I have used various versions of azelaic acid for 15 years and I loooove it. It stings for the first week or so, but after that, there is no discomfort. I use it morning and night with my BPO and it really keeps my skin from becoming red, which is important, because BPO on its own will make my old marks very red/purple. It also fades old marks and reduces flakiness.

My insurance does not cover it so I have been ordering it from various online pharmacies in faraway places. It usually costs me $50 for a four-month supply, which is not bad. I have not found a difference between any of the foreign 20% creams. I have never used the 15% gel.

Give it time. In chronic or acute acne, you will always get worse as the product lifts what lies beneath to the surface. Once that occurs, you will begin to see improvement!

Tip: Wash your face well am and pm and apply. Go to bed with a dirty face....

Live with your acne!

Best of luck!

I do not recommend this product. I was on it for 7 weeks and it continuously made my skin worse. I have been off of it for 2 weeks now and my skin is STILL worse. Some of the pimples it created have been on my face for over a month and will not go away. I only had moderate acne at worst, and now I have big pimples that I have never had before. I was so disappointed because I really thought this product would work.

I wish I didnt try azelex. My skin was looking pretty good before I went on it but I really wanted to get rid of those red mark..

I don't think what I had was an initial breakout since I got little bumps at the end of the 3rd week of use.

Great product! I started using Azelex abouta year ago, and i havent seen a zit since! It doesnt bleach your skin like BP. My skin gets very dark in the summer, and this is the first product that hasnt caused any kind of discoloration in my skin. Also it was easy to apply and works anywhere you have acne! Overall great product. :)

I love the way this medication has lighted my dark acne scars. I am a carmel complexed african american. Your skin will get worse before it gets better, but the irritation is worth the outcome. I found it is better to wait at least 30 mins after you wash your face to apply the medication. It doesnt burn or itch as much.

I am still giving it a 3 rating and recommending it (with caution) because it is not necessary that it will give an allergic reaction to others and in all honesty, if I overlook the allergy, it was the one thing that was working for me.

I am writing this review as a word of precaution to all other users. I used it on my face, neck and upper chest. For the first 2weeks, I had NO problem, not even the tingling that was mentioned in the leaflet and my acne was so much better. On the beginning of 3rd week there was a slight tingling-burning sensation, more on my neck and chest than face which I ignored. The sensation was more on my neck so I stopped using there but restarted yesterday and..........I woke up night feeling terrible. My face, neck and chest had turned red and I have huge urticarial patches all around.

I never thought when the tingling started that I could be allergic. I thought I am having the side effect of tingling as mentioned in the leaflet.

Burning, burning, itching, itching, please help me fire brigade!

I have a very sensitive skin, I have no clue what development team thought they should think of a 20% acidic cream but well, hey, if it seems to work in vitro?

Anyway, no one's skin should have to deal with such a harsh acidic product.

Made me want to scratch my skin off, tried it three nights in a row but could bear it the third night anymore. Going to hand it back in to the phamacy tomorrow.

After 3 months on Accutane my acne went from moderate to ligh/non existant...I get an occasional pimple. I was put on Aczone to maintain my skin(that stuff is amazing) I ran out and decided I wanted to give Azelex a try..I applied it to my forhead and chin since those are my problem areas. It made my skin dry at first but I used moisturizer afterwards and then my skin returned to it's normal condition. About a couple hours later my skin felt like I had this thick film over it, I took out my blotting sheets and I was amazed at how oily this made my skin! It's not a coincidence since it's only oily in the areas I applied Azelex, that and the fact I haven't been oily for over a month. Everyone is different since some people say it's too drying. Try it because it might work for you.

So, I started using the QV range (a brand based in Australia) and although my skin was looking lovely, I still broke out occasionally.

So I e-mailed the company my thoughts and the lady recommended me their product Azclear Action Lotion -- I think their other product is AcneDerm.

Anyway, so I started using it and at first nothing happened, then I broke out (it was looking pretty horrible and I was feeling somewhat depressed as my initial skin was clearer than my then-current skin.

But I stuck to it and eventually I found myself with a blemish-free forehead. My cheeks are; however, slowly recovering (and the marks are fading!). I want to try putting on my nose but I really don't want to live with a pimply nose for a few months. I'd rather deal with the occasional pimple (and attack it with benzoyl peroxide).

I am worried, however, of the long term side effects as I find myself begin to break out if I stop using this. Maybe I'll try to wean myself off it...

BUT, it is definitely worth it in comparison to benzoyl peroxide as it does not bleach clothes nor does it make your skin dry - (just apply a moisturiser after use).