azelaic acid
Azelaic acid (Finacea) is a dicarboxylic acid. It's a topical medication used to treat mild-to-moderate rosacea in adults. It works by easing skin redness and inflammation. Azelaic acid (Finacea) is applied to the skin twice daily, in the morning and evening. This medication comes as a gel and foam. Some side effects of azelaic acid (Finacea) include mild burning, tingling, and itching. It's available as brand name and generic medications.
What is Azelaic acid (Finacea)?
What is Azelaic acid (Finacea) used for?
- Treatment of papules and pustules in adults with mild-to-moderate rosacea
How Azelaic acid (Finacea) works
Azelaic acid (Finacea) is a dicarboxylic acid. The exact way it treats rosacea isn't well-understood. But it's thought to work by easing skin inflammation.
Drug facts
Side effects of Azelaic acid (Finacea)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Less Common Side Effects
- Dryness
- Redness
- Rash
- Peeling skin
- Skin irritation
Azelaic acid (Finacea) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: eye swelling, swelling of the face and throat, trouble breathing, rash, hives
The following Azelaic acid (Finacea) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Burning, itching, crusting, or peeling of treated skin
- Wheezing or trouble breathing
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Change in skin color
- Mild skin irritation, redness, or dryness
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Pros and cons of Azelaic acid (Finacea)
Pros
- Available as a gel and foam
- Applied to the skin; convenient for people who don't like pills
- Can wear cosmetics after it dries
Cons
- Might take months to see improvement
- Can cause skin irritation, such as burning or dryness
- Can cause skin color to lighten
Pharmacist tips for Azelaic acid (Finacea)
- Let your dermatologist know all the products you are considering using or currently using for your skin. Using certain products with azelaic acid (Finacea) can cause or worsen skin irritation. Avoid products that can be too harsh or drying on your skin, such as those that contain alcohol or astringents.
- While you're using azelaic acid (Finacea), try to avoid triggers that might worsen your rosacea, such as alcohol, hot drinks, or spicy foods.
More tips on how to use azelaic acid (Finacea)
- Before applying azelaic acid (Finacea), wash the area to be treated with a mild cleanser and pat dry with a soft towel.
- Avoid applying azelaic acid (Finacea) too close to eyes and mouth, since this can cause irritation. If contact occurs, wash your eyes with large amounts of water. If the irritation doesn't go away, contact your dermatologist.
- Don't apply bandages or wraps on the areas of skin where you applied azelaic acid (Finacea). Putting bandages or wraps over the areas might affect how much medication gets absorbed.
- Azelaic acid (Finacea) can cause dryness, itching, scaling, or stinging, especially during the first few weeks of treatment. This is more commonly seen in the gel and cream. Speak to your dermatologist if the irritation gets worse or does not go away over time.
- If you're using azelaic acid (Finacea) foam, make sure you shake well before use. Safely throw away the bottle 8 weeks after opening, even if there's still medication in it.
- If you don't see improvement in your rosacea after 3 months, let your dermatologist know. They might want to talk with you about other options.
- You can apply cosmetics over azelaic acid (Finacea) after it dries to give your skin the chance to absorb the medication. If you apply cosmetics before it dries, your skin might not absorb the full dose of the medication.
Common questions about Finacea
Finacea (azelaic acid 15%) foam and gel are only FDA-approved to treat rosacea. There's a different brand called Azelex (azelaic acid 20%) cream that's approved to treat mild-to-moderate acne. Both Finacea and Azelex are available only by prescription from a dermatologist.
No, you can only get Finacea (azelaic acid) and other prescription-strength azelaic acid at the pharmacy with a prescription from a dermatologist. There are some topical azelaic acids that can be found over-the-counter (OTC), such as azelaic acid 10% cream. In general, these products have a lower concentration of azelaic acid compared to what's in the prescription-strength version and they aren't FDA-approved to treat rosacea. Rather, OTC azelaic acid is typically marketed to help with acne or skin blemishes. Talk with your healthcare team if you have more questions about the difference between prescription and OTC azelaic acid.
The length of time it takes for you to see results from Finacea depends on how severe your skin condition is and your body's response to the medication. You might need to apply this medication twice daily for up to 3 months before your skin starts to get better. Let your dermatologist know if your skin doesn't start to improve by this time because they might ask you to consider other options.
Typically, your dermatologist will ask you to apply Finacea to your face twice daily, in the morning and evening. Ask your care team if you're not sure how often to use this medication.
Burning, tingling, and pain at the application site are the most common side effects of Finacea. You're more likely to experience these side effects if you use the gel form of the medication. Most of the time, these side effects are mild and temporary, and should go away after the first few weeks of treatment. Typically, you can continue to use Finacea if you experience mild burning or tingling. But let your dermatology team know right away if your symptoms are severe or if the skin irritation doesn't get better after a few weeks. They might ask you to consider other options.
Be careful using Finacea if you already have dry skin because it can worsen your condition. This medication can cause side effects such as dryness, peeling, and rash, especially during the first few weeks after you start treatment. If the skin irritations are severe or do not go away with time, talk to your dermatologist to see if this medication is still a good option for you.
Ask your dermatologist if you can continue Finacea during pregnancy. Because this medication is applied to the skin, it's not likely to get absorbed into the bloodstream and cause harm to the unborn baby. In general, azelaic acid is considered safe during pregnancy, but you should talk with your healthcare team if you have specific concerns.
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Risks and warnings for Azelaic acid (Finacea)
Azelaic acid (Finacea) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Loss of skin color
Azelaic acid (Finacea) can cause loss of skin color in the areas of skin where you apply the medication. This is because this medication prevents your skin from making melanin, the pigment responsible for skin color. The loss of skin color is more noticeable if you have a darker skin tone. Let your dermatologist know if you notice any changes in skin color.
Eye and mouth irritation
Azelaic acid (Finacea) can cause irritation in the eyes, mouth, nose, and genitals. If it gets in your eyes, wash your eyes with lots of water. Speak to your dermatologist if the irritation does not go away after washing your eye.
Worsening asthma (gel only)
People who have used different forms of azelaic acid, including the gel form, have reported worsening asthma. If you have asthma, it's important to keep your rescue inhaler with you so you can use it in the rare case of an asthma attack. If you've experienced an asthma attack while using azelaic acid (Finacea), let your healthcare team know right away. They can talk with you to see if you should continue treatment or consider other options.
Flammable (foam only)
Azelaic acid (Finacea) (Finacea) foam is flammable because of one of the ingredients in the can. The foam can easily catch on fire. Avoid fire, flame, or smoking during and after using the medication. Don't store the foam bottle where the temperature is too hot (above 120°F). Don't damage or burn the empty foam bottles because it can still leak the flammable ingredient or cause an explosion. Call your local waste management service to see how you can safely dispose of the empty foam bottles.
Azelaic acid (Finacea) dosage
Tube of gel| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50g of 15% | 1 tube | $36.79 | $36.79 |
Typical dosage for Azelaic acid (Finacea)
- Finacea (azelaic acid 15%) foam: The typical dose is to apply a small amount of foam (enough to cover the affected area) to the entire face twice daily, in the morning and evening.
- Finacea (azelaic acid 15%) gel: The typical dose is to massage a thin layer of gel to the affected areas of the face twice daily, in the morning and evening.
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