Ecological Formulas Melazepam Cream, 2 Ounce (Pack of 1)

I have rosacea type 1 and although the evidence for azelaic acid helping with flushing is largely anecdotal, there have been some studies showing it can be helpful with erythema. More importantly, I've tried prescription azelaic acid in the past and found it to be helpful with lowering the inflammation/redness so I wanted to continue using it.Unfortunately I had a problem with my new insurance wanting to cover the prescription gel and was still on hold after over a month in the process. I was going crazy and couldn't wait anymore, especially since I had this awful, terrible rash of bumps all around my mouth for months that wouldn't go away. I suspected it was perioral dermatitis, which azelaic acid is supposed to help as well so I was eager to get my hands on some.My husband also has acne rosacea and his skin was acting up pretty badly so I decided to bite the bullet and order some of this stuff for us both. I'm so, so glad I did. It's only been 2 weeks of using the cream and the PD around my mouth is GONE. After months and months of trying everything under the sun to cure it. It's still too soon to say about the flushing (the research points to around 8 weeks before seeing max effect on that) but overall my pores are looking better and it also got rid of a weird dry patch on my nose. My husband's skin is also clearing up very nicely.I do still have a weird rash on my forehead that I suspect is fungal acne, which this product has not helped clear up (I'm going to try an OTC fungal cream for that). HOWEVER, this product IS fungal acne safe which is awesome, so I feel confident to keep using it while I tackle that issue next.As many have mentioned, this cream is a little gritty, but honestly I don't find it that bad at all. I just mix a little bit of it with another facial moisturizer to apply and I barely even notice the grittiness. Best of all, I have experienced ZERO irritation with this cream, whereas with the prescription gel I would sometimes get burning and flushing after applying. I'm thinking it's because this is in a more moisturizing base.Overall I'm super satisfied with this product, and even if they ever do get around to filling my prescription azelaic acid I'll probably just keep using this instead.

2/8/25: Background, I have oily skin. I take 10mg of accutane every 3 days. I use a .5% SA wash 1x/day. I've been using this for just a week 1x/day and so far so good. My skin feels a lot smoother, bit lighter, no negative reaction yet. My routine:- cleanse face, pat face dry- apply a pea size all over (only at nite for now)- layer a humectant and occlusive moisturizer on topI have a bit of PIH that I'd like to remove so will see how it works in a couple months and will update review.

If you're looking for a replacement for your overseas source for 20% azelaic acid, this works in a pinch but the formulation is weird and unpleasant. Most notably it contains small sharp crystals, it's not just "gritty" as some users complain, the pieces are actually painfully sharp. I think some user irritation with this due to this. I couldn't get clear photos to show, but if you rub in some on the back of your hand and tilt your hand back in forth in the light you can see tiny clear flakes, like glitter, that almost feel like glass if you can get them up and onto your fingernail. Some component of this formula crystalizes and it's gnarly.It's also quite unpleasantly thick, so to manage both of these issues I mix mine with something else in my skincare routine, like toner, and rub and mix it in the palm of my hand for several minutes to break down the crystals a little. Even still when I apply it I can always feel a few. This is a stupid amount of effort to make this product usable.

To a beginner with facial acids, use caution when approaching this product. This cream is a 20% azelaic acid product and as such, is extremely potent. If you have never used face acids before, consider starting with a lower concentration before graduating to this 20% product. That being said, I found this to be an excellent product and a great alternative for some prescription azelaic acid products such as Finacea which comes in both a cream and gel but is usually only a 15% concentration. While I like the texture of The Ordinary's 10% Azelaic Acid better, I prefer this Melazepam cream because of the higher concentration. At 20% results such as skin color evening and pigmentation fading can be seen much more quickly. The best way to use this product is to apply a thin layer to the skin after cleansing and toning in the evening. Allow the product to sit for about 20 mins, then continue on with moisturizer, etc. It is important to allow the product to sit before continuing on because it needs to be at a certain pH level in order to be most effective, and applying other products disrupts the pH of the cream. Overall, one of my favorite facial acid products.