Short answer. Azelaic acid and niacinamide may be compatible, but no trial we found tested the pair on skin. A 2025 review says azelaic acid "may be compatible with other antioxidant agents like vitamin C or niacinamide" (Petrovici et al., PMC12472904). If your azelaic acid came on prescription, ask your dermatologist or pharmacist before you add niacinamide.
Add the products on your shelf to Oleah. Oleah can flag products on your shelf that may not belong together. The day 3 check-in is the first look after you start.
Published 5 November 2026. Last updated 5 November 2026. Sources checked 31 October 2026. Written by the Oleah team from the sources listed below.
What are azelaic acid and niacinamide?
Azelaic acid is an acid that a yeast makes naturally. A 2024 review calls it "a non-phenolic, saturated dicarboxylic acid with nine carbon atoms, naturally produced by the yeast Malassezia" (Feng et al., PubMed 39464747).
Niacinamide is a form of vitamin B3. DermNet describes nicotinamide, also called niacinamide, as "the water-soluble, active form of vitamin B3" (DermNet, nicotinamide).
Can you use azelaic acid and niacinamide together?
They may be, though no source we found sets a firm rule. The 2025 review by Petrovici and colleagues says azelaic acid may be compatible with niacinamide. It also says that any extra benefit from combining them has yet to be fully substantiated (PMC12472904).
A 2025 pharmacy lab study mixed azelaic acid and niacinamide in one cream base. The authors wrote that the mix of azelaic acid and niacinamide "also showed sustained stability with BUDs of 180 days" (PubMed 40164066). BUD means beyond-use date. That study tested the cream in the lab, not on anyone's skin.
| Question | What the sources say |
|---|---|
| Can they share a routine? | A 2025 review says they may be compatible. |
| Do they work better together? | The same review says that has yet to be fully substantiated. |
| Has the mix been tested? | One lab study found the mix stable for 180 days. It did not test skin. |
| Which goes first? | We did not find a source that sets an order. Follow the label. |
| Prescription azelaic acid? | Ask your dermatologist or pharmacist first. |
What strength is your azelaic acid?
Check the label first. A 2024 review says "In clinical applications, the most commonly used concentrations of AZA are 15% and 20%" (Feng et al., PMC11512533). The same review says the strength used in cosmetic products "is typically lower and often combined with other ingredients."
DermNet says azelaic acid "is available at a concentration of 20%" as a cream in a number of countries (DermNet, azelaic acid). It says a 15% gel was approved for use in the US. If yours was prescribed, ask your dermatologist or pharmacist before you add niacinamide. Cleveland Clinic says to use prescribed azelaic acid cream "as directed on the prescription label" (Cleveland Clinic).
Which goes on first?
Follow the label on each product you own. We did not find a dermatology source that sets an order for these two. Cleveland Clinic says niacinamide "can be used once or twice daily after gentle cleansing during your regular skin care routine" (Cleveland Clinic, niacinamide). For the usual order of steps, read what order should you apply skincare.
What does the evidence say?
"Local application of 15% or 20% AZA is well tolerated in humans" Xiaoyue Feng and colleagues, Clinical, Cosmetic and Investigational Dermatology, 2024, via PMC
The same review lists the main side effects as "stinging, burning, or itching." For your routine, this means adding one product at a time. Then you know which one your skin is reacting to.
How do you add them one at a time?
- Pick the new one. If you already use one of the two, keep it the same and add the other.
- Patch test it first. The American Academy of Dermatology (AAD) says to "Apply the product to a test spot twice daily for seven to 10 days" (AAD).
- Add one new product at a time. Dermatologist Marisa Garshick, MD, FAAD, told the AAD "it is always best to introduce one new product at a time to ensure your skin can tolerate it" (AAD, 28 October 2025).
- Add the products on your shelf to Oleah. Oleah can flag products on your shelf that may not belong together. The day 3 check-in is the first look after you start.
- Keep the rest of your routine the same. Same cleanser, same moisturiser, same sunscreen.
How can you tell how it is going over time?
Look at a record, not one mirror glance. Take the morning face scan in Oleah, which takes about 30 seconds. Then look at the day 3 check-in, the day 7 report and the day 14 report.
These are looks at your own scans. They are not a promise that anything will change by a set day. If you change two products in the same week, you cannot tell which one made the difference. For more on this, read how to know if skincare is working.
What if your skin stings?
If a product stings, burns or makes your skin red, wash it off and stop using it. If a doctor prescribed it, ask them first. If your skin stays sore, see a pharmacist or doctor. If it blisters or swells, see a doctor today. If your lips, tongue or throat swell, or you have trouble breathing, call emergency services now. Oleah is not a doctor and does not give medical advice.
For more on when to stop, read when should you stop using a skincare product.
How to check this on your own shelf
Oleah is our iPhone app for the skincare you already own. You add the products on your shelf or in your routine, and each morning you take a quick face scan that takes about 30 seconds. Oleah can flag products on your shelf that may not belong together. There is a check-in on day 3, a report on day 7 and a report on day 14. Oleah is not a doctor and does not give medical advice.
Download the free iPhone beta. Add the products on your shelf, then take a quick face scan in the morning.
Related: can you use niacinamide and vitamin C together? and how do you read a skincare ingredient list?
Questions people ask
Can you use azelaic acid and niacinamide together? A 2025 review says azelaic acid may be compatible with niacinamide. No trial we found tested the pair on skin.
Which goes first, azelaic acid or niacinamide? Follow the label on each product. We did not find a dermatology source that sets an order.
Can I add niacinamide to prescription azelaic acid? Ask your dermatologist or pharmacist first. Cleveland Clinic says to use prescribed azelaic acid as directed on the prescription label.
Can I start azelaic acid and niacinamide in the same week? Start one at a time. Dermatologist Marisa Garshick told the AAD it is always best to introduce one new product at a time.
What if my skin feels sore? If your skin stays sore, see a pharmacist or doctor. Oleah is not a doctor and does not give medical advice.
Sources
- Petrovici AG et al., "A Comprehensive Review of Azelaic Acid Pharmacological Properties, Clinical Applications, and Innovative Topical Formulations", Pharmaceuticals, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12472904/. Accessed 31 October 2026.
- Feng X et al., "Azelaic Acid: Mechanisms of Action and Clinical Applications", Clinical, Cosmetic and Investigational Dermatology, 2024. https://pubmed.ncbi.nlm.nih.gov/39464747/ and https://pmc.ncbi.nlm.nih.gov/articles/PMC11512533/. Accessed 31 October 2026.
- Marianni B et al., "Compatibility of Active Pharmaceutical Ingredients Combinations Compounded in Cleoderm™, a Cream Base for Personalized Dermatological Treatments", International Journal of Pharmaceutical Compounding, 2025. https://pubmed.ncbi.nlm.nih.gov/40164066/. Accessed 31 October 2026.
- DermNet, "Nicotinamide". https://dermnetnz.org/topics/nicotinamide. Accessed 31 October 2026.
- DermNet, "Azelaic acid". https://dermnetnz.org/topics/azelaic-acid. Accessed 31 October 2026.
- Cleveland Clinic, "Azelaic Acid Cream". https://my.clevelandclinic.org/health/drugs/18510-azelaic-acid-cream. Accessed 31 October 2026.
- Cleveland Clinic, "Niacinamide: What It Is and Skin Benefits", 6 February 2026. https://health.clevelandclinic.org/niacinamide. Accessed 31 October 2026.
- American Academy of Dermatology, "How to test skin care products". https://www.aad.org/public/everyday-care/skin-care-secrets/prevent-skin-problems/test-skin-care-products. Accessed 31 October 2026.
- American Academy of Dermatology, "A dermatologist's guide to skincare from growing up to glowing up", 28 October 2025. https://www.aad.org/news/dermatologist-guide-skincare. Accessed 31 October 2026.
Oleah tracks how your skin looks. It is not a medical device. See a doctor about skin conditions.
