This product was mentioned in
with an average of
Thought of another one- I buy 20% azelaic acid from Amazon for $13. No Rx, I've been using my current tube for over 6 weeks three times a week and still going.
I know, I know, it's supposed to be Rx at that strength. I don't know how they get away with it, but it's the real deal, and my no longer red face can attest to that.
Ecological Formulas Melazepam Cream [link]
Product name: Melazepam
Azelaic acid %: 20%
Price (range): ~$12 for 1.7oz
Country of purchase: USA, Amazon
Skin info: Normal, Fitzpatrick 2, very mildly PD/eczema/rosacea-prone
Ingredient list: Deionized water‚ Azelaic Acid‚ Cetearyl Alcohol‚ Ceteareth-20‚ Mineral Oil‚ Propylene Gycol‚ Petrolatum‚ C12-C15 Alkyl Benzoate‚ Carthamus Tinctorius (Safflower Seed oil)‚ Polyacrylamide‚ C13-C14 Isoparaffin‚ Laureth-7‚ Glyceryl Stearate‚ PEG-100 Stearate‚ Isopropyl Alcohol‚ L-carnitine‚ Benzyl Alcohol‚ Xanthan Gum‚ Potassium Sorbate‚ Potassium Hydroxide.
Special info: N/A
Experience & opinion: I've been using Melazepam for 9+ months and I love the stuff. It's my only active, so I feel comfortable attributing the vast majority of my progress to it specifically.
It's a suspension, so be prepared for a gritty texture. I see a lot if complaints about this but I personally have no issues with spreadability or skin-feel. Comes in a tube and has somewhat of an alcohol scent.
I use it once every two nights over moisturizer as my last step. I personally haven't experienced any dryness or irritation. I do get a slight itchy/tingling feeling if I don't let my moisturizer sink in fully first, but I think that's pretty normal for azelaic acid.
My skin tone has evened out a lot, redness on/around my chin has decreased, hormonal acne has been eliminated, and my skin is a lot smoother. I have no intention to stop using it any time soon, or to change up the frequency or method of application.
Very easy to get prescribed, and it helps a lot. For the record, I've also used Melazepam azelaic acid cream from Amazon ($13/tube), and it seemed to work just as well for 1/8 the price! I only went back to the prescription Finacea because I'd met my insurance deductible and out-of-pocket, and it was effectively free. :)
No problem! I’m about to go to bed but if you have more questions following this I’ll get to you in the morning friend!
You need to baby your skin, not nuke it. Your skin is being dehydrated by Dr. Bronners and possibly Thayers Witch Hazel. Physical exfoliation is likely the last thing you need right now.
First step, PLEASE stop using Dr. Bronner’s on your face!!! That should be your first move. Its pH of 8.9 is far too high for your skin (4-5.5), which damages your acid mantle and leaves your skin vulnerable to acne and irritation. Switch to something with a lower pH. I use Cerave Foaming Facial Cleanser (pH 5.5), which is in the right range and available at drugstores. You can search the sub for other low pH cleansers. Once you switch to a gentler cleanser, give it a week or two before adding another product to your regimen. You want to know if things make your skin better or worse, otherwise you may end up with more skin problems and no idea what caused them.
Once your cleanser has been sorted, you can look into other helpful skincare. Possibly a plant oil high in linoleic acid like rosehip or evening primrose oil to inhibit acne production. A gentle BHA toner would further aid in acne treatment, prevention of ingrown hairs, and maybe reduce the hyperpigmentation that results from these issues.
Eventually, you might want to add azelaic acid. I don’t know what the source of your acne is, but mine has responded really well to application of Ecological Formulas Melazepam. It’s really helped with my hyperpigmentation from old spots. I also spot apply it when I see a new spot brewing. There are other products featuring azelaic acid, so do some research and see what will suit your needs.
Again, add skincare products one at a time, with at least a week or two in between. Good luck!
I use Melazepan 20% Azelaic Acid (that I get on Amazon for like $15) and it's the only product I've tried that actually has a tangible effect on my rosacea. I've used so many redness products (basically anything on AB that has the redness tag) and none of them do anything except for AA. Plus, it's instant -- or OK, it takes like 10 min, but it's not not other products where it takes a month of use. I also only wait about 5 minutes after application and the effects still last. The one drawback is that it can be drying, but it's not a problem if you add an extra moisturizing layer.
The Ordinary's version is only 10% AA and quite frankly, sucks because of the reason you mentioned. If it's the only one you've tried, do yourself a favor and try a stronger one that has a better texture that TO's!
I have used the Finacea gel in a tube for years. I typically put it on after cleansing but before moisturizing. My skin is so sensitive that those are the only steps in my routine.
Unsolicited advice: Due to cost of Finacea ($94 with insurance), I've switched to Melazepam azelaic acid (bought on Amazon), and it's SO much more effective for me than Finacea ever was. Finacea just seemed so useless to me. It never prevented my Rosacea acne or sped up the healing time. Melazepam does both, and it costs just $14.
So if you're not eventually seeing a benefit from Finacea, consider switching.
Are you located in the US? Amazon has a Melazapam Azaelic Acid that's fantastic and cheap. I believe it's stronger than TO's version, though both are thick, non-cosmetically elegant formulas.
I have insanely sensitive skin and I love azelaic acid. Completely eradicated my acne when I couldn’t even keep 2.5% benzoyl peroxide on my skin for 30 seconds without a rash.
Niacinamide gives me itchy hives so I’m not really a fan. Just know that you don’t need a Curology prescription to get niacinamide or azelaic acid. The Ordinary has a 10% azelaic acid cream and a zinc/niacinamide serum. There’s also this azelaic acid cream available on amazon which I think is 15%.
I’ve used both The Ordinary’s azelaic acid cream and the Melazepam. They are both a bit gritty and prone to pilling so they’re definitely better used at night and not under makeup. When first using azelaic acid, it will definitely sting so be warned. The first time I used it, I almost threw out the bottle because it actually hurt. Then I came back to it months later and decided to tough out the burning sensation. I was sure I was going to wake up with a rash but instead I woke up with the smoothest, clearest, softest skin I’ve even had in my life. A few months of regular use and I barely get pimples, my acne scars have faded and my skin is calm. I’m not exaggerating when I say that azelaic acid has made my skin the best it’s ever been. And don’t worry, with regular use the stinging sensation goes away. Definitely recommend!
This worked wonders for me. It works well for acne too. It burns a little the first few times you use it. I would blend it with a little moisturizer the first few times. It should make a noticeable difference in just 2 weeks. Mine is almost completely gone now. I have to use it twice a week to prevent flair ups. I've been using this for 20 years.
Have been using drunk elephant AHA for a while, but wanting to add azelaic acid (just picked this one up from Amazon, supposed to be a Finacea dupe). I've been testing the azelaic acid (at night) while waiting for my next AHA shipment to arrive and it seems to be working decently.
My AHA just arrived today so I'm wondering if I can use them in conjunction and if so, how? Which one comes first and do I need to include extra wait time? I had been using it as the second last step of my routine before moisturiser not realising it was pH dependant... Any help appreciated!
I ordered mine on amazon. It’s at 20% formula. There are other brands that sell lower percentage formulas at 10% and 15% if you want to start slower and gentler.
Azelaic acid could definitely help! It’s often prescribed for rosacea but you can get it in near prescription-strength formulations OTC as well. It has helped with both my redness and my acne. Though it stings, my sensitive skin has tolerated it extremely well.
The Ordinary makes a 10% formulation and Melazepam is a 15% formulation that you can get on Amazon. I’ve tried both and they both work very well! They are sort of gritty and prone to pilling so are best used at night. Like I mentioned, they do sting (it can hurt tbh...) but that sensation goes away with regular use. I don’t get acne anymore because of this stuff. Totally love it and it will always be apart of my routine.
As for what in your routine could be bothering your skin - most people with rosacea have very sensitive skin and should avoid products with fragrance and essential oils. So the rose witch hazel could be upsetting your skin. I know that products will claim that rose is “soothing” and “calms redness” but rose is just perfume and it can be really irritating for those of us with sensitive skin. Maybe give plain witch hazel a shot?
Ecological Formulas Melazepam Cream [link]
This stuff of miraculous. Works fast and actually makes your skin look nice and clear. Apply it at night on top of your moisturizer. It burns a little the first 3 times you use it. In 3 weeks you will have clear skin. Don't forget to drink lots of water and try to avoid rosacea triggering foods.
[Ecological Formulas Melazepam Cream [link]
This worked wonders for me. I got rosacea after giving birth. This makes it go away. It burns a little at first. You can put it on over moisturizer at first, then it will stop burning. It takes about 2weeks of every day use to make a big difference. Mine totally went away. I use it whenever I get a flair up. It's a miracle. It also works well on acne (even cystic.) Nothing the derm gave me worked as well, or as fast.
When tretinoin isn't enough, it's often recommended to add azelaic acid to the PM routine. I suggest using tretinoin and azelaic acid on alternate nights.
If you're in the US, you don't need a prescription for azelaic acid, you can buy it on Amazon. Here is a link to Melazepam 20%.
Ecological Formulas Melazepam Cream [link].
I tried all sorts of things, and I always looked like I had sunburn. The doctors prescriptions did not help. This helped. It burns a little at first, so you want to mix it with a little bit of face cream. After I while I was able to stop using it everyday. I get compliments on my skin. My boss tried it for her acne she had for ever. Her skin is clear now
I purchased melazepam from Amazon. Your skin doesn’t necessarily look like acne, but rather milia or Keratosis Pilaris. Some good exfoliating should help in either case, something gentle with aha/bha like glycolic/lactic acid.
I bought melazepam off of Amazon. here. . The texture is a little gritty (I just rub it in my hands a little to beak it down before application) but other than that it’s worked wonders.
It took me almost a year to see improvement. I started using azelaic acid and it helped my redness and acne so much when I paired it with tret. I use it in the morning after I moisturize. I let my moisturizer sink in for 10-15 minutes then I take a small amount of melazepam (it’s suppose to be a 20% azelaic acid) and then on my other finger I add some water and mix it then spread it on my face. It can feel gritty so that’s why I add the water. I feel like it helps it spread and sink into my skin faster. I then use my Tretinoin at night.
It can also be irritating though, but not as bad as tret. At first my face would tingle or itch sometimes but after a bit it stopped. You could also try the ordinary 10% and then switch to a higher percentage. In the states you need a prescription for 20% but I’ve been buying it off of Amazon cause it’s cheaper.
Here’s the link to the melazepam if you would like it.
Ecological Formulas Melazepam Cream [link]
This works wonders on rosácea better than any prescription medication I have ever used.
On mild rosacea, it should clear it up enough that you won't ever get spider veins again. The laser treatment will make you happy.
I can only tell you what helped me. After pregnancy, I started using DHC Cleansing Oil and then finished off with non alcohol witch hazel on a cotton pad. CeraVe moisturizer with hyaluronic acid, after it soaked in I topped it with this:
Ecological Formulas Melazepam Cream [link]
This was the game changer. If I used that, I could put Vaseline on top without any breakouts. Everyone I recommend this to has had positive results. It works miracles on Rosacea and acne. My baby is 26 now, and I still use the Azelaic acid 3 times a week. I need the vaseline, and the azelaic acid makes it possible.
I don't see a lot of acne, it does look like rosacea to me BUT keep in mind I am not a diagnostician.
Azelaic Acid treats both acne and rosacea. As a prescription medication, it's super expensive here in the US, but you can get over the counter versions. The Ordinary has a 10% Azelaic Acid product, Paula's Choice has a 10% Azelaic Acid booster and you can also get Melazepam on Amazon. It's 20% and usually around $15.
Lots of people love the CeraVe Moisturizing Cream so stick with it if it works for you. There's nothing wrong with it. Definitely avoid products that contain fragrance or other irritants.
Are you using sunscreen?
I'm glad you are doing better. Mental health slumps are the absolute worst.
If you're in the US, you can get this one through Amazon, Melazepam. I heard it's good, pretty reasonable price, and it has 20% AA. I personally think 15% + are more effective based on my experience. I've tried TO's AA and didn't like it.
TO's wasn't strong enough for me, it's also super silicone-y which isn't for everyone. I recently made the switch to melazepam (20% azelaic acid instead of 10%) and it's been a game changer honestly.
You can buy it on amazon and I think they ship to Canada: here
It's an azelaic acid that can be bought over-the-counter. I get mine on Amazon for ~$13 here [link]
I find it to be very gentle, but I also have pretty tough skin. I started using it bi-nightly right away and never had any purging whatsoever. In fact, the difference after a week was incredible! Very effective as improving texture & stubborn acne scars.
It is an active though, so YMMV.
I’m not sure if linking is allowed, I’ll remove if it isn’t. I get it from Amazon - Ecological Formulas brand Melazepam Cream.
It goes under makeup just fine for me, and when I was researching which one to buy, I read a lot of complaints from people that The Ordinary’s silicone base doesn’t do well under makeup). The Ecological Formulas one is also 20%, which is stronger than The Ordinary’s. For me, it hasn’t been harsh or anything (and my skin is pretty sensitive to harsh ingredients). Worst I’ve had is a little bit of a mildly prickly feeling when I first put it on but that goes away fast.
Hi! Just wanted to let you know that Automod has removed your comment because it contains an Amazon referral link, which we don't allow in the sub. Could you please edit the URL so that everything from (and including) "tag=" is removed?
Here's the tag free link for an easy copy & paste: [link]
If you've done that, please reply to this message so I can approve your comment. Thank you!
I had gotten really clear sticking to fungal acne safe products only & especially this Melazepam cream Ecological Formulas Melazepam Cream [link]. But then I waxed my face with the Bliss wax kit which said to use the pre/post oil. That kicked it off then I made it worse by panicking and trying other products that people had gotten clear skin with (but were not FA safe) 😔
Thanks for the well wishes! I was wondering where u found it as I haven’t seen it online yet. Did u get it on amazon?
I started with melazapam non perscription but 20% azelaic acid. You can find it on amazon here: [link]
Then after I finished that tube I moved onto Skinoren which is prescription 20% azelaic acid. I bought it on ebay from a seller in Europe with good reviews since its so expensive in the states. It worked great for me. I know some people feel iffy about buying skincare on ebay but I just made sure to only buy from a seller who had really good reviews. Sometimes you can't find skinoren on ebay though and that's when I go back to the melazapam.
The difference between the two is that the melazapam is grittier than the skinoren (smoother for sure). This would bother me if I was wearing it during the day. But I don't. I wear this on top of my moisturizer at night before I go to bed. Hope that helps, feel free to ask more questions!
I see that you're already using TO 10% Azelaic Acid.
I recommend using a higher strength azelaic acid product, like Melazepam, which contains 20% azelaic acid.
Here is the Amazon link: amazon.com/Ecological-Formulas-Melazepam-Cream/dp/B001WUEJ4U/
Melazapam, purchased from Amazon. Very non-cosmetically elegant, heavy feeling, but damn does it do its job (and I just use it at night, as a first step before the rest of my routine).
This knocked out my CCs COMPLETELY. I used to have so many. I still break out with some cystic acne though but it’s getting more under control
And of course!! Happy to help
Does anyone know if the following is safe for fungal acne prone skin? I can't seem to find anything that would irritate it:
Ecological Formulas Melazepam Cream
I've added azeliac acid 20% (Melazepam cream- [link]) into my routine about three days ago and I'm experiencing some dryness that I'd like to fix. I have a dry skin type. Here's my routine:
Cerave Hydrating Cleanser
Lubriderm Daily Moisture Lotion
Biore Watery Essence Suncreen
Oil cleanse with pure mineral oil
Before I started the Melazepam, I would use Vaseline at night occasionally when I was feeling dry. However I read that actives and Vaseline don't mix. Does this apply to azeliac acid as well? I miss my Vaseline :(
Any help would be great, thanks!
It does look similar to mine and I get it in the same areas. I get the same kind of bumps that look like my PIH too but are a little raised. One thing you could try is melazepam cream. It’s supposed to have 20% Azelaic acid and is available on Amazon
I tried this before my first appointment with this derm and saw some improvement. It does make your face itch, but some people even use it in place of the finacea
I like it, but I have to say it's one of the heavier oils I've used. I prefer camellia japonica or passionfruit seed oil, both from GoW. That said, the rosehip keeps my dry skin from showing fine lines and stops the itching I get from two eczema spots I get on my eyelid. The plumping ability keeps me coming back.
For redness, I feel my melazepam has fixed that. For $13 for a several month supply from Amazon, it can't be beat. You can search the sub for info/directions, it is a pH sensitive active.
For hormonal acne, I take a single spearmint supplement every morning and my years of monthly chin spots have ended.
I’ve always had acne-prone and generally bad, sensitive skin. Used proactiv for many of my teenage years which seemed to work best. Around college, the acne went away for a while, and that’s when the rosacea flares really started. Diagnosed with papulopustular type around 2013. I struggled for years trying to find the right combination of products, every cream you could name. And this is where I have landed:
Morning face wash: neutrogena ultra gentle daily cleanser
Follow up with azelaic acid cream aka melazepam
Moisturize with aveeno positively radiant daily cream
At night, I use target brand’s charcoal pore cleanser and again follow up with the azelaic acid.
I also take doxycycline 50mg daily. Have tried coming off it before and I immediately flare up badly.
I truly think the melazepam is when I really started seeing a difference. I highly encourage those who haven’t tried azelaic acid to give it a chance. No prescription needed and relatively cheap from amazon.
It’s been a long and emotionally exhausting journey. No one really can understand what it’s like to hate your own face. Very grateful to have found something that finally works!
Hugs to my fellow rosaceans!
I also have this problem with my insurance. I’ve had good work-around luck with DIY azelaic acid ([link]), sulfur masks ([link]), and the vet version of soolantra ([link] ). This version is sticky like Vaseline. But it’s cheap so you won’t lose much if you don’t like it. After I determined it worked for me I switched to this one which isn’t so sticky ([link]).
I use a very gentle cleanser (I like albolene and vanicream) and moisturizer, plus sunscreen during the day.
Just a warning if you try the ivermectin - my skin got a lot worse than I have ever seen it around days 4-10. But then it improved tremendously. I think this is why dermatologists use doxycycline with it in the beginning to reduce the inflammatory reaction to the mite die-off. But stick with it and it’s so so worth it.
Finally, here is my routine:
Sulfur mask (10 Min every other night)-then rinse with lukewarm water
Azelaic acid (3 times a week)
Ivermectin (every night right at bedtime)
Vaseline (if I’m really dry)
Here are a few links to posts with good info from over at Skincare Addiction
For me, I buy 20% melazepam for $13.50, a non-Rx form available on Amazon. The tube seems to last forever.
I treat it as an active, using it after a 20 min wait following Vitamin C, and I give it its own wait time. For me it has decreased redness, improved texture, and decreased the appearance of my SFs. I have pretty hardy skin, so I started out using it every day, and have never had an issue with sensitivity, over exfoliation, or dryness. I do skip it 2 days before and after my TCA peels.
Editing to add- I find it to be a matte semi gritty cream that smooths in and disappears, much gentler and with a nicer "feel" than the Ordinary's sorry excuse for an AZA.
You could try Melazepam for Azelaic Acid. I've never used TO's version, so I can't compare the two, but this works great for me. Garden of Wisdom also sells an 8-10% AzA, but I didn't find it as effective. Paula's Choice also just released a 10% AzA for the American market. I've heard good things about the version sold in Europe.
I recently ordered this from Amazon. It's 20% Azelaic Acid
There's also 20% AzA you can get from Amazon called Melazepam for around the same price as the TO AzA.
I just started seeing Brent Goedjen at Dermatology Affiliates. You know they're good cause they're in Buckhead and wealthy people don't mess around with their cosmetic doctors. They also have a text service where you can ask questions and they'll get back to you within 24 hours.
He recommended 1) a temporary oral antibiotic to reset everything, 2) topical clindamycin for bacterial control, and 3) azelaic acid. I could have used something stronger like tretinoin but I declined at this time. The oral antibiotic hurt my stomach so I stopped taking it. I'm not sure if the clindamycin did anything. The azelaic acid alone has been a complete game changer. I'm down to just using it like once or twice a week and it's radically changed my skin. Example: I had a beauty mark I picked at for years because I assumed it was a zit just like everything else. Now I can tell it's a mole!
I just buy the azelaic acid off Amazon here and used this write up to start using it carefully. Happy to talk more about it!
I highly recommend Tretinoin* and Azelaic Acid** for your skin.
*Join r/tretinoin, they have a ton of useful advice. First, read their wiki: https://www.reddit.com/r/tretinoin/wiki/index
**Read this page: Azelaic Acid. If you're in the US, you can get it on Amazon - Melazepam is a popular option.
This is how I'd structure your routines (it will take 3 to 6 months to see results):
Azelaic Acid (if you use a low percentage like 10%, apply azelaic acid before moisturizer)
Sunscreen SPF 30-50
Wait 20 minutes
Occlusive (like Vaseline) (can be applied to whole face or just dry areas)
Azelaic acid! It improves my acne overnight and my PIH fades about twice as fast as usual using this. It's hard to get a hold of if you're in the US/Canada but you can buy Melazepam on amazon or the ordinary 10% azelaic acid. It's otc in Australia and Europe. I use Azclear which is available in Australia. You can also get Finacea which is more effective and layers better but it's more expensive. Sesderma is available in Europe. I believe Benton snail bee high content essence has azelaic acid too, you can get it on iherb.
EDIT: added some more links
Not OP, but I adore Melazepam and here's the seller I use on Amazon.
In some places azelaic acid is available OTC as Finacea (and/or maybe Skinoren?). Otherwise Amazon sells Melazepam (20%) or GiGi Bioplasma (15%).
Melazapam from Amazon! [link]
Note the other ingredients just in case you're sensitive to any of them. :)
Yes. Have you tried azelaic acid? I've used Melazepam (available on Amazon), and it worked pretty well. I also have used Paula's Choice azelaic acid booster. It's not as strong, but it also seems to help.
However, nothing makes my skin completely clear, so I just live with varying degrees of broken out.
Check out Melazepam on Amazon. I can't compare, as it's the only one I've used, but it works for me.
Vanicream is a good brand that doesn't contain animal products or tests on animals. This brand has a Gentle Facial Cleanser, Lite Lotion, and Skin Cream. It's available at CVS and Walgreens.
Another good company is The Ordinary. This brand uses a lot of science jargon so it can be confusing. Here is a guide for some of their products. I think their Azelaic Acid Suspension 10% might be good for you. Another option is Ecological Formulas Melazepam 20&#37; on Amazon. Azelaic acid is produced by a type of yeast that lives on the skin. Here is video on Azelaic Acid from a dermatologist. If you decide to use this, I suggest you put it on after moisturizer when the skin is dry to reduce irritation. This can be irritating/itchy. Start by using it 2-3x per week and see how your skin feels before deciding if you want to increase, decrease, or maintain usage.
Another good option for sunscreen is Australian Gold Botanical Sunscreen Tinted Face Mineral Lotion Broad Spectrum SPF 50.
Seconding azelaic acid for redness! I use this one, Melazapam and it's pretty much knocked out my redness completely, as well as fading acne scars and preventing new zits!
I personally recommend the Cos De Baha brand, I use this eBay seller.
Does your mother live in the US? Because she can order 20% azelaic acid from Amazon. The brand is called Melazepam: https://www.amazon.com/Ecological-Formulas-Melazepam-Cream/dp/B001WUEJ4U/
Sounds like you have dehydrated skin: https://www.reddit.com/r/SkincareAddiction/comments/8wxwuv/misc_dehydrated_skin_an_updated_guide_to_healing/
You need to stop using tretinoin until your skin is 100% healed.
I suggest using a 5% urea cream to heal your skin. Eucerin Advanced Repair Cream is a good option (make sure to get the Cream, not the Lotion, because the Lotion is greasier). Read this post to learn more about urea: https://thenakedchemist.com/what-is-urea-and-its-benefits-in-skincare/
For hormonal acne, check out azelaic acid. Here's a link to Melazepam 20%: https://www.amazon.com/Ecological-Formulas-Melazepam-Cream/dp/B001WUEJ4U/
This is how I'd structure your routines:
AM: Non-foaming cleanser > HA > Urea cream > SPF
PM: Non-foaming cleanser > HA > Urea cream > Melazepam (spot treatment)
Depending on the severity of your dehydration, your skin should be healed in 2 to 4 weeks.
Also tagging u/justicefoodie.
Like Cold-Chip9789, I was also going to suggest Azelaic Acid. If you're in the US, you don't need a prescription for it, you can buy it on Amazon. Here's a link to Melazepam 20%.
You've been using Tretinoin for quite a while... Do you think you might have dehydrated skin? Check out that link and let me know what you think.
Lastly, have you ever tried adjusting your diet to see if it affects your skin? I started getting acne around age 11-12, and cutting out dairy made a HUGE difference for me. Caffeine, sugar, and alcohol are also common acne triggers.
Some decent picture reviews.
Melazepam from Amazon, $15 for 20% [link]
You're welcome! You might also like Melazepam, which contains 20% azelaic acid: https://www.amazon.com/Ecological-Formulas-Melazepam-Cream/dp/B001WUEJ4U/
I suspected your skin may have been more PIE once you said you're pale. Not absolute, but if you're darker your skin is more melanin rich and thus PIH is more likely. Since your blanching test showed more PIE than PIH the hydroquinone won't be useful (if at all) because it works with melanin which is why it's such a popular ingredient marketed to darker skin tones.
Kind of bad news, PIE is difficult to get rid of because this is more of inflammation and issue with capillaries in your skin being damaged. It's also a recently recognized skin condition and not much product research is there for it. But you're not without hope, in terms of PIE you'll want rosacea treatment and products. The most proven active to use for rosacea is azelaic acid has the popular ones. There is one that I noticed was missing and it's Melazepam and here's one ]post discussing it vs The Ordinary's]([link]). Overall summary is the Melazepam is stronger (it's higher percentage) and grittier, but the texture is due to difficulty of incorporating azelaic acid so that may be unavoidable unless you choose lower concentration or pay for the more expensive brands (Paula's Choice). I suggest reading through the azelaic acid wiki thoroughly to pick up tips to avoid irritation and which product sounds good.
If you want to use the tretinoin you have on hand it's worth a shot. There's no correct course for PIE. It's more of trial and error since much isn't known. As a general rec I suggest searching for posts in r/skincareaddiction and r/asianbeauty about PIE to learn what helped others and get ideas of what you haven't used but sounds promising. I also find this Asian Beauty post on PIE well written that should help you understand more about difference between PIE and PIH.
As a last bit, PIE won't fade quickly depending how bad it is so don't feel discouraged if it takes a year. Know that PIE is due to inflammation of capillaries underneath the skin and healing needs to take place. Be patient. Take photos to document, because the changes won't be as noticeable which can be discouraging. Photos as a visual comparison will make it easier to tell if your routine is working too.
Not OP but I found this and reviews seem to corroborate it works well!! Ecological Formulas Melazepam Cream [link]
What are your guy's thoughts on the melazapam azelaic acid on amazon?
You can order AA off Amazon. Melazepam Cream and here's a really informational blog post about it. I have been doing 2 nights tret alternated with 1 night AA for a few years and now and have great results, but my skin is on the sensitive side so you might be able to do it more frequently. Just remember you're using a strong active and go slowly.
I've also found that using a gentle BHA like theCosrx BHA Blackhead Power Liquid really helps. It's like the tret brings everything to the surface and then the BHA clears it out.
Not OP, and never tried Accutane, but I am also an azelaic acid convert. I use this tube and order it straight from Amazon. In fact, my derm told me to just order it online. It's worked wonders. This is a great primer on how to use it.
If you're in the US, you don't need a prescription for azelaic acid.
I personally recommend Cos De Baha 10% Azelaic Acid Serum, but they're out of stock on Amazon. However, they're in stock on Ebay: https://www.ebay.com/itm/Facial-Serum-Azelaic-Acid-10-B3-Face-Rosacea-Acne-Pimple-Pigmentation-Blackhead/133035195369. That is the Ebay seller that I used, and it took 1 week for them to deliver it from South Korea to California.
Melazepam 20% is also available on Amazon: https://www.amazon.com/Ecological-Formulas-Melazepam-Cream/dp/B001WUEJ4U/.
Azelaic acid is often recommended for redness and rosacea.
I use this one, Ecological Formulas Melazepam Cream [link]. I apply it after tret, they compliment each other.
Adelaido acid lotion will tame that right down. I used to look sunburned, now my skin is even toned pale. Look for it on Amazon Ecological Formulas Melazepam Cream [link]
Same, I use the Melazepam cream, I buy it on Amazon, Ecological Formulas Melazepam Cream [link].
Skin Profile: Normal/Combo, little oilier in the summer, dryer in the winter | Fitzpatrick 2 | Mainly just trying to maintain
Bioderma Sensibio H2O (HG)
Vanicream Gentle Facial Cleanser (HG)
Ocusoft Foaming Lid Scrub (RP)
Paula's Choice 2% BHA Liquid—just for SFs (WNP?)
Expensive Water Mist:
Avene Thermal Spring Water (RP)
Hada Labo Tokyo Skin Plumping Gel Cream (RP)
CeraVe Moisturizing Cream almost always mixed with squalane oil (HG)
Timeless Squalane mixed with CeraVe cream (HG)
EltaMD UV Clear SPF 46 - Untinted (HG)
Neutrogena Clear Face SPF 55 for when I need something water resistant (RP)
Melazepam - 20% Azelaic Acid (HG)
Nivia Moisture (RP)
EltaMD UV Lip Balm SPF 31 (RP)
I haven't changed much since the last time this was posted. The PC BHA and Avene Thermal Water are both newish products, added around the beginning of March.
I'm still happy with what I have going and there aren't really any major issues I'm concerned with addressing, mainly just enjoying having a set routine and trying to maintain what I've got going. I do think it would be fun to add a vitamin C at some point in the future for general skin tone, but I'm not in a big rush.
I like the thermal water for dampening my face after actives/before moisturizers. I'm not convinced the water is anything special so I'm really paying for the fine mist aspect, but it seems to last a long time and it would last even longer if I only used it for after actives but I've been using it twice a day after I wash my face.
I got the BHA for my SFs, but I can't say it's doing much on its own. I'm sticking with it mainly because it's not hurting anything and I'd like to use it up and give it more of a chance before I try something else. I'm using it every other day now, so I may try upping to daily use, or adding in oil cleansing on the mornings I use it to see if the two together have more of an impact.
It does look like rosacea could partially be what’s going on (not a doctor, and you should see one since rosacea can progress to be quite serious). If it is rosacea, in my experience you’re going to need something specific for it. And nothing in your current regimen will likely treat it.
Azelaic acid and metronidazole are two topical drugs commonly used.
This paper from 2003 found that azelaic acid gel, like Finacea, twice per day was more effective than metronidazole. Note that Finacea/azelaic gel is prescription only and expensive, in the US at least
This paper found that azelaic acid cream, like Melazepam, was equally effective as topical metronidazole, with higher satisfaction.
For my own skin, metronidazole cream seems to be much more effective than azelaic acid cream (Melazepam), and its more cosmetically elegant. But I wouldn’t put too much importance on my personal results.
So, azelaic acid might be a good place to start; doubly so since you don’t need a prescription and it is assumed to be safe during pregnancy. And there’s good evidence for azelaic acid on acne, as well.
I’ve been using a cleanser by REN. Their evercalm cleansing milk. It’s pricey, but I feel like it’s helped. I bought a 28$ sampling box from Sephora. The other REN products didn’t really do anything.
It’s $32, but you don’t need a lot to cleanse. It doesn’t lather, so it feels kinda weird and counter productive. I use bioderma or garneier miceller water to remove the little makeup I wear, then cleanse.
The ordinary’s alpha arbutin 2%+HA has helped my redness very much.
Also azelaic acid has helped a lot.
CeraVe Hydrating cleanser burned my skin and made my face beet red. Vanicream also makes my face slightly red, but not as bad as the CeraVe HC.
There are also products by Dr. Jart that are supposed to help redness. The Cicapair line. The color correcting treatment with 30 spf gave me closed comedones, and it moves around on my face and didn’t match the color of my pale skin.
If you know products that irritate your skin you can look up the possible culprit on www.skincarisma.com. Then look up products you’d like to try to see if they have ingredients that would irritate your skin. Good Luck!
PS; I tried fractional laser for my broken capillaries. I don’t recommend it. I don’t think it did anything and I got a scar from a blister.
IMO vitamin C serum isn't great for sun spots and melasma.
Maybe you can try one or two of these products/treatments:
Hm, have you tried ordering the 20% azelaic acid from Amazon? [link]
Was looking at this one
Is this good? And any other opinions would be helpful
Check out the rosacea HG thread - even for just general redness, the recs there are solid! Tips like "avoid alcohol and fragrance in products" are helpful to keep in mind, and then some of the ingredient recs like niacinamide and azelaic acid are helpful as well.
A good niacinamide serum to look into would be Skinlex 10% Niacinamide - affordable, has a fantastic percentage of niacinamide, and also contains NAG (N-Acetyl Glucosamine) which works with niacinamide to give you better results.
A good azelaic acid product to look into would be The Ordinary's and melazepam
There's also this AB thread for redness/irritation
A couple products that I've heard about a lot for their soothing abilities are Paula's Choice Enriched Calming Toner and Dr. Jart's Cicapair Line (I linked to Sephora, but you can find em for much cheaper.) Specifically the Cicapair Color Correcting Treatment, which balances out red tones in the skin. It would be a good addition to an AM routine!
There are also cheap ones on amazon for example:
This is a 20% azelaic acid cream. I bought it for about 12 dollars on eBay.
Here's an Amazon link to 20% AzA: https://www.amazon.com/Ecological-Formulas-Melazepam-Cream/dp/B001WUEJ4U/