Azelaic Acid Topical Antibacterial Compare To Other Treatments OverviewHow to UseSide EffectsHow It WorksPregnancy & Breastfeeding Azelaic acid works through the following mechanism: Antibacterial activity Azelaic acid kills acne bacteria (C. acnes). Relevant Article(s): Prescription Medications Alternative Therapies for Acne Relevant Forum(s): Prescription acne medications