A New Topical for Acne: Rosacea Gel Killin’ It on Acne Treatment

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Finacea (azelaic acid 15% gel) works just as well as a topical retinoid (similar to Retin-A) called adapalene (Differin) for women with adult acne. Finacea was tested for 9 months against the topical adapalene gel in a 2014 study.

Results showed that Finacea gel was similar in effectiveness to adapalene 0.1% gel and that Finacea had a clear advantage in terms of tolerability. Skin redness, dryness and scaling were much lower in the Finacea (azelaic acid) treated group. That’s a big deal.

Azelaic acid 15% gel is currently used for the treatment of rosacea, but used twice a day it improved acne to the same extent as the most commonly used gels—the Retin-A (retinoid) gels.

Of note, azelaic acid 15% gel’s approved indication is in treating mild to moderate rosacea. The other bummer is the cost: a 50 gram tube of Finacea (azelaic acid 15%) is expensive, more expensive than adapalene gel 0.1% which is now available as a generic. Worth it?

Dr O.

Finacea is available as a brand name only, and will likely cost over $200 per 50 g tube, even with a discount card. If covered by insurance, it is typically considered a Tier 2 or 3 drug, meaning you’ll pay a moderate to high co-pay, though there is a manufacturer coupon that will take $10 off for insured patients. Generic adapalene is less expensive but still pricey if you’re paying out of pocket—starting at about $80 with a discount for a 45 g tube of gel. However, if you’re insured, adapalene will likely be covered as a Tier 1 drug, meaning you’ll pay only only your lowest co-pay.

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