Erik Peters

Azelaic acid and tretinoin together? Absolutely!
Wanna learn why it works?

Tretinoin is the gold standard retinoid. It normalizes skin cell turnover so pores stop clogging. It builds collagen. It’s the most studied anti-aging topical product ever made.
Every derm you know uses it.

Azelaic acid is the quiet workhorse. It kills acne bacteria, calms inflammation, and blocks tyrosinase, the enzyme that makes pigment. But what’s really cool is that it preferentially targets overactive pigment cells. So it fades dark spots without lightening normal skin.

Thus, Tretinoin+azelaic acid are a great duo 👍🏼 they hit acne, redness, and hyperpigmentation from different angles. Older melasma data even showed adding tretinoin to azelaic acid got results faster than azelaic alone.

Who it’s great for:
✔️ Acne that leaves dark marks behind (PIH)
✔️ Melasma
✔️ Adult acne that also runs red and reactive
✔️ Deeper skin tones prone to pigment
✔️ Sun damage and uneven tone
Who should pause:
✖️ Pregnant or trying. Skip the tretinoin. Azelaic is generally considered a safer option, but talk to your doc.
✖️ Active rosacea flare. Azelaic yes. Tretinoin can make it angrier.
✖️ Damaged barrier. Fix that first.
How I start my patients:
Azelaic in the morning. Tretinoin at night, pea sized, 2 to 3 nights a week, then build up. Moisturizer always. SPF every single day or you’re wasting your time.
A little tingling from azelaic the first couple weeks is normal. Burning and peeling that won’t quit is not. Back off and reassess.

Give it 8 to 12 weeks. Good skin is a long game.

Save this. Send it to the friend whose dark spots won’t fade.

Dr. Erik Peterson | Board-certified dermatologist, NYC

So you want to get lasers but you’re also on Accutane? Let’s talk about the nuances to what’s safe and what’s not.

A nose by any other name would smell just as sweet; but filler in the wrong spot can be super dangerous.
Placing filler in the nose is no small feat, but its impact can be showstopping. Read along for more info. And comment NOSE to get a free scratch-n-sniff dermatology card in the mail.

Curious how I became a dermatologist? Here’s the full path…and what makes it one of the hardest roads in medicine.
∙ 4 years undergrad, USC
∙ 4 years medical school, NYU
∙ 1 year internship — 80-hour hospital weeks at Mount Sinai in NYC
∙ 3 year dermatology residency at University of Miami, where I was elected chief resident of Cosmetics and trained in Mohs micrographic surgery (skin cancer removal)
∙ Research fellowship in hair/alopecia, with training by two of the most published hair loss physicians in the world
∙ ASDS cosmetic surgery fellowship - blepharoplasty, hair transplants, liposuction, lasers, scar revision.

14+ years. Thousands of hours. One incredible specialty.