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?
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.