Before I boarded the plane in Northern California, I was flipping through my Facebook when I was served an ad for a new Paula’s Choice product: the Azelaic Acid Booster. Of course, as an azelaic acid devotee, my interest was piqued. I flipped through the ingredients and quickly realized I had used this product before, shipped and sold to me from the EU in the silver packaging of the RESIST Skin Transforming Multi-Correction Treatment.
Up until recently, you could have this product shipped to you from the EU, but as a commenter on my blog noted, you can no longer have this product imported into the US. This was fairly upsetting, as the product works quite well (better than The Ordinary’s Azelaic Acid suspension, in my experience) and combines AzA (10%), BHA (2%), and skin-brightening licorice root – a wonderful combination for fighting acne and post-inflammatory hyperpigmentation at the same time.
I’ve already seen some people asking about this new product, so I figured I’d so a quick review on it in case you are considering taking the plunge!
First off, I wanted to show the ingredient list alongside the new ingredient list for the Azelaic Acid Booster, which is now being sold on the US Paula’s Choice website.
Azelaic Acid Booster Ingredients
Water (Aqua), Azelaic Acid (skin-soothing, antioxidant, exfoliant), C12-15 Alkyl Benzoate (emollient), Caprylic/Capric Triglyceride (skin-replenishing), Methyl Glucose Sesquistearate (emollient), Glycerin (skin-replenishing), Cetearyl Alcohol (texture enhancer), Glyceryl Stearate (texture enhancer), Dimethicone (hydration/texture enhancer), Salicylic Acid (exfoliant), Adenosine (skin-restoring), Glycyrrhiza Glabra (Licorice) Root Extract (skin-soothing), Boerhavia Diffusa Root Extract (skin-soothing), Allantoin (skin-soothing), Bisabolol (skin-soothing), Cyclopentasiloxane (texture enhancer), Xanthan Gum (stabilizer), Sclerotium Gum (stabilizer), Propanediol (hydration), Butylene Glycol (hydration), Phenoxyethanol (preservative).
RESIST Skin Transforming Multi-Correction Treatment Ingredients
Aqua, Azelaic Acid (skin brightener/antioxidant), C12-15 Alkyl Benzoate (texture-enhancing), Caprylic/Capric Triglyceride (hydration/skin replenishing), Methyl Glucose Sesquistearate (texture-enhancing), Glycerine (hydration/skin replenishing), Cetearyl Alcohol (texture-enhancing), Glyceryl Stearate (texture-enhancing), Dimethicone (hydration), Cyclopentasiloxane (hydration), Propanediol (hydration), Salicylic Acid (Beta Hydroxy Acid, exfoliant), Butylene Glycol (hydration), Sclerotium Gum (texture-enhancing), Xanthan Gum (texture-enhancing), Allantoin (skin-soothing), Bisabolol (skin-soothing), Glycyrrhiza Glabra (Licorice) Root Extract (skin-soothing), Adenosine (skin-restoring), Boerhavia Diffusa Root Extract (antioxidant), Phenoxyethanol (preservative).
The ingredients are exactly the same, just arranged differently. This is probably due to the FDA’s packaging requirements (specifically the Fair Packaging and Label Act of 1967), which requires that all ingredients in order of concentrations up to 1% be listed in order of concentration, rather than the actual formula. Admittedly, I have not purchased a tube of the Azelaic Acid Booster, so I can’t tell you for certain that it has the identical feel and results, but I do feel pretty confident in assuming that it is the same product formula for both.
I’ve written an entire post on the benefits of Azelaic Acid (AzA), so please feel free to check it out if you want to know all the details, but in general, AzA is an anti-inflammatory, anti-bacterial ingredient that is frequently used in acne and rosacea treatments, especially with sensitive skin types that are more prone to irritation from ingredients like benzoyl peroxide (BP) and tretinoin (Retin-A). In one study I cited, 20% AzA combined with glycolid acid (AHA) has been shown to be just as efficacious in treating mild-to-moderate acne as .025% tretinoin. In another study, it was shown to be as effective as 5% BP as well as 1% clindamycin.
It is also bacteriostatic, repressing the ability of bacteria to reproduce, which may be why it is anti-inflammatory. In addition to these characteristics, it is also a tyrosinase inhibitor, with a special affinity for abnormal melanocytes, making it ideal in treatment of melasma or post-inflammatory hyperpigmentation (PIH). In fact, it is much safer and typically more preferred to hydroquinone, which is a skin lightener that tends to target all skin cells and has created concerns due to potentially causing tumors in mice. In an open study comparing 20% AzA twice daily to 4% hydroquinone, it showed to be just as effective if not more effective than the hydroquinone in reducing mild melasma.
This formula also contains 2% salicylic acid (BHA), a derivative of salicin. It is oil-soluable, making it more effective at penetrating to the areas most effected by acne. Like it’s cousin, AHA (frequently found in the forms of glycolic or lactic acid), it helps to break apart the corneocytes that do not shed properly, which ideally prevents breakouts from occurring. It is not as photo-sensitizing as an AHA and in many people it is not nearly as irritating, even being characterized as “soothing” or “anti-inflammatory” (perhaps due to the fact that it serves as an active metabolite of asprin). Unfortunately, according to the 2016 “Guidelines of Care for the Management of Acne Vulgaris” from the Journal of the American Academy of Dermatology, “clinical trials demonstrating the efficacy of salicylic acid in acne are limited.”
This product also contains licorice root extract, which I talked a bit about in my review of Kikumasamune Sake Skin Lotion:
Licorice root extract is similarly a tyrosinase inhibitor as well as an anti-irritant – with some studies signalling that it may be able to absorb UVA and UVB rays. It is more effective than kojic acid and some studies put it at 75x more effective than ascorbic acid (though Dr Dray raises some interesting points regarding the efficacy of L-AA). “The chief constituent of licorice root is glycyrrhizin, present in concentrations that range from 5 to 24 percent depending on the variety of licorice used.”²
I went through about half of the tube of this product before shelving it, as I felt like it aggravated the erythema in my rosacea, as most BHA products do. I’ve always avoided the areas around my nose, where I get the most flushed, and with this product I did have to apply the product there to deliver the benefits of AzA to my rosacean-prone areas.
It does have the exact same side effects as Finacea, tingling and itching upon first use (this eventually goes away, but is much worse if you are new to AzA), but this felt very assuring to me that it contained the amount of AzA that it is advertising (10%).
It also feels quite similar to Finacea Gel, but feels perhaps a bit smoother and spreads a touch easier. It also has a very Finacea-esc scent that is difficult to describe if you’ve never used azelaic acid products before. It is not strong by any means, nor does it linger, but I am very attuned to the scent after years of using Finacea.
Unfortunately, I don’t have much acne these days to tell you whether or not it is ideal for acne, but I did feel like my pores looked a bit clearer and smoother while I was using it, though not markedly better than when I use 2% BHA Liquid. Nor do I have much scarring and hyperpigmentation to be able to say for sure whether this formula helped with lightening any dark spots.
Other than the erythema, my skin did not have any issues with the formulation, and felt no more hydrated or irritated than when I use my regular Finacea.
It did feel much more efficacious than the Ordinary’s Azelaic Acid 10%, which I used briefly a couple of months back. To compare, the Ordinary’s AzA is suspended in a very powdery, primer-like silicone formula, which I wasn’t the biggest fan of. I also didn’t feel like it really did much, and I didn’t feel any of the itchy tingle of the AzA on application.
All-in-all though, if you do well with BHA and are looking to add AzA to your routine, I think this is a wonderful product.