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Hi Carole, azelaic acid reduces the growth of the keratin reducing the thickness of the skin (acne suffers tend to have a thicker skin which means it gets more congested) due to this skin peels would not be advisable. I would recommend continuing for 6 months with the gel and anti-biotics and having a good skincare routine including an anti-bacterial wash, oil controlling moisturiser. With all things give it all time and if in 6 months the skin has not improved then re think what to do next. Vicki