Key takeaways
Azelaic acid (Finacea) and metronidazole (Flagyl) are both medications used to treat skin conditions, but they belong to different medication classes and have distinct uses. Azelaic acid is a dicarboxylic acid used topically to treat mild-to-moderate rosacea, while metronidazole is a nitroimidazole antibiotic taken orally to treat various bacterial and parasitic infections, such as trichomoniasis and bacterial vaginosis. Azelaic acid is applied to the skin as a gel or foam twice daily, whereas metronidazole is taken by mouth, typically three times a day. Azelaic acid is available as a lower-cost generic, and its common side effects include mild burning and itching. Metronidazole is also available as a generic and can cause side effects like nausea and a metallic taste. It's important to avoid alcohol while taking metronidazole due to the risk of a serious reaction. While azelaic acid is generally safe during pregnancy, metronidazole should be avoided in the first trimester. Additionally, metronidazole has more potential drug interactions, such as with disulfiram and blood thinners, compared to azelaic acid.
