Azelaic acid cream not helping, is there an Ayurvedic alternative?

Question

I’ve been using azelaic acid cream for the past two months for my acne, and honestly, I was hoping for better results by now. My dermatologist prescribed it after I complained about the constant breakouts on my cheeks and forehead that leave behind dark spots. At first, I thought it was working because my skin felt a little smoother, but then I started noticing some weird stuff—like my skin getting really dry and flaky in some spots while being super oily in others. Also, I feel like my acne hasn’t really improved that much. Some days it looks better, and then suddenly, I’ll wake up with three new pimples. It’s frustrating.

I also feel like my skin is kind of irritated now? Like there’s this mild burning sensation, especially after I apply azelaic acid cream, even though I follow all the instructions. I make sure my skin is dry before applying it, and I don’t use any other strong products. I also use a gentle cleanser and moisturizer, so I don’t get why my skin is still reacting like this. Maybe it's purging, but two months seems like a long time for that?

Before this, I tried benzoyl peroxide, but it made my skin super red and sensitive, so I had to stop. My acne has always been up and down, but I really thought azelaic acid cream would help more since I read so many good reviews about it. Now I’m wondering if this is even the right treatment for me. I know Ayurveda takes a more holistic approach to skincare, and I’m curious if there’s something better suited for my skin type.

Are there Ayurvedic treatments that work similarly to azelaic acid cream but without the irritation? Could this be an internal issue, like digestion or stress, causing the acne to persist? I also wonder if there are dietary changes or herbs that might help balance my skin. I feel like I’ve been treating the symptoms, but maybe I need to fix something deeper. Any advice on what to do next?

Dr. Harsha Joy · Answer

In Ayurveda, acne is often seen as a result of imbalances in Pitta dosha, which governs heat and inflammation in the body, and Kapha, which can lead to excess oil production. The irritation and dryness you're experiencing could be a sign that the Pitta in your skin is aggravated, possibly due to the drying effect of the azelaic acid, while the excess oiliness points to Kapha imbalance. Ayurveda emphasizes treating the root cause by balancing both internal and external factors.

For a gentler, more holistic approach, you can consider herbs like Turmeric and Neem, which are known for their anti-inflammatory, antimicrobial, and skin-healing properties. Neem can be applied as a paste or used in oil form to help clear up acne without the harsh irritation. Aloe Vera is also soothing for the skin and can help with redness, dryness, and irritation. For internal healing, Triphala, a blend of three fruits, is great for detoxification and improving digestion, which is often linked to skin health. Supporting your digestive health is key, as Ayurveda believes that poor digestion (Ama) leads to skin imbalances, and improving gut health can clear up skin issues. Ashwagandha is another herb to consider for stress management, as stress can exacerbate acne by increasing inflammation and hormone imbalances.

Diet-wise, it's beneficial to focus on cooling, anti-inflammatory foods that balance Pitta, such as fresh fruits and vegetables, leafy greens, and hydrating foods like cucumbers and melons. Avoid spicy, fried, or greasy foods that may aggravate the skin, and opt for more whole grains and lean proteins. Drinking warm water with lemon or mint can also help to detoxify and promote digestion, which can have a positive impact on your skin.

You can also try an Ayurvedic facial routine, which involves gentle cleansing with oils like Jojoba (which mimics the skin’s natural oils), followed by a soothing mask made from Turmeric and Honey, which can calm inflammation and brighten skin tone.

Lastly, be patient with Ayurvedic treatments, as they focus on gradual, long-term healing. It might take a few weeks to notice significant changes, but the key is addressing both the internal imbalances and external skin care needs. If your acne persists or worsens, it’s always a good idea to consult with an Ayurvedic practitioner for a personalized treatment plan.

Azelaic acid cream not helping, is there an Ayurvedic alternative? - #16935

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