From the Guidelines
Finacea, a prescription medication containing 15% azelaic acid, is recommended for the treatment of rosacea and acne, with application of a thin layer to affected areas twice daily, morning and evening, after cleansing, as it has been shown to improve symptoms in 51% of patients with marked improvement or complete remission 1.
Mechanism of Action
Finacea works through multiple mechanisms, including antimicrobial properties against P. acnes bacteria, reducing inflammation, and normalizing abnormal keratinization (skin cell buildup) that contributes to both acne and rosacea.
Application and Dosage
For optimal results, consistent use for at least 12 weeks is recommended, with most patients seeing improvement within 4-8 weeks.
- Apply a thin layer to affected areas twice daily, morning and evening, after cleansing.
- If you have sensitive skin, start with once-daily application and gradually increase to twice daily as tolerance develops.
Side Effects and Tolerance
Common side effects include temporary burning, stinging, or itching upon application, which typically diminish with continued use. Finacea is generally well-tolerated and can be used alongside other skincare products, though you should wait until it dries before applying other products.
Recommendation
The use of Finacea is conditionally recommended for patients with acne, as stated in the guidelines of care for the management of acne vulgaris 1.
From the FDA Drug Label
The exact mechanism of action of azelaic acid is not known. Azelaic acid has been shown to possess antimicrobial activity against Propionibacterium acnes and Staphylococcus epidermidis. A normalization of keratinization leading to an anticomedonal effect of azelaic acid may also contribute to its clinical activity.
The drug Finacea is actually azelaic acid, it is used for its antimicrobial and anticomedonal effects.
- Main uses: treatment of acne and rosacea.
- Key benefits:
From the Research
Finacea Overview
- Finacea, also known as azelaic acid 15% gel, is a topical treatment for rosacea 3.
- It has multiple modes of action, including an anti-inflammatory effect achieved by reducing reactive oxygen species 3.
- Clinical studies have shown that azelaic acid 15% gel is an effective and safe first-line topical therapeutic option in patients with mild-to-moderate papulopustular rosacea 3.
Efficacy and Safety
- Significant continuous improvement in the number of inflammatory lesions and in erythema has been shown over a period of 15 weeks with azelaic acid 15% gel 3.
- Adverse effects associated with azelaic acid 15% gel are mostly mild or transient and do not usually necessitate discontinuation of therapy 3.
- A study comparing azelaic acid gel 15% plus oral doxycycline 40 mg versus metronidazole gel 1% plus oral doxycycline 40 mg found that both regimens were safe, efficacious, and well tolerated 4.
Comparison with Other Treatments
- Azelaic acid 15% gel has been compared to metronidazole gel 1% in combination with oral doxycycline 40 mg, with results showing a possible trend toward greater and earlier benefit with the azelaic acid-based regimen 4.
- Topical metronidazole, sulfacetamide/sulfur, and azelaic acid are generally effective for patients with mild rosacea, while combination therapy with oral tetracyclines and topical agents is the first-line choice for moderate papulopustular rosacea 5.
- Maintenance treatment with topical metronidazole decreases relapses and allows for longer intervals between flares 6.