Compare · Ingredients

Azelaic Acid vs Cica

Azelaic Acid: Treats acne and rosacea bumps; may also help uneven pigmentation. Cica: Used in soothing moisturizers; ingredient-specific clinical evidence is limited.

Research updated 2026-10-25

Five azelaic acid tubes and bottles on white, most marked 10 percent, from Peach Slices, Paula's Choice, Facetheory, The Ordinary and Naturium

Five centella creams on white, a green-tinted jar plus tubes labeled Madagascar Centella, Madeca Cream and Cica Cream Plus

Which one?At a glance What it helps Diagrams Using both Strengths Results Safety How it works Products Questions

Which one is right for you?

Choose Azelaic Acid if…

Choose for acne or rosacea bumps, especially when uneven tone is also a concern.

Acne or rosacea bumps
Dark marks after spots
Pregnancy, where many alternatives are off the table

Choose Cica if…

Consider for a gentle moisturizer; check the complete formula and your tolerance.

Sensitive, easily irritated skin
You want a soothing moisturizer
No known plant allergies

Fine together

Can you use both?

Cica soothes and can calm the tingle of azelaic acid.

At a glance

● Azelaic Acid

● Cica

Type

Anti-inflammatory and pigment-targeting acid

Centella asiatica extract family

What it does

Treats acne and rosacea bumps; may also help uneven pigmentation.

Used in soothing moisturizers; ingredient-specific clinical evidence is limited.

Best for

Rosacea; Acne; Post-Inflammatory Hyperpigmentation

Sensitive Skin; Wrinkles and Fine Lines

Studied concentrations

15% gel for rosacea in vehicle-controlled trials; 20% creams are also used clinically.

0.1% madecassoside with 5% vitamin C in a small photoaging trial.

When to use

Morning or night, as directed by the finished product.

Morning or night, as directed by the finished product.

Time to results

Often 8–12 weeks in small cosmetic studies; results may be subtle

Comfort may improve quickly; reassess persistent dryness

Irritation

Stinging, itching and dryness can occur; reduce use for persistent irritation.

Can cause a contact rash; avoid assuming botanical products are allergy-free.

Sensitive skin

Choose a simple formula and test a small area first. Individual tolerance matters more than an ingredient’s reputation for being gentle.

Choose a simple formula and test a small area first. Individual tolerance matters more than an ingredient’s reputation for being gentle.

Available

Prescription or cosmetic status depends on the active, formula and country; check the label.

Cosmetic or OTC products; some high-strength procedures are separate treatments.

What it helps

Compare uses by strength of evidence. Evidence level describes confidence in a benefit, not its size.

Evidence level

Azelaic Acid

Cica

Strong evidenceMost established uses

Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Two large trials support 15% gel for inflammatory bumps, with some erythema improvement.

—

Moderate evidenceSome supportive research

Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

A guideline-supported topical option; evidence depends on the strength and formula.

—

Limited evidenceEarly or small studies

Flat light-brown residual marks on a fair cheek.

Post-Inflammatory Hyperpigmentation

May help acne-related pigment; the reviewed rosacea trials did not measure this benefit.

Sensitive Skin on light skin.

Sensitive Skin

Some formulas may feel comfortable, but an extract alone is not a proven treatment.

A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

A small madecassoside/vitamin C trial reported improvement; the ingredients cannot be separated.

Insufficient evidence

Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

The cited rosacea trials and acne guideline do not establish melasma clearance.

A relaxed forehead with pronounced deep horizontal furrows.

Deep Wrinkles

The reviewed sources do not establish this ingredient as a treatment for this concern.

Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

The reviewed sources do not establish this ingredient as a treatment for this concern.

Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

The reviewed sources do not establish this ingredient as a treatment for this concern.

Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

The reviewed sources do not establish this ingredient as a treatment for this concern.

Scars on light skin.

Scars

The cited combination photoaging study did not test scar treatment.

How it works

Azelaic Acid mechanism diagram. Helps calm inflammation: Acts on pathways involved in acne and rosacea. Affects pigment production: Tyrosinase-related activity may help dark marks. — Open full-size diagram
Diagram explanation and sources
Helps calm inflammation: Acts on pathways involved in acne and rosacea. Affects pigment production: Tyrosinase-related activity may help dark marks.
Schematic illustration; not a measurement of skin penetration. Effects vary with ingredient identity and formulation.
Source 1 · Source 2

Cica mechanism diagram. Contains plant compounds: Extracts may include madecassoside and related molecules. Repair signaling is being studied: Laboratory findings do not guarantee clinical repair. — Open full-size diagram
Diagram explanation and sources
Contains plant compounds: Extracts may include madecassoside and related molecules. Repair signaling is being studied: Laboratory findings do not guarantee clinical repair.
Schematic illustration; not a measurement of skin penetration. Effects vary with ingredient identity and formulation. Some illustrated pathways are experimental; laboratory findings do not establish a clinical treatment benefit.
Source 1

Using both in one routine

Built from where each one usually sits in a routine. Introduce one at a time.

Morning

Step 1

Cleanser

Step 2

Azelaic AcidMorning or night

Step 3

CicaMorning or night

Step 4

Sunscreen

Night

Step 1

Cleanser

Step 2

Azelaic AcidMorning or night

Step 3

CicaMorning or night

Strengths and forms

Concentrations

Azelaic acid strength should be read together with the product’s indication. Prescription examples include 15% gel for inflammatory rosacea and 20% cream for acne.

15%

20%

Prescription rosacea formulation

Gel formulations are labeled for inflammatory papules and pustules of rosacea. They are not simply a weaker version of a 20% acne cream.

Prescription acne cream

A cream strength used for acne. The cream base and indication differ from the 15% rosacea gel.

Choosing a strength: Choose by the concern and finished product. Cosmetic azelaic acid products are not automatically equivalent to prescription formulations.

Higher strengths: Stinging and irritation can limit use. A larger number does not prove better delivery or better results for a different diagnosis.

Formula matters: Gel, foam and cream vehicles affect delivery and tolerability. Do not compare their percentages as if they were identical formulations.

Cica usually means Centella asiatica extract, a mixture whose composition varies with extraction and standardization. There is no established percentage scale that makes different cica products equally potent.

Choosing a strength: Check whether the label names whole Centella extract, madecassoside, asiaticoside, or another purified compound.

Higher strengths: A higher extract percentage does not necessarily mean more of the compounds studied in clinical research.

Formula matters: A study of 0.1% madecassoside with 5% vitamin C cannot be used as a recommended percentage for whole cica extract.

Forms

Cream · Gel · Foam

Cream · Serum · Mask

When you’ll see results

Approximate windows, not promises.

● Azelaic Acid

● Cica

First few weeks

First few weeksAssess tolerance and texture; immediate softness can come from the base formula.

First few weeksSkin may feel softer soon after use; relief depends on the formula.

4–8 weeks

4–8 weeksSubtle changes may appear in some tested products; evidence varies.

4–8 weeksJudge hydration, comfort and whether dryness is recurring.

8–12 weeks

8–12 weeksCompare photographs in the same lighting and reassess benefit.

8–12 weeksPersistent cracking, itch or a rash needs reassessment.

3–6 months

3–6 monthsPhotoaging trials often need several months; expect modest rather than dramatic change.

3–6 monthsContinue if comfortable; hydration usually requires ongoing use.

6–12 months

6–12 monthsLong-term evidence is limited for many cosmetic actives; continue only if useful.

6–12 monthsMoisturizing does not establish reversal of structural ageing or scars.

Safety and sensitive skin

Common reactions

Stinging, itching and dryness can occur; reduce use for persistent irritation.

Can cause a contact rash; avoid assuming botanical products are allergy-free.

When to stop

Stop for persistent burning, swelling, blistering or a new rash. Seek urgent care for breathing difficulty or a severe allergic reaction.

Stop for persistent burning, swelling, blistering or a new rash. Seek urgent care for breathing difficulty or a severe allergic reaction.

Sensitive or inflamed skin

Choose a simple formula and test a small area first. Individual tolerance matters more than an ingredient’s reputation for being gentle.

Choose a simple formula and test a small area first. Individual tolerance matters more than an ingredient’s reputation for being gentle.

Important limits

Do not use a cosmetic product as a substitute for diagnosis of an unexplained, changing or persistent skin problem.

Do not use a cosmetic product as a substitute for diagnosis of an unexplained, changing or persistent skin problem.

Pregnancy

It is the usual first choice. Very little is absorbed through the skin, it has a long record, and it is what dermatologists switch people to when retinoids stop. Confirm with the doctor managing your pregnancy.

Applied to the skin, very little is expected to be absorbed, but ask the doctor managing your pregnancy. Mention it separately if you also take gotu kola by mouth.

How it works

In the skin

On the skin. The finished product delivers azelaic acid in a particular vehicle.

Entering skin. Below the 500 Da guideline; delivery still depends on the formula, solubility, stability and skin condition. Size does not prove effectiveness or penetration depth.

Conversion. No activation step is established as necessary for its intended topical role.

Skin response. Acts on inflammation, acne-related bacteria and pigment pathways; it is not simply an exfoliating peel.

Additional effects. Proposed pathways do not establish a measured depth of delivery or clinical benefit beyond the studies cited.

On the skin. The finished product delivers cica in a particular vehicle.

Entering skin. No single molecular mass. The 500 Da guideline cannot be applied to this whole ingredient family or mixture.

Conversion. No activation step is established as necessary for its intended topical role.

Skin response. Contains plant compounds studied for inflammatory and repair signalling; extracts are not chemically identical.

Additional effects. Proposed pathways do not establish a measured depth of delivery or clinical benefit beyond the studies cited.

Getting in

Below the 500 Da guideline; delivery still depends on the formula, solubility, stability and skin condition. Size does not prove effectiveness or penetration depth.

No single molecular mass. The 500 Da guideline cannot be applied to this whole ingredient family or mixture.

Product examples

Azelaic Acid

Anua Azelaic Acid 3 Cica Skin Clarifying Toner

Cica

SKIN1004 Madagascar Centella Tone Brightening Boosting Toner
La Roche-Posay Cicaplast Baume B5 — A thick repair balm for damaged, irritated skin. For after a procedure, a retinoid overdose, or a barrier meltdown.

Common questions

Azelaic Acid:What should I choose azelaic acid for?

Choose for acne or rosacea bumps, especially when uneven tone is also a concern.

Azelaic Acid:How strong is the evidence?

Two large vehicle-controlled trials support 15% gel for papulopustular rosacea. Acne has guideline support, but a 10% cosmetic serum should not be assumed equivalent to a studied prescription formula.

Cica:What should I choose cica for?

Consider for a gentle moisturizer; check the complete formula and your tolerance.

Cica:How strong is the evidence?

A 20-person study tested madecassoside together with vitamin C for six months. It cannot isolate Centella extract or establish treatment of acne, eczema or scars.

Sources

Sources and further reading

Dermapedia on YouTube