Dermomedica Azelaic Cream

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.

Your skin makes glycerin on its own (mostly from sebaceous oil breakdown) and shuttles it to your outermost layer of skin, or your epidermis, via aquaporin-3.

Aquaporin-3 is a transporter that is essential for normal skin hydration, elasticity, and repair. Interestingly, mice lacking in AQP3 have dry and less elastic skin that can be fully corrected with glycerin.

This ingredient is non-irritating, plays well with almost every ingredient, and works across all skin types. Typical use is anywhere between 3-10% but can go up to 79% in some leave-on products.

Just know very high concentrations (>40%) can feel tacky in low humidity.

Glycerin is the name for this ingredient in American English. British English uses Glycerol/Glycerine.

It plays several roles in a formula:

Typical use levels for this ingredient sit around 1-10% and the Cosmetic Ingredient Review Expert Panel has affirmed safety at concentrations up to 25% in leave-on products.

Multiple assessments have found it to be non-irritating and non-sensitizing to most people.

However, there have been some cases of allergic contact dermatitis in patients with chronically compromised skin barriers.

Cetearyl alcohol has a comedogenic rating of 2 and irritancy rating of 1. Both of these numbers come from the 1989 study that used rabbit ears; a "2" means mildly comedogenic and a "1" means low irritancy.

Here's the catch: rabbit skin is more sensitive than human skin and throws a lot of false positives. A 1996 reappraisal found that ingredients rated 1-2 in the rabbit ear tests are generally safe for humans.

Remember comedogenic ratings are unable to assess the entire formula of a product or how it will react on your skin. Just be sure to patch test if you are unsure about certain ingredients.

This ingredient is not fungal acne safe. Cetearyl alcohol is a fatty alcohol with chain lengths that fall within the range that Malassezia can metabolize.

A 2019 study has also observed Malassezia growth in the presence of this ingredient, confirming it to be not-fungal acne safe.

These "skin-like" liquid crystals improve skin barrier integrity and promote the delivery of actives into the skin.

This ingredient is well-tolerated and has no significant sensitization data.

Because it is derived from the fatty acids in olive oil, this ingredient may not be fungal acne safe.

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.

As a humectant, Sorbitol helps draw water to the skin. This helps keep the skin hydrated. Sorbitol also helps create a thicker texture in products. You might find sorbitol in your toothpaste and other gels.

It is a non-irritating ingredient that is great for those with dry skin.

Sorbitol is a prebiotic. It helps promote the growth of healthy bacteria on your skin. The bacteria on your skin form a microbiome. This microbiome helps protect your skin from infection and harmful bacteria.

This ingredient is also known as part of Olivem 1000, with Cetearyl Olivate being the other part.

According to a manufacturer, this ingredient helps preserve the natural microbiome of skin. Having a healthy microbiome helps keep our skin healthy and protects against harmful bacteria.

Please note, having a healthy microbiome is different from fungal acne; a healthy microbiome includes small amounts of yeast that normally live on your skin without causing problems.

Fungal acne happens when one type of yeast (Malassezia) grows out of control. This is usually because it's feeding on certain oils or fatty acids. Due to the olive oil base, this ingredient may not be fungal acne safe.

Though it has "alcohol" in the name, it is not related to denatured alcohol or ethyl alcohol.

The FDA allows products labeled "alcohol-free" to have fatty alcohols.

This ingredient may not be fungal acne safe. It is a primary fatty alcohol with a chain length above 12 carbons. A study from 2019 show Malassezia can feed on fatty alcohols in this range, so it may trigger fungal acne in those prone to it.

This ingredient is typically used in concentrations between 1-10%. Studies have found it to be non-sensitizing, non-phototoxic, and non-photoallergenic.

A close cousin of this ingredient is Glyceryl Stearate SE ("self-emulsifying"). This just has a small amount of sodium or potassium stearate added so it can emulsify without a co-emulsifier.

Since this ingredient is an ester of a C18 fatty acid, it may not be fungal acne safe. The Malassezia yeast can potentially metabolize within the C11-C24 range.

Fun fact: The human body also creates Glyceryl Stearate naturally.

Hexylresorcinol works well with other ingredients. Studies show this ingredient boosts the effect of niacinamide, various forms of vitamin C, and retinoids.

Many consider this to be a safer alternative to hydroquinone. In fact, this ingredient produces the same results as hydroquinone in lower amounts.

Fun fact: This ingredient can also be found food and medicine for treating skin infections.

Gentle reminder from SkinSort: all skin tones are beautiful!

Tocopheryl Acetate is commonly found in both skincare and dietary supplements.

In vitro research found an increase in skin hydration by 58% and a decrease in TEWL by 37.8% after 24 hours of applying this ingredient (pretty impressive for a single ingredient!).

Besides hydration, shea butter also contains triterpenes that have anti-inflammatory potential. In particule, lupeol cinnamate has shown the highest anti-inflammatory activity in vivo.

Shea butter also contains vitamins A and E which may contribute to antioxidant activity.

While Shea Butter has an SPF rating of about 3-4, it is not a sunscreen replacement.

This ingredient may not be fungal acne safe because its fatty acids fall within the C11-C24 range that the Malassezia yeast can metabolize.

Dimethicone comes in different viscosities:

Depending on the viscosity, dimethicone has different properties.

Ingredients lists don't always show which type is used, so we recommend reaching out to the brand if you have questions about the viscosity.

This ingredient is unlikely to cause irritation because it does not get absorbed into skin. However, people with silicone allergies should be careful about using this ingredient.

Note: Dimethicone may contribute to pilling. This is because it is not oil or water soluble, so pilling may occur when layered with products. When mixed with heavy oils in a formula, the outcome is also quite greasy.

Safety-wise, the CIR Expert Panel has concluded it to be safe in cosmetics when formulated to be non-irritating and non-sensitizing.

Free stearic acid is a C18 fatty acid that the Malassezia yeast can substrate, so this ingredient may not be fungal acne safe.

Interestingly, the size of the molecule affects its behavior:

Some clinical evidence links low molecular weight versions to improved wrinkle depth, elasticity, anti-inflammatory effects, and barrier repair.

Many serums use a blend of both weights so you can get surface hydration plus longer-lasting and deeper effects.

You'll typically see concentrations between 0.1-2% for this ingredient.

Evidence for mint as a "treatment" ingredient is limited and depends heavily on the specific extract type and concentration.

In large percentages, peppermint extract may sensitize the skin.

Your skin can't convert salicin to salicylic acid because it needs specific enzymes that aren't present on the skin's surface. It won't behave like true salicylic acid, especially at the concentrations used in cosmetics.

However, this ingredient has its own perks. It contains flavonoids, polyphenols, and tannins that give it proven antioxidant and soothing properties.

An 8-week clinical study found a cream with 2% of this extract improved skin microcirculation, elasticity, and dark circles. This is most likely due to its role in increasing hyaluronic acid synthesis in fibroblasts and improved vascular integrity.

Another study found a topical serum with 0.5% salicin showed improvements in visible signs of aging, hyperpigmentation, and texture.

Just be careful if you have a known aspirin/salicylate allergy and be sure to consult with a medical professional about using this ingredient if you do.

Fun fact: Willow Bark extract has been used for thousands of years and ancient civilizations used white willow to help treat pain and fevers.

As a polysaccharide, Maltodextrin has moisturizing properties. Polysaccharides are a type of carbohydrate. The top layer of skin uses polysaccharides to retain water, keeping the skin hydrated.

Maltodextrin is water soluble and has a sweet taste.

Xanthan gum is a pretty common and great ingredient. It is a natural, non-toxic, non-irritating ingredient that is also commonly used in food products.

Like other types of silica, this ingredient can be used to thicken a product. As an absorbent, it may be used to absorb extra water or help prevent clumping.

Although “aluminum” in an ingredient name can raise red flags for some consumers, the form and usage context matter significantly. For typical topical applications, there is no substantial evidence of health risks - such as cancer, neurotoxicity, or systemic “aluminum overload.”

Is it bad for your skin?

The answer comes down to concentration. Patch and wash studies have found highly concentrated alcohol-based hand rubs (60-100%) cause less barrier disruption than washing with a basic detergent like SLS. The only measurable effect in these studies was a temporary dip in skin hydration.

Concentrations below 12-15% in leave-on cosmetics is generally well-tolerated. Concentrations above start to see increased transepidermal water loss (TEWL) and reduced hydration.

In concentrations about 58%, it creates temporary channels in your skin's lipid layers to become more permeable and allow other ingredients to slip through easily.

This ingredient can be up to 80% of the formula in alcohol-based perfumes.

Overall, this ingredient is probably harmless if found lower down an ingredients list but worth side-eyeing if it's high up (especially if your barrier is already struggling).

Alcohol can worsen dry skin, eczema, and oily skin, especially at higher concentrations. This is because it can increase transepidermal water loss and decrease hydration to disrupt the skin barrier.

According to the National Rosacea Society based in the US, you should be mindful of products with these alcohols in the top half of ingredients.

True allergic contact dermatitis to ethanol is uncommon, but be sure to patch test if you have dry or sensitive skin.

Because it is not a free-fatty acid, this ingredient is fungal acne safe (there's nothing for Malassezia to feed on).

Industry-reported use ranges from 8% in rinse-off products and 2% in leave-on formulations.

As a humectant, it pulls water into the skin. But it's a pretty minor moisturizing ingredient compared to other humectants, like glycerin.

Interestingly, it can act as a mild penetration enhancer. One in vitro study on human skin found a 12% concentration upped the absorption of mometasone furoate (a medicinal ingredient used to treat inflammatory skin conditions) up to 7%.

This ingredient is typically used at levels of 0.1-10% depending on the role it's playing.

A patch test study on eczema patients didn't find a significant increase in irritation versus the control group, but the potential for irritation rises at higher concentrations.

On top of that, this ingredient can counteract the effects of hard water by binding to the minerals in it.

One thing worth knowing is that Disodium EDTA has been shown to be a mild penetration enhancer. It can help other ingredients absorb into skin more effectively which can be a double-edged sword (great for actives, but can also make the active too strong if you have sensitive skin).

Clinical patch testing showed no significant skin irritation at typical use concentrations and minimal dermal absorption.

You'll most likely see this ingredient near the end of an ingredient list. It's typically found in concentrations less than 1%.

When exposed to air, these two compounds become strong allergens. This ingredient exhibits cytotoxicity at low concentrations; amounts of 0.25% have been shown to damage skin cells.

A study from Japan found this ingredient caused lavender sensitivity after widespread exposure.

Lavender essential oil has some antimicrobial, antibacterial, and anti-inflammatory properties. However, the cons of this ingredient may outweight the pros.

More research is needed to confirm lavender essential oil's effects when used in aromatherapy.

Lavandula Angustifolia is known as the English Lavender and famous for creating purple fields in Provence, France.

This ingredient has a scent that is floral, spicy tropical, and citrus-like.