin will be more sensitive to the UV ray as well. Avoid the sun for a while, or apply a generous amount of sunscreen to protect your skin during this time. This is especially so if you are treating your back acne scars using chemical peel as well. The increased photosensitivity due to the chemical peel might increase the hyperpigmentation of your back acne scars if you do not protect your back properly.

Should you do chemical peel for back acne?

Chemical peel can really help your back acne and your back acne scars if you have them. However, there are some precautions you will need to take note of before you embark on the chemical peel journey.

Understand your acne type

If you have back acne where it is only surface level and most likely caused by clogged pores or blackheads/whiteheads that are infected, yes chemical peel for back acne can help. However, there are different types of back acne. One of them is cystic acne on the back, which can be caused by inflammation/infection deep in the body system. I would suggest you to find the root cause of this cystic acne, which can be reaction to a certain food ingredient, hormonal imbalance, to mention a few. Personally, I tamed down my back acne a couple of years ago by taking Zinc supplement. Zinc supplement is very good for the skin when taken in moderate amount. A lot of acne sufferers have lower zinc level in their body compared to people with clear skin. Read up more about Zinc supplement for acne in my other post.

Sun protection post chemical peel is necessary

chemical peel for back acne_sunscreen

Also, be mindful of sun protection post chemical peel. If you cannot limit your sun exposure post chemical peel for some reason, perhaps wait until you can protect your skin from the sun before you do this procedure. Chemical peels are not cheap and you would want to get the most benefit out of it. You do not want to get acne-free skin in the expense of getting pigmentation or hyperpigmentation. 

Cheaper alternative to chemical peel at home

As mentioned, acids used in chemical peels are mainly lactic acid and salicylic acid in high concentration. If you cannot afford professionally-administered chemical peels, you can start by doing it at home by buying skincare products containing lactic acid or salicylic acid. You can try with lower concentration before working your way up. If you can be consistent in doing it every night, you might get as good result from chemical peels at beauty center, at a fraction of the price. The caveat is, you need to do it consistently and perhaps over a longer period of time. 

AHA vs BHA: Best Exfoliator for Acne

What are AHA and BHA? We may often encounter these names on skincare products and are not really sure what they are. They are chemical exfoliators that are very potent in unclogging pores on the surface and from within. In my opinion, they are the best exfoliator for acne and acne prone skin. I have covered the topic of skin barrier repair products, which can help with acne. Now, let’s educate ourselves a little bit on these potent exfoliating chemicals and also learn about AHA vs BHA.

AHA vs BHA: what is AHA and what is BHA?

AHA stands for Alpha Hydroxy Acid. It is derived from natural substances like sugar cane, milk, and some fruits. There are AHAs that are derived synthetically as well. AHA is a water-loving/hydrophilic, water-soluble acid with small molecules. They exfoliate the surface of the skin and at the same time hydrate the skin. Most of the workings by AHA are on the surface of the skin. That is, they do not penetrate deep into the pores or deeper layer of the skin. However, they are still a potent ingredient to rejuvenate aging skinAHA is also the best exfoliator for acne that is smaller, only on the surface and less severe.

BHA stands for Beta Hydroxy Acid. It is oil-loving acid and therefore can penetrate deeper into the skin pores and get through the sebum that clogs the pores. BHA exfoliates the skin by refining and normalizing the lining of the skin pore. Moreover, BHA is also anti-inflammatory and anti-bacterial. Therefore it is often used to treat blackheads, whiteheads and acne. The most common type of BHA is salicylic acid. BHA is the best exfoliator for acne that is deeper in the skin because it works its way to skin deeper layers.

Now you understand AHA vs BHA and the difference in the way they work on the skin. The combination of their varying functions makes AHA and BHA the best exfoliator for acne.

AHA vs BHA: Incorporate in your routine

best exfoliator for acne_skincare

When people hear the word “chemical” or “acid”, they often feel scared to put this substance on their skin. Do not fret! There are some acids that are good for the skin. And when used properly in the right range of concentration, they can do your skin wonder. In fact, AHA and BHA may be a game-changer in your skincare routine. This is especially so if you are dealing with clogged pores, dull and tired skin, aging skin, and acne.

AHA and BHA are the best exfoliator for acne prone skin. They are chemical exfoliator, as opposed to physical exfoliators like St Yves facial scrub. For people with sensitive, acne-prone skin with breakouts, you should never scrub your skin. When your skin is breaking out and irritated, the last thing you should do is to scrub and irritate it further. You might be tempted to scrub your face hoping to get rid of the dead skin cells, dirt, and sebum that clog the pores. However, you can do it using a gentler method using AHA and BHA. If you are not sure to use AHA vs BHA, try both and start with a lower concentration.

How to use AHA vs BHA?

To get the benefits of the best exfoliator for acne, you need to understand how to use them.

Rather than picking AHA vs BHA, you can use both within the same day but alternate them. For instance, AHA in the morning and BHA at night or vice versa. I recommend not to use any of these products in the morning as they make your skin more photosensitive. So the best way to use AHA and BHA is to use them on alternate nights.

When using AHA or BHA, your skin becomes more sensitive to light and more prone to hyperpigmentation. Always use sunscreen with SPF 50, whether you leave the house or not as sun rays still get into the house through windows or doors. Moreover, don’t forget to reapply every 3-4 hours.

Don’t combine AHA or BHA products with Vitamin C. AHA, BHA and Vitamin C altogether may be too acidic and too harsh for the skin. Be kind to your skin barrier. If your skin barrier is damaged, your are prone to skin irritation.

I apply AHA or BHA after cleansing at night. If you want to combine these best exfoliator for acne you can use this order: AHA/BHA, facial essence, moisturizer or hydrating serums. If you use hydrating toner, you can do it in this order: AHA/BHA, toner, and moisturizer.

What best exfoliator for acne to try?

AHA is effective in the range of 5-15%, while BHA is effective in the range of 1-2%. When you start you can use it 2-3 times a week at first, starting from low percentage of acid when you are introducing these products onto your skin before working your way up if you think this works for you. If you want to incorporate AHA and BHA on daily basis, you can use products that have a lower percentage of the acids (low percentage, but high frequency).

Other than using BHA as actives, you can also use BHA in the cleansing step of your skincare routine. Some “anti-acne” or “deep cleansing” cleansers often have salicylic acid (BHA) in their formulation. Examples are Cerave Renewing SA Cleanser, Neutrogena Deep Clean Cream Cleanser, La Roche-Posay Effaclar Medicated Gel Cleanser, to name a few.

Favorite best exfoliators for acne

  • Paula’s choice BHA (2% BHA) – I am currently using this. So far I am satisfied with the results. You use it consistently for 1-2 weeks and you can notice that your nose pores look more refined, and the blackheads / sebaceous filaments production seems to be under control.
  • Alpha-H Liquid Gold (5% Glycolic Acid) – This product has received rave reviews from a lot of skincare junkies. It contains glycolic acid, and it exfoliates while moisturizing the skin at the same time. It is ideal for aging, tired-looking skin. In fact, this brand has a myriad of glycolic acid-containing products to choose from.
  • CosRx Pimple Clear Pad (0.5% BHA) – Good for beginners on BHA. This contains a very low percentage of BHA. However, if your skin is very sensitive and you want to see how BHA works for you, try this out. This product is one of the bestsellers from CosRx (a Korean brand).
  • Drunk Elephant T.L.C. Framboos Glycolic Night Serum (AHA and BHA blend 12%)This might be too advanced for those who want to start using AHA / BHA for the first time. The percentage of AHA BHA is high and you may feel some tingling sensation when you use this. However with persistent usage, many find this blend really smoothes their skin, making their skin more glowing and radiant.

Spot treatment using the best exfoliator for acne

If you have acne and you are into homemade stuff, I bet you have heard or maybe you have even tried an aspirin mask. This mask is a tried and tested method to treat your acne at home. It works well on acne or pimples because of the salicylic acid contained in aspirin. What you do is crush a few uncoated aspirins and mix them with water or honey (honey is moisturizing). We recommend that you use honey in your mask mix to prevent your skin from becoming overly dry.

Bear in mind that this mask is quite drying on the skin, so if you have some pimples here and there, you may want to just spot treat the pimples. The BHA  will help to calm the inflammation on your skin down and therefore reduce redness and swelling. Don’t forget to put on moisturizer or facial oil after rinsing off the mask. This best exfoliator for acne is not limited to toning the skin, but you can use it for spot treatment as well.

Should you use AHA vs BHA as best exfoliator for acne? 

You should try either AHA, BHA or both. I am glad I try them out early and reap the benefits on my skin. They really helped me with my whiteheads, clogged pores, blackheads, and my persistent issue with acne. I will continue using AHA and BHA in my skincare routine for the rest of my life. So, start your journey with these best exfoliator for acne today!

Learn more about skincare, acne and skin health with me!