Can azelaic acid remove darkening around the lips?

In general, azelaic acid can help improve certain types of perioral hyperpigmentation, but its effectiveness is limited for cases caused by genetic or structural factors. If in doubt, it is advisable to consult a healthcare professional beforehand. The detailed analysis is as follows:

If the darkening around the lips is due to post-inflammatory pigmentation or dullness caused by excessive sebum production, azelaic acid may be effective. It works by inhibiting melanin production and accelerating pigment metabolism. With consistent long-term use (typically 2–3 months), it can gradually lighten perioral darkness while regulating sebum secretion and improving local skin condition, showing relatively noticeable results in such cases.

However, if the perioral darkening is caused by genetic factors, inherent skin tone differences, or structural issues (such as dense vellus hair), azelaic acid is generally ineffective. This type of hyperpigmentation has little to do with abnormal melanin deposition, and azelaic acid cannot alter genetic traits or anatomical structures. Blind usage not only yields minimal improvement but may also cause skin irritation or discomfort. Alternative, targeted approaches are recommended in these situations.

Prior to using azelaic acid, perform a patch test behind the ear to assess tolerance. Begin initially with low frequency (e.g., every other day) and on a small area. Avoid mucosal regions, as the skin around the lips is sensitive. Discontinue use immediately if redness, swelling, or stinging occurs, and seek medical advice when necessary.