Skin&Lab Azelaic Acid 10% Balancing Serum Versus KISOCare Houttuynia Cordata Leaf Extract 77% + Azelaic Acid 5% Lotion

OTC Azelaic acid is usually available in concentrations from 10-15% and anything over requires a prescription.

Here's what each tier does best:

Unlike other acids, azelaic acid will not make your skin more photosensitive/sun sensitive.

Though this ingredient is naturally occurring in grains like wheat, rye, and barley, it is usually synthetically created for cosmetics to ensure stability and effectiveness.

Though this ingredient works well with most skin types, some people with sensitive skin may experience a reaction such as allergic rashes, closed comedones, or itchiness.

These compounds allow centella to dial back inflammation, encourage the skin to build and hold onto collagen, support the barrier and hydration, and bring solid antioxidant activity to protect against signs of aging.

Centella also carries a nice supporting cast of Vitamin A, vitamin C, several B vitamins, and amino acids. Put it all together and you get an ingredient that soothes, hydrates, and protects, all at once.

Most of centella's magic comes from the four big compounds (Asiaticoside, Madecassoside, Asiatic Acid, and Madecassic Acid). These are the actives doing the heavy lifting in almost every centella study.

Here is the short version of what they do in the skin:

So it is not just soothing for the sake of soothing. Centella calms the skin AND helps it rebuild.

Just FYI, not all centella on an ingredient list is the same. What you are getting actually depends on the extract:

Fun fact on the ratios: the leaves tend to be richest in Madecassoside and Asiaticoside, and lower in the two acids. The exact amounts shift with where the plant is grown and how it is processed. This means purity really does vary brand to brand.

Centella is one of the most easygoing actives out there.

It layers well with basically everything: niacinamide, hyaluronic acid, peptides, and vitamin C, and also pairs nicely with stronger actives like retinoids and exfoliating acids where it can help take the edge off irritation.

On the safety side, centella and its triterpenes are classified as weak sensitizers, meaning allergic reactions are possible but uncommon.

Patch tests at 1% and 5% came back negative in test panels, and creams at typical use levels did not cause allergic reactions across large groups of people.

But as with any new active, a patch test is still a smart move for very reactive skin.

Centella is widely used because it is effective at low percentages. For context, human safety testing found no meaningful irritation from creams containing centella extract at everyday use levels (the tested amounts were well under 1%).

The irritancy threshold in animal testing was also above 30% (so real-world formulas sit far below anything concerning).

In collagen lab studies, higher concentrations drove more collagen synthesis, so serums built around centella tend to feature it more prominently.

Bottom line: you will find centella working nicely anywhere from a fraction of a percent up to hero-ingredient levels depending on whether it is a supporting soother or the main event.

Fun fact: Centella has been used as a medicine and in food for many centuries. As a medicine, it is used to treat burns, scratches, and wounds.