Is azelaic acid safe during pregnancy and breastfeeding?
MotherToBaby lists topical azelaic acid among the acne treatments that may be used during pregnancy if needed. LactMed considers it low risk while breastfeeding because only about 4% is absorbed after skin use, and azelaic acid already occurs naturally in food, the bloodstream and breast milk.
Also listed on labels as: azelaic acid, Finacea, Azelex.
Azelaic acid by stage
Trying to conceive
No concern found while trying to conceivePregnancy guidance allows topical azelaic acid if needed, so there is no reason to stop while trying to conceive. [1]
Pregnant
No concern found during pregnancyMotherToBaby says products containing azelaic acid may be used during pregnancy if needed. It has not been specifically studied in pregnancy, but it is considered acceptable to use on the skin. [1][2]
Breastfeeding
No concern found while breastfeedingOnly about 4% is absorbed after topical use, and it occurs naturally in foods and breast milk, so LactMed considers it low risk. Do not apply it to the breast or nipple, and keep treated skin away from your baby. [3]
Postpartum
No concern found postpartumThe pregnancy and breastfeeding guidance already finds no concern with topical use, and nothing changes after birth. [1]
What it is
Azelaic acid treats acne, rosacea and uneven pigment. You will find it in OTC serums (often around 10%) and prescription gels such as Finacea (15%) and Azelex (20%).
Why it is a common pregnancy swap
Because retinoids and hydroquinone are usually avoided during pregnancy, azelaic acid is often suggested as an alternative for acne and dark patches. Little is absorbed through the skin.
Practical tips
- Prescription-strength products should still be discussed with the prescriber.
- While breastfeeding, keep it off the breast and nipple and off skin your baby touches.
Azelaic acid: common questions
Can I use azelaic acid while pregnant?
MotherToBaby lists azelaic acid among topical acne treatments that may be used during pregnancy if needed. Ask your healthcare provider about prescription-strength products.
Can I use azelaic acid while breastfeeding?
LactMed considers it low risk because only about 4% is absorbed and it occurs naturally in breast milk. Keep it off the breast and nipple.
Sources
- MotherToBaby. Topical Acne Treatments (fact sheet). February 2026.
- InfantRisk Center. An Overview of the Safety of Skin Care Products During Pregnancy. April 2020.
- LactMed (NIH). Azelaic Acid — Drugs and Lactation Database. Current entry.
Momclear provides educational information based on recognised ingredients. It does not diagnose, treat, or replace advice from a doctor, midwife, or pharmacist. A "no concern" result is not a guarantee of safety — always check with a healthcare professional if you are unsure.