Quick Comparison
Azelaic Acid
- • OTC and prescription strengths
- • Helps redness + bumps
- • Generally well-tolerated
- • Can sting initially
Metronidazole
- • Prescription-only
- • Reduces inflammation
- • Often used for papulopustular
- • Gentle for many users
How They Differ
Choosing depends on access, tolerance, and symptom pattern.
Availability
Azelaic acid is OTC at lower strengths; metronidazole requires a prescription.
Primary focus
Azelaic acid targets redness and bumps; metronidazole focuses on inflammation control.
Tolerance
Both are usually well-tolerated, but azelaic acid may tingle early on.
Use cases
Metronidazole is often first-line for inflammatory bumps, while azelaic can be a versatile option.
How to choose
If you want an OTC option, start with azelaic acid. If bumps are persistent or you need a prescription approach, discuss metronidazole with a clinician.
Last updated: 2026-01-16