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The brand notes that while PHAs are typically gentler (thanks to their larger molecular size compared to AHAs and BHAs), pairing them with a higher dose of azelaic acid may still lead to temporary skin purging as your skin adjusts, but patience pays off

doi: 10.1007/s00125-004-1448-x 169 SalpeterSRWalshJMEOrmistonTMGreyberEBuckleyNSSalpeterEE

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The majority are minor, but awareness of them assists patients in making informed decisions