The Ordinary's Azelaic Acid Suspension 10% for cystic acne, plus my skincare routine

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For some reason, after I moved to California back in December, I started to experience more breakouts than I'd had in a long time. They were worst on my chin, but also happened on my nose, cheeks, and forehead. I had a combination of inflammatory acne (the scabby, infected pores on the surface) and cystic acne (those deep, swollen, underground pimples)--the latter concentrated on my chin and upper lip. I don't know what caused my skin to react this way. Something hormonal? Climate? Different water? Since I couldn't prevent it, I decided to treat it.

I bought this tube of The Ordinary's Azelaic Acid (for some reason I spell azelaic wrong in a different way every single time) back in July when I made a small order from Well.ca and had it shipped to my sister in Canada. I mainly chose products based on what had the best reviews, because I was curious about the brand. In addition to this stuff, I ended up with their Caffeine Solution (reviewed here and passed on to a friend), Buffet (which I've finished and will review soon), and the Matrixyl + HA (which I'm currently using).

(I know there has been drama and bad publicity about Deciem, the parent company of The Ordinary, lately. I don't really know what to think of it, and since I bought this months before any of that happened, it wasn't a consideration. You can easily find out what's been going on with a Google search and make up your own mind.)

After I wrote my post about not having a use for The Ordinary's Vitamin C, I looked at this tube and kicked myself. Another brightening product? Really? Well, azelaic acid in fact has a number of functions, and perhaps what it's most often used for it to treat acne. For instance, it's typically part of the acne medication prescribed by Curology. Yet The Ordinary's description of the product on their US site doesn't mention anything about acne (though it does say it fights acne in Canada). They write, in in much more straightforward prose than is typical for them:

Found in grains, Azelaic Acid is produced naturally by yeast that lives on normal skin. It brightens the skin tone while visibly improving the evenness of skin texture and reducing the look of blemishes. It is a multi-functional support ingredient for all skin types and also acts as an effective antioxidant. This formula offers a very high 10% concentration of high-purity Azelaic Acid in a lightweight cream-gel system.

If it's often used for acne, why no mention of that here? I suspect it has to do with drug labeling laws. If a product claims to treat acne, then it's classified as a drug by the FDA and has to have "drug facts" and other information on its label. There are other regulations for products classified as drugs in the US as well. For instance, Paula's Choice sells two versions of its popular 2% BHA liquid with the exact same ingredients. One is labelled as an acne treatment and one isn't--the difference is in the labeling, not the product itself. (So buy whichever one you can find on sale.) Deciem, I assume, has chosen to avoid the extra burden of these regulations by simply not mentioning acne and relying on its unusually informed consumer base to know the properties of azelaic acid. (I don't fault them for going this route, although they might miss out on some potential customers.)

Fortunately, I read about azelaic acid for cystic acne somewhere (probably Reddit, but I can't find the exact post now) and was excited to find that I already had a tube of it in my hoard. According to Deciem, you only need to use a pea-sized amount each day, and they generally seem to advise applying it at night.

It's a fairly thick cream formula, and it dries in seconds, so you need to spread it quickly. I find it easier to use a patting motion than rubbing. It has a mildly unpleasant smell, kind of like the bedroom of a college boy with moderately-good hygiene, but it doesn't linger. I concentrate the product in the problem areas mentioned above, though as you will see in my skincare routine described below, the moisturizer I put on top probably causes it to be more evenly distributed across my face in the end. It's not gritty like The Ordinary's Vit C, and I don't feel any sensation at all on my skin when I apply it.

I decided to do a proper test of this product by applying it daily for a month without adding any other new products to my routine, limiting my use of strong actives like retinol for the first couple of weeks, and taking weekly photos of my skin. I wanted to keep going for at least a month, since my cystic acne breakouts tended to be worst the week before my period. I'm really glad I have documentation, because sometimes it can be hard to see progress without photographic evidence. When I took the last of the four photos below, I considered not even posting them, because I thought there hadn't been any real improvement over time. But I think the photos say otherwise. Left to right, weeks 1 (immediately before beginning azelaic acid) through 4 (all without any makeup):

The most dramatic improvement is, in fact, not really visible in these photos: the decrease in cystic pimples. I still get one or two during the week before my period (I'm actually in the second month of using the azelaic acid as I write this), but they are much smaller, less painful, and they disappear in just a few days instead of a couple of weeks (or more!). I just had one pop up a couple of days ago, and it's almost gone today.

The reason I thought there wasn't a visible improvement, despite being happy with the results, was that I still had an unusual amount of inflammatory acne on my chin. I've managed to get that under control too, though that's a topic for another post (spoiler: honey mask). I think you can see from the photos that even with remaining acne on my chin, nose, and forehead, the redness in those areas had decreased significantly with just the addition of the azelaic acid. Really, that should have been more obvious to me, because I've found myself needing to do less color correction/concealing (as described here) with continued azelaic acid use. (The one thing that's sticking around is that red scar/PIH/PIE mark in the middle of my top lip that was left behind by a cystic zit. If anyone has suggestions for fading it more quickly, I would be grateful.)

This is all very exciting for me! It's rare that I get such good results from a new product in this short a time. I thought I would list out my full skincare routine here, so that you can see where the azelaic acid fits in. As I've pointed out recently, you don't need to use nearly as many products as I do to have nice skin. I like to try new things and especially to review and blog about them, so I use more than I necessarily need. I haven't listed products I use sporadically like masks and oils. This is my daily routine.

Morning

Gentle cleanse (currently Paula's Choice Moisture Boost Cleanser or Simple Micellar Water)
Exfoliate with BHA (currently Paula's Choice 2% BHA Liquid)
Wait 5-10 minutes
Hydrating serum mixed with a couple of drops of niacinamide booster (currently The Ordinary Matrixyl 10% + HA and Paula's Choice 15% Niacinamide Booster)
Light Moisturizer (currently Clinique Moisturizing Gel)
Wait 10 minutes
Sunscreen (currently La Roche-Posay SPF 60 Fluid or Kinesys SPF 30)

Night

Double cleanse (currently Neutrogena Cleansing Oil and Simple Micellar Water)
Hydrating serum (currently Paula's Choice Redness Relief Serum)
Azelaic acid treatment (currently The Ordinary Azelaic Acid Suspension 10%)
Wait 5-10 minutes
Heavier moisturizer (currently Cetaphil Moisturizing Lotion or Origins Night-a-Mins Cream or Paula's Choice Hydrating Treatment Mask)

I think I still have another month or two worth of this azelaic acid in my tube, and I'll probably replace it with the same thing when it's empty. It's been an excellent addition to my routine. Besides Deciem's website, it's available places like Sephora and Well.ca ($10 off $40 CAD with code brutallyhonestbeauty--anyone can make a coupon code). But do you know of any other good, non-prescription sources of azelaic acid out there? Paula's Choice sells it outside of North America (I assume not here because of some of those drug regulations discussed above), though I'm hoping that some recent social media posts they're written about azelaic acid mean they'll offer it here soon, too.

UPDATE: Paula's Choice Azelaic Acid Booster is now available in North America.

Has anyone else had good (or bad?) results with azelaic acid? Did you use a prescription product?

I don't need this: Review of The Ordinary Vitamin C Suspension 23% + HA Spheres 2% and The Ordinary Caffeine Solution 5% + EGCG

Yes, I just wrote a post about over-consumption in skincare, and now I'm reviewing a couple of products from one of the trendiest brands of the moment. But this is also a post about not trying to use things you I should know won't work for you me. Maybe you can learn from my mistakes, since I obviously can't.

The first of the two products I'm reviewing here is The Ordinary's Vitamin C Suspension 23% + HA Spheres 2%. Emi from Project Swatch kindly gave me her tube when I expressed interest after her review, in which she found she didn't like using it because of the grittiness. For some reason I wanted to test my mettle against the unappealing texture, since I can usually stand weird products so long as I use them at night. I won't go into all of the technical details of how this product is supposed to work, but I will direct you to this excellent and thorough review of 27 products from The Ordinary. You can also read about them on Deciem's website (the company that makes The Ordinary), but I will point out that that they often make little attempt to provide really accessible information--and in fact, I think this is part of their marketing plan. Is there a word like "greenwashing" for marketing that presents everything in a very technical, scientific way, to make it sound more advanced and unique? I mean look at the product names. Broken down to basics, maybe, but hardly ordinary.

In general, vitamin C is supposed to "brighten" by fading extra pigmentation, and to prevent or repair sun damage. Here's a great explanation of antioxidant effects from Lab Muffin (still sciency, but a much better presentation than Deciem's). And here's where I went wrong. How many products do I own that claim to "brighten" skin? I don't even want to count. How many times have I actually noticed a difference in my skin as a result of using a brightening product? Rarely-to-never. I don't have hyper-pigmentation or dark spots or the usual things that brightening products are meant to brighten. And so while I don't think that it was completely useless to use this particular product, because I probably got some invisible preventative effects from the antioxidants, I didn't see any noticeable improvements in my skin while using it. That doesn't mean that it doesn't work or that you won't love it! It means I didn't need it, because I already use other good antioxidant products.

Left: Review of The Ordinary Vitamin C Suspension 23% + HA Spheres 2%; Right: The Ordinary Caffeine Solution 5% + EGCG

I can tell you something about my experience of applying the Vitamin C Suspension, however, since it is an unusual product. You can read on the product page about why it feels the way it does, but I would describe the texture as feeling like a small amount of baking soda mixed into a lotion. Deciem says that it "tingles," but I would describe the sensation as more of a mild burning. I don't recommend using this stuff if you have any broken skin on your face, like a recently scabbed-over zit, because it will sting like fuck. As I hoped, the texture doesn't bother me too much. I apply a thin layer and leave it for 15-20 minutes, and then lightly apply moisturizer on top. By the time I add the moisturizer, most of the grittiness has gone away, but I still prefer to add another layer, because it's quite greasy. In fact, I can still feel the oiliness on my hands even after washing them with soap. With a more pleasant moisturizer over it, however, it feels ok while I sleep, and it washes off easily in the morning. The product itself doesn't have any fragrance when I apply it, but by morning my face smells like it has fake tanner on it, which is interesting. That smell washes off with the product. Also, if you happen to get any of it on your lips, it has a very sour taste.

My story with the Caffeine Solution is similar. I purchased this stuff myself from Well.ca ($10 off with code brutallyhonestbeauty), and had it shipped to my sister in Canada along with a few other products from The Ordinary. I'd read a few brief reviews from people who said it really helped with their dark circles, but apparently I didn't pay close attention, or I would have known it wasn't likely to help me. It works by constricting blood vessels to reduce puffiness and it also reduces dark pigmentation under the eyes. My dark circles are not caused by either of those things--instead, the skin under my eyes is translucent, which makes it look purple-blue. (You can see what I mean here.) In addition, quite the opposite of puffy, my undereye area is somewhat sunken (you can see here). So in fact, I would benefit more from increased puffiness and pigment, not the opposite!

But I tried the serum anyway for about a week, since I had it, after all. I was curious. It didn't improve my dark circles, as I should have expected. I don't know if it made the sunken, shriveled skin under my eyes worse, but it certainly didn't help. Let me advise you to READ THE FUCKING PRODUCT DESCRIPTION BEFORE YOU BUY SOMETHING. Honestly, I don't think there are any products other than concealer out there that can help my ghoulish blue circles, though I'm trying some eye patches to see if they will plump up the skin temporarily (recommended by Mimi from Makeup Withdrawal).

The texture of the Caffeine Solution is lovely, by the way, in case it's the kind of thing that might be of use to you. It's a thin serum that absorbs quickly. The bottle ought to last forever, because you'll only need a drop max for each eye.

I need to stop using things simply because I'm intrigued by reviews, and think carefully about what will actually benefit my skin. I do that most of the time, but my curiosity got the better of me this time. The Ordinary is an interesting line of products, and I have a few more to test out in the coming months. It's a cheap way to try fairly basic formulations and ingredients and to rule out what doesn't work for you (I guess I've accomplished that), which can be difficult to do with more complex, often more expensive, products. I haven't done a price-per-ounce analysis here, and I might attempt one in the future, though I'm not sure exactly what would be best to compare these types of products to. Suggestions?

Have any of you have good luck with skincare from The Ordinary?

(I really would like to get up to two posts a week, instead of just one, but I haven't quite got the hang of my new schedule. Working on it!)