Finacea is a topical rosacea treatment made by Intendis. Its main active ingredient is azelaic acid 15%. Officially, finacea “is a topical treatment for the inflammatory bumps and lesions of mild to moderate rosacea”.
Other topical and systemic treatments exist for the papules and pustules of rosacea, so finacea is not your only choice for treating these rosacea symptoms.
A 20% cream formulation of the drug (Azelex, Allergan) has been marketed since 1996 for treatment of acne.
In the last few years several papers have been published comparing finacea to other topicals, and most importanly for us, assessing finacea’s efficacy in treating some rosacea symptoms.
A 2003 article titled A Comparison of 15% Azelaic Acid Gel and 0.75% Metronidazole Gel in the Topical Treatment of Papulopustular Rosacea found that “Azelaic acid gel was superior to metronidazole gel in reduction of mean nominal lesion count and mean percent decrease in inflammatory lesions”. Neither treatment had a clinically appreciable effect on telangiectasia. Benefits from using metronidazole plateauxed after 8 weeks, but continued to be seen by those using azelaic acid.
This study showed azelaic acid was better than metronidazole, even more so than the 1999 study titled A comparison of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea. This 1999 study concluded that 20% azelaic acid cream was merely a safe and effective alternative to metronidazole 0.75%.
Another 2003 article titled Efficacy and safety of azelaic acid (15%) gel as a new treatment for papulopustular rosacea: Results from two vehicle-controlled, randomized phase III studies showed that 15% azelaic acid gel was significantly better at reducing papules and pustules than the vehicle gel (i.e. compared to a preparation without the active ingredient).
A followup paper in 2004 titled Azelaic Acid 15% Gel: In the Treatment of Papulopustular Rosacea summarized the 2 cited 2003 papers above. Additionally one can find published papers relating to azelaic acid and the treatment of perioral dermatitis and acne.
With regards to treating the erythema (redness) of rosacea, only erythema in the presence of papules and pustules has been studied. Thus finacea’s affect on transient erythema is unknown.
Finacea is not suitable to those with a sensitivity to propylene glycol. About 20% of various trialists report mild side effects from using finacea, compared to 14% using just the vehicle gel. See the prescribing information for more warnings and safety usage information.
A 2004 paper titled Noxious sensory perceptions in patients with mild to moderate rosacea treated with azelaic acid 15% gel was unable to prove via the lactic acid facial sting test (and others) that azelaic acid caused increases in the senstivity of 40 mild to moderate rosacea sufferers.
A 2005 paper titled Cumulative irritation potential of metronidazole gel compared to azelaic acid gel after repeated applications to healthy skin found that when applied to healthy skin, metronidazole gel was less irritating than azelaic acid.
What has been your experience with Finacea ? Would you recommend it to other rosacea sufferers ? Feel free to leave a comment below.
19 comments ↓
I have found Finacea very helpful reducing chronic
inflammation with redness and burning, on my forehead.
Thanks Chris,
great to hear that finacea has worked so well for you.
davidp.
I’ve had Rosacea for a few years but it came and went with varying levels of redness etc. About two years ago I started taking Financea and was using this to treat the rosacea - with moderate success. However, about a year ago I started having other problems - gynocomasita - and was told to stop taking the Finacea. The gynocomastia problems subsided and I therefore started using topical OTC cortizone cream to manage flair-ups. Now that winter has settled in and an agressive flair up occurred, I’ve decided to go see my dermatologist. He has prescribed me with metronidazole topical lotion 0.75% that I put on twice a day, and he told me I needed to stay away from OTC cortizone. I’ve been taking the metronisdazole for 1 week and find that my redness is worse. Is this normal? In addtion, I’m very active and particpate in bike racing and other high stress sports - ice hockey, skiing etc. -, do I need to stop doing them to get over this? Appreciate this site, it very helpful.
Thanks in advance,
Jim
Hi Jim, when you say `take finacea’ do you mean orally or just topically ? You are doing the right thing to steer away from regular use of cortisone, even in the otc strengths. It can cause thinning of the skin, and even bring on rosacea itself. Some people do react badly to metronidazole, but in general it is well tolerated. You may also be suffering from withdrawal from the topical steroid. You may need to gently wean yourself off the cortisone.
Vigorous exercise may cause a flush, but this doesn’t mean that you can never do these things, just that you need to be aware and try to keep cool.
Hopefully you will be able to get over your steroid withdrawal and get back to a normal routine soon. Here are some hints on how to treat steroid induced rosacea symptoms http://rosacea-support.org/treating-steroid-induced-rosacea
davidp.
Finacea has been working for me. I have suffered 17 years with rosacea metro gel 75mg made my skin more inflamed. I am glad i found finacea thank you dr sidney.
I have suffered 17 years with rosacea. I was using metro gel 75mg.the flare ups and pustilès was getting worse.finacea has saved my life the flare
ups diminished and no more papules or pustiles.
Finacea has been a wonderful discovery. I started using it two weeks ago and I am thrilled to “have my face back.” Roseacea causes redness of course, but I also look older and more tired when it gets really bad. Finacea has made it all dissapear. There is some redness but it is so manageable now.
I am curious about any toxicity or contra-indications, side effects, etc. of Finacea gel. Are there any?
Hi Kt,
The Finacea prescribing information lists some contra-indications. See
http://www.finacea-us.com/legal/finacea_pi.pdf
for more details.
ADVERSE REACTIONS:
Overall, treatment related adverse events, including burning, stinging/tingling, dryness/tightness/scaling, itching, and erythema/irritation/redness.
…
In patients using azelaic acid formulations, the following additional adverse experiences have been reported rarely: worsening of asthma, vitiligo depigmentation,
small depigmented spots, hypertrichosis, reddening (signs of keratosis pilaris), and exacerbation of recurrent herpes labialis.
davidp.
i have just started using finacea, and it works great. I am a teenager, and unfortunitely have a mild case of rosacea, which i had mistaken as acne. after irritating it so much with acne products, i got finacea, and i could see a difference the morning after i first used it. each day my skin is becoming less red. i have found that if you put on a moisturizer first, like purpose redness reducing moisturizer, and the put the finacea on before the moisturizer is completely dry, it cuts down on the slight itchy feeling. i would recommend finacea.
How does one diagnose rosacea vs acne? I have a 16 year old daughter that is always battling acne and nothing has worked for her (although she hasn’t yet tried oral antibiotics, which we’re trying to avoid). I have rosacea and Finacea works very well for me.
Hi Corena, rosacea and acne can share similar looking symptoms - especially with the papules and pustules that you see see with rosacea. I had a go at answering this question in the FAQ:
see http://rosacea-support.org/frequently-asked-questions
Section 1.2
“Is is common that Rosacea does not present with blackheads that are seen with Acne Vulgaris. Also the age of onset, and the location of redness is a clue. Rosacea is commonly an adult disease, and is generally restricted to the nose, cheeks, chin and forehead. It can coexist with acne vulgaris.
Some rosacea sufferers have a significant acne component in their symptoms so it can be easily confused with acne vulgaris. The papules and pustules of rosacea tend to be less follicular in origin.”
Many rosacea treatments are suitable for acne sufferers, but the reverse is less true.
davidp.
Hi David,
I started using Finacea about 2 weeks ago. I am seeing what I believe to be “good skin.” I am too skeptical to get really excited over it just yet. I was diagnosed 2 years ago and have tried many things out of desperation…metrogel, doxy, nizoral, otc’s, herbals, yogurt, vinegar, oils, antibacterials, $2500 light treatments, even urotherapy. The hardest part is how long it takes me to put on makeup. My kids think I am obsessed with my face. I hate makeup. I never had to wear it.
I have rosacea on my face, arms, ears, neck and chest.
Maybe TMI for some, but first, after bathing, I had to sit with a 10x mirror and remove the multitude of peeling scabs, many “invisible.” Meaning, you couldn’t even see them until you scrape your nail over an area and then a dry round scab would appear, that was as thin as a layer of skin from, say a sunburn. The reason I had to go thru such lengths, is because all those flakes and scabs become really pronounced when foundation is applied to them. I was actually losing my left eyebrow from the scabs, the hair wouldn’t grow back because of them.
But since using the Finacea gel, I don’t have them anymore. Every pore on my face was enlarged and full of something that I couldn’t sqeeze or scrub out. It is all disappearing. I actually can slide my fingers over my skin and feel smooth, soft skin. It’s been years. I mixed some in a small spray bottle and spray it into my scalp, all other areas, uses less and gets into those areas better.
I still have a really bad outbreak around my nostril and between my eyebrows, but every day is looking a little more hopeful.
What product could I use next to ensure the proper washing, and restore the proper microbes to my face?
Thank you and the persons that created and made this drug available.
Hi Liana, good luck with continuing to use finacaea. Have you ever tried an anti-fungal like nizoral to see if it might help any seborrheic dermatitis you have ?
Hi David. In the first paragraph, I talk about using nizoral, yes prescription strength and the shampoo.
I was recently diagnosed with Rosacea. I had redness on my neck, face, and chest every time I got out of the shower. It went away after about 30 minutes, but I didn’t know what was causing the red blotches. It is typical for acne to appear? I have clear skin except for the redness. Will it definitely progress to stage 2? Does that happen to everyone eventually? Does it go away with age? I am 34 now.
Thanks,
L
I’ve been using finacaea for about 5 weeks now and have noticed little difference. In fact, I just had a break-out today. Would it be working for me by now or should I continue with it another 2 weeks until I go back to the derm.? What else would work for me?
How long can you safely use finacea? I have been using it for close to two years without problems.I only have patches of rosacea now that flare up when heat is on, or it gets humid otherwise I am pretty clear.It has also lightened my melasma.I would like to continue using it.
Hello I just was diagnosed with a mild case of rosacea and have been taking finacea for a week today and tonight I was getting ready for a party I was hosting and was really stressed and hot and then I had the most awful dizzy spell.Should I be worried?So far finacea has been working and I have been so excited to hope my face will return to normal,but wonder if I should continue using it.Please Help
Thanks Marla
Hi Marla,
It is possible that the finacea has side effects that are not mentioned in the prescribing information. It could also be stress of course. Take it easy and get back to your doctor if you notice more dizziness.
davidp.
Are there any reports of Finacea making heartburn worse?
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