21AA 21% Azelaic Acid Cream
$99.99 — available on subscription
Prescription 21% azelaic acid for stubborn dark spots, discoloration, redness and post-blemish marks. Compounded cream · 30 mL / 1 fl oz.
Description
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Clearer, calmer, more even-looking skin—with 21% prescription azelaic acid
21AA is UluRx’s prescription compounded topical treatment containing 21% azelaic acid in an exclusive pharmaceutical cream base, not available over the counter. It is formulated for people looking to improve the appearance of stubborn discoloration while also supporting calmer, clearer-looking skin.
What 21AA can help improve
- Dark spots and discoloration
- Melasma and uneven-looking pigmentation
- Post-blemish and post-acne marks
- Visible redness
- Uneven-looking skin tone and texture
- Acne-prone and congested-looking skin
Face + body. Use up to twice daily as tolerated and as directed by your prescriber. Daily broad-spectrum sunscreen is essential.
★★★★★
“This product is off the charts. It works. It’s gentle, and it’s now a must-have in my skincare routine.”
— Britt, UluRx client
Why 21%? Because concentration matters.
There are many lower-strength azelaic acid cosmetics on the market. 21AA is different: it contains 21% prescription azelaic acid. Twenty-percent azelaic acid is a concentration with substantial clinical research behind it, including randomized trials and systematic reviews evaluating hyperpigmentation and melasma.
In head-to-head research for melasma, 20% azelaic acid has shown clinically meaningful improvement and has been compared directly with hydroquinone. Research has found 20% azelaic acid more effective than 2% hydroquinone in some comparisons and without a significant difference from 4% hydroquinone in others. Hydroquinone remains an important prescription option for appropriate patients; high-strength azelaic acid offers a well-studied alternative approach.
21% azelaic acid is only half the story
What carries an active ingredient matters, too.
21AA isn’t mixed into an ordinary over-the-counter moisturizer. UluRx compounds it in an exclusive pharmaceutical cream base, a professional compounding vehicle made for topical prescriptions and not available over the counter. The base is designed to enhance penetration and support efficient absorption into the skin. It is compatible with acids and pharmaceutical actives and is designed to be cosmetically elegant and moisturizing.
Why UluRx chose it: hypoallergenic • dermatologist tested • penetration enhancing • moisturizing • compatible with acids • no parabens • no MI/MCI • no mineral oil • no petrolatum.
This isn’t an off-the-shelf beauty cream with azelaic acid added. It is a prescription compounded treatment in a professional pharmaceutical base selected to carry active ingredients into the skin.
What’s in 21AA?
Active ingredient: Azelaic Acid 21%
Base: Exclusive pharmaceutical cream base, not available over the counter. It is hypoallergenic, dermatologist tested, moisturizing, penetration enhancing, and free of parabens, MI/MCI, mineral oil and petrolatum.
Size: 30 mL / 1 fl oz.
“I have struggled for years with dark spots, but I have sensitive skin. I use this twice a day, and I feel like a new woman. Love, love, love this stuff.”
— Staci, UluRx client
Your price and what happens next
21AA cream costs $99.99. When provider review is required, a $20 review fee applies once per order. One bottle plus that review is $119.99 before tax. Eligible review-fee waivers are calculated at checkout. Shipping is free.
- Order and questionnaire: Place your order and complete the online medical questionnaire.
- Provider review: A licensed provider reviews your information and determines whether treatment is appropriate. Allow 1–3 business days for review.
- Compounding and shipping: If prescribed, your medication is compounded and quality-checked, taking another 2–4 business days, then shipped with tracking.
If treatment is declined, we issue your refund immediately.
How to use 21AA
Apply as directed by your prescribing provider, up to twice daily as tolerated. 21AA may be used on the face or body. Avoid the eyes, mouth and other mucous membranes, and wash your hands after application. If you are introducing azelaic acid or using other strong active skincare, your provider may recommend starting more gradually.
Daily broad-spectrum sunscreen is essential when treating discoloration and helps protect visible improvement.
Build Your Skin Routine
21AA azelaic acid cream can be used as part of a broader prescription skincare routine. Take the UluRx Skin Care Quiz for personalized product recommendations.
For stubborn discoloration, explore the UluRx Dark Spot Corrector Duo. Azelaic acid and topical retinoids are also used in dermatology for pigmentation concerns, and published literature has reported enhanced skin-lightening effects when azelaic acid is used with tretinoin. If both are appropriate for your skin, explore Tretinoin Collagen Constructor. Because combining active treatments can increase irritation, follow your prescribing provider’s directions for how and when to use them.
Pregnancy and safety
Topical azelaic acid is commonly considered among the topical ingredients that may be used during pregnancy, and systemic absorption following topical application is minimal. Because 21AA is a prescription compounded medication, tell your provider if you are pregnant, breastfeeding or planning pregnancy so they can determine whether treatment is appropriate for you.
For topical use only. Do not use if you have a known hypersensitivity to azelaic acid or another ingredient in the formulation. Temporary burning, stinging, itching, dryness or irritation can occur, particularly when beginning treatment. Stop use and contact your healthcare provider for significant or persistent irritation or signs of an allergic reaction.
Frequently Asked Questions
When is the provider review fee waived?
Review-fee waivers may apply to qualifying auto-refill orders, orders of $500 or more after discounts, or eligible repeat prescriptions recognized through your signed-in account. Checkout calculates the applicable fee. The review fee, when required, applies once per order rather than once per bottle.
Which refill interval should I choose?
For once-daily facial use, a 30 mL bottle typically lasts about 60 days, so the every-two-months auto-refill option may fit that routine. Choose one-time purchase if you prefer to order as needed. Auto-refill options bill $99.99 at the interval you select. Follow your prescribing provider’s directions; treatment area and amount used can affect your refill timing.
What is UluRx 21AA?
UluRx 21AA is a compounded prescription topical treatment containing 21% azelaic acid in an exclusive pharmaceutical cream base. Each bottle contains 30 mL.
Why use 21% azelaic acid instead of a 10% cosmetic?
Lower-strength cosmetic azelaic acid products can be useful. UluRx 21AA is a prescription-strength option. The 20% concentration has substantial clinical research behind it for pigmentation concerns, including studies comparing it with hydroquinone.
Is 21% azelaic acid stronger than over-the-counter azelaic acid?
Many cosmetic azelaic acid products are sold at lower concentrations such as 10%. 21AA contains 21% azelaic acid and is a compounded prescription medication intended for patients seeking a high-strength treatment option.
How is 21AA different from hydroquinone?
They are different prescription approaches to pigmentation concerns. Hydroquinone remains an important option for appropriate patients. High-strength azelaic acid also has substantial clinical evidence, including studies that directly compared 20% azelaic acid with hydroquinone for melasma. Your provider can determine which approach is appropriate for you.
Can azelaic acid help dark spots and melasma?
Azelaic acid has been studied for melasma and hyperpigmentation. Individual response varies, and sun protection is an important part of treatment.
Can I use 21AA on my body?
Yes. Your provider may direct you to use 21AA on appropriate areas of the face or body.
How often can I use 21AA?
It may be used up to twice daily as tolerated and as directed by your prescribing provider.
Can I use 21AA with tretinoin, vitamin C or other skincare?
Azelaic acid may be used in a routine that includes other active skincare, but combining strong actives can increase irritation. Tell your prescribing provider what you use so they can recommend the appropriate schedule for your skin.
How long does a 30 mL bottle last?
A 30 mL bottle typically lasts about 60 days with once-daily facial use. The amount used and treatment area can affect how long it lasts. Follow your prescribing provider’s directions.
Do I need sunscreen?
Yes. Daily broad-spectrum sunscreen is an important part of treating discoloration and protecting visible improvement.
Is 21AA prescription-only?
Yes. 21AA is a compounded prescription medication. The cream costs $99.99, with a $20 provider review fee per order when required. Eligible waivers are calculated at checkout. Treatment is prescribed only if medically appropriate. No office visit is required.
Can azelaic acid be used during pregnancy?
Topical azelaic acid is commonly considered an option during pregnancy because systemic absorption is minimal. Tell your provider if you are pregnant, breastfeeding or planning pregnancy so they can determine whether 21AA is appropriate for you.
Clinical Research & References
Published research has evaluated 20% azelaic acid for melasma and hyperpigmentation, including randomized controlled trials and systematic reviews comparing it with hydroquinone. Individual results vary.
Selected research:
Azelaic acid versus hydroquinone for melasma: systematic review and meta-analysis of randomized controlled trials. 2023. PMID: 37457606.
Double-blind randomized trial comparing 20% azelaic acid with 4% hydroquinone for melasma. PMID: 1816137.
Systematic review of topical treatments for melasma, including 20% azelaic acid. 2023. PMID: 37550898.
Cochrane-derived review of interventions for melasma, including azelaic acid and hydroquinone comparisons. PMID: 24438951.
Meta-analysis of monotherapy treatments for melasma including azelaic acid and hydroquinone. PMID: 36566490.
Compounded medications are prepared for an individual patient based on a licensed prescriber’s determination. They are not reviewed by the FDA for safety, effectiveness or manufacturing quality in the same way as FDA-approved drugs. Individual results vary.
Azelaic acid 21% compounded in an exclusive pharmaceutical cream base. Hypoallergenic and dermatologist tested; formulated without parabens, MI/MCI, mineral oil or petrolatum.
How to order 21AA
- Order and questionnaire: Choose one-time purchase or an auto-refill plan, complete checkout, then complete the online medical questionnaire.
- Licensed-provider review: A provider reviews your information and determines whether treatment is appropriate. Allow 1–3 business days for review. A prescription is issued only if medically appropriate.
- Compounding and shipping: If prescribed, your cream is compounded and quality-checked, taking another 2–4 business days, then shipped with tracking.
Price: 21AA cream is $99.99. A $20 provider review fee applies once per order when required. One bottle plus required review is $119.99 before tax. Eligible waivers are calculated at checkout. FREE shipping. No office visit required.
If treatment is declined, we issue your refund immediately.
Questions? Email info@ulurx.com or call/text (602) 315-1530.
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