Ingredient Beauty BenefitsInternational non-proprietary name · Azelaic Acid
Azelaic acid: better than placebo in rosacea, though Cochrane rated most of the trials at high risk of bias
All six products registered in Korea are over the counter. In a Cochrane review, azelaic acid beat placebo on participants' own assessments (three trials pooled, risk ratio 1.52), and a phase 3 trial of a 15% foam also beat vehicle. The review noted that most included studies were at high or unclear risk of bias.
Last checked Sep 16, 2026
Azelaic acid is a dicarboxylic acid found in grains. In Korea it is a medicine, not a cosmetic — available over the counter after speaking to a pharmacist.
Elsewhere it is used for acne, rosacea and pigmentation alike. What this page has verified is the rosacea evidence. Evidence for the other uses has not been carried over as if it weighed the same.
What is established
Better than placebo, on evidence the reviewers rated as low quality
The 2011 Cochrane review 'Interventions for rosacea' pooled 58 randomised controlled trials and 6,633 participants. Among them, three trials of azelaic acid pooled showed it was more effective than placebo on participants' own assessments (risk ratio 1.52).
The same review assessed the majority of included studies as being at high or unclear risk of bias. The authors concluded there was 'some evidence to support the effectiveness of topical metronidazole, azelaic acid, and doxycycline (40 mg)', with well-designed, adequately powered trials still required.
A later phase 3 randomised, double-blind, vehicle-controlled trial tested a 15% foam. Both the investigator global assessment success rate and the reduction in inflammatory lesion count were significantly better than vehicle (P < .001 for each). Drug-related adverse events were mainly mild to moderate local skin reactions. Neither paper reports its sample size in the abstract.
- Randomised controlled trial in people (3) · sample size not reported · Compared with vehicle (same formula minus the active) · Funding publicly funded · Endpoint scores from blinded assessors PMID 21412882
- Randomised controlled trial in people · sample size not reported · Compared with vehicle (same formula minus the active) · Funding not declared · Endpoint scores from blinded assessors PMID 26244354
All six products registered in Korea are over the counter
The Korean drug register lists six products with azelaic acid as the active ingredient, all classified over the counter (checked 16 September 2026). They can be bought at a pharmacy without a prescription.
It is not on the functional cosmetic list — neither among the nine whitening actives nor as the acne active (salicylic acid 0.5%).
That is why you rarely see 'azelaic acid' on a Korean cosmetic ingredient list. Same substance, different regulatory column.
Known risks
- Stinging, burning, itching and dryness at the application site are common, mostly in the first weeks.
- It lightens pigment, so on deeper skin tones it can take colour out of areas you did not intend.
- Rosacea and acne are medical conditions. Seeing a clinician beats self-managing for months.
- Keep it away from eyes, lips and mucous membranes.
What is not established
- The evidence for pigmentation has not been verified on this page. It is a common use, but only the rosacea trials were checked here.
- Neither paper gives a sample size in its abstract, so the effect size cannot be read alongside the number of people.
- We found no established data on use during pregnancy. Ask a pharmacist or doctor.
Whether and how to use it is decided with a doctor or pharmacist.
What this article relies on
- 의약품안전나라 — 의약품등 정보검색 (품목 허가사항)식품의약품안전처 · Checked on 2026-09-16
- PubMed — 미국 국립의학도서관 문헌 데이터베이스National Library of Medicine · Checked on 2026-09-16