Ingredient Showdown: Azelaic Acid vs. Hydroquinone

At Lion Pose we live and breathe science, and we love breaking down a lengthy research study into layman's terms so everyone can learn and grow their skincare knowledge. This time, we've broken down an ingredient comparison study, published by the National Institute of Health.

Background: Azelaic Acid vs. Hydroquinone

To start, a bit of background on our ingredients: Both azelaic acid and hydroquinone are commonly used treatments for hyperpigmentation and melasma, but they are regulated somewhat differently.

Products with hydroquinone (regardless of concentration) must be prescribed by a dermatologist - this is relatively new legislation which only went into effect a year ago. On the other hand, products with azelaic acid are found over the counter, but only with concentrations up to 10%. Anything above that must be prescribed by a physician.

Overview & Findings

This NIH research study compared the effects of 20% azelaic acid and 4% hydroquinone cream in the treatment of melasma, a pigmentation issue common in skin of color. All patients in the study were treated twice daily with one of the two creams.

The study found that after 2-months of treatment, the patients who were treated with azelaic acid cream showed significantly better results compared to those patients who were treated with the hydroquinone cream.

So is Azelaic Acid really better than Hydroquinone?

The short answer is - possibly (ugh, we know, right?). Truth is, there are a couple of things to note about this study that can help digest the findings:

  1. The study was conducted with only 29 patients, and it was an open-trial study, meaning that the patients knew which treatment they were receiving. So a larger blind study could be more effective at drawing a conclusion.
  2. The study was conducted with very high concentrations of each active ingredient. Neither ingredient in those high concentrations are available over-the-counter. So maybe don't go out and buy every OTC product with azelaic acid just yet.
  3. This isn't the first study to be conducted on this topic. This NIH study from 1991 tested the exact same two ingredients in the same concentrations, and also found azelaic acid to be the more effective treatment.

The Conclusion

Azelaic acid is certainly a contender to hydroquinone. Many out there swear by hydroquinone as the only ingredient that truly works for melasma and hyperpigmentation, but the reality is, that is likely not true. We are excited to see what other studies come out comparing these two ingredients and will be first to report back here with their findings.