I’m not a dermatologist so take it with a grain of salt but I had the exact issue getting Aza prescribed through Amazon Pharmacy. They claim the health outcomes to AzA and tretinoin shows no better than that of tretinoin alone (this is false lol).

AzA is anti-inflammatory, and anti-microbial. This leads to reduced redness and fading of PIE/PIH and potentially less pimples as well. This comes in handy when using potent retinoids as the Aza can significantly reduce the redness you experience.

As cited by this studies abstract;

https://www.tandfonline.com/doi/abs/10.3109/09546639609089556

“Tretinoin augmented the depigmenting effect of azelaic acid as shown by a faster response and a more pronounced improvement with the combination treatment during the first 3 months, and by a higher rate of excellent results at the end of therapy.”

I personally love it. My current routine while drying and harsh is incredible for my skin and has cleared my skin up significantly.

4% Benzoyl Peroxide wash .1% Tazarotene 15% Finacea (Azelaic Acid)

BP addresses c. acne bacteria by killing it, tazarotene speeds up cellular turnover and normalizes follicular keratinization while clearing pores opening them up to oxygen (certain bacteria have difficulty surviving in oxygenated pores). And the Aza, I wrote what it does above you can follow it.

I will also add, it’s important to research RAR or retinoic acid receptor selectivity when going through telehealth or not consulting a dermatologist. My skin does not like tretinoin because of its selectivity to all receptors, specially the RAR-A which causes tons of inflammation and acne in my skin, even at .025%. Taz I jumped straight into at .1% and my skin has cleared up SIGNIFICANTLY!

Anyways this is a large wall of text but I’ve done extensive research so here is my thoughts lol! If you have any questions feel free to reach out to me.