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.
32 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?
I was diagnosed with rosacea in Mar 2008 (though it may be adult acne from changes in hormonal birth control). Treatment with oral doxycycline finally controlled the outbreak after 8 weeks. 2 weeks later, I had a horrible and sudden outbreak on the opposite side of my face and went back on doxycycline. I also got my first Finacea Rx 3 days ago. I saw OVERNIGHT improvement, and this is continuing daily. I have heard reports of tingling or burning–I don’t have that, but I do have an odd sensation like insect bites/stings starting about half an hour after application. It’s not bad and hardly noticeable. The improvement in my skin is amazing–even the red patch on the opposite side from the previous eruption is better!
I can’t believe it. Liana, You’re details were almost spot on for me. No pun intended. I spend countless hours peeling scabbed skin and dead skin from my face where old spots were and where I’m picked and squeezed. I’ve been suffering from skin problems for about 12-14 years (since I started college). Started mild, Progressively worse each year, and me in the pits from the emotional trodding a decade and a half of continuous and weird acne-like lesions on my forehead, scalp, and neck bring to a person’s self-esteem. Oh yeah, and lately they’ve been showing up on my chest, doing really big damage to the particularly fragile skin.
Was vaguely diagnosed a few years ago by a equally vague dermatologist with a “autoimmune skin condition of some sort, we don’t know really what, but here’s some super steroid cream and good luck with all that.”
Although starting out as rather rashy looking spots on my scalp and forehead(red, rough skin) over the years mine have consistently become quite pustular, with deep inflammation and the rest of my skin seems to be terrible. My forehead, that which isn’t currently in pustules, seems fully clogged (not with blackheads, but with visibly clogged pores that can be squeezed out). This was never the case in the past. My lower face has become quite bumpy too, not pustular but flesh colored giving my face a rough appearance.
I used steroids for too long (gee it’s great to find out that I may have been increasing my rosacea problems with it), and have now given them up for good. They would work on the inflammed spot briefly but would never completely dissipate the spot. I’m sure I’ve skirted the line with skin athropy. In looking for a better name for my diagnosis, I had dismissed Rosacea for a long time as a possibility because I had mistakenly thought I needed to have experienced large red patches of inflamed skin. In fact, I now believe my early red spots were very small “patches” which have worsened into stage 2 papules and pustules. Seems to be bit more uncommon presentation of rosacea.
I have just started a sulfur treatment two days ago(soap and ointment) and and will be adding azelaic acid in two weeks when I receive the product. The sulfur soap (probably from the licorice root extract) had a slight immediate anti-inflammatory effect, which was a relief to the most sore spots that I’ve picked and squeezed at. what a disorder to have when you’re a natural picker). Spots are still present, less inflamed, and no new ones have appeared. I’m trying not to get my hopes up, but I am hoping azelaic acid will be a helpful step for me.
Also, a bit confused here, where did Liana mention that she had seborrheic dermatitis?
Thanks for the site.
My roscea started slowly about 5 years ago (aged)75 and became really bad. Tried most available creams. At night I apply a thin layer of SAVLON cream. The big change came for me with the use of a drug (prescription ony) AROPAX (paroxetine) 20mg in the morning; prescribed by a specialist. Very little rosacea now. Somtimes in very Hot and Humid situations a little. David C.
Hi David,
Did the Paroxetine help with flushing or in other ways help you cope with rosacea ? Did you notice any other side effects ?
Great to hear that you are getting a handle on your rosacea.
davidp.
I had really bad acne starting around age 12. Benzoyl peroxide was nightmare! It left my skin feeling raw. Eventually, I went through two rounds of Accutane and that made a huge improvement. For some reason, my dermatologist kept trying other treatments… Retin-A (didn’t help much), tetracycline (I turned out to be allergic), erythromycin (useless), and the worst… chemical peels (which made my skin very inflamed).
Now I’m 32. People have been telling me for a few years that I always looked “flushed” or ask if I have a sunburn. I have noticed that my skin is very dry and sensitive to sunburn, wind, and heat, but I had pretty much given up on trying new products. They all just seemed to make the problem worse. Big surprise… I started using Finacea a few days ago and I’m already noticing a difference! I never thought about rosacea, even though one of my great-grandmothers had a terrible case. Looks like I have it too.
Thanks for this website. It’s so helpful to hear about other peoples’ experiences.
I have mild to moderate acne. I’m on retin-a for 6 months now and obagi nu-derm for 3 months and I’m liking the results. But I asked my derm if we can replace retin-a with something I can use during pregnancy coz I don’t want to worry about it if I get pregnant, and she prescribed Finacea. I still get one or two pimples every now and then and the hyperpigmentation due to the 1st 3 months with retin-a is fading. I’m scared to start Finacea because of the warning of hypopigmentation. I’m a Filipino and don’t have very white skin.. What are the odds of me getting it? Is there an initial breakout? And do you really blush when you drink something hot because of it - if so did it go away?
I was diagnosed 25 years ago (i’m 42 )and tried just about everything under the sun I had the worst experience with Metro-Gel and doxycycline did nothing
I just started using Finacea and so far I’m pleased with the results and it’s been two weeks
Hey that is great news Christine, especially after having had rosacea for so long ! All the best for finacea continuing to help you.
davidp.
Until 6 months ago, I had great skin. Then adult acne started to creep in. I have tried facils, products, nothing has helped. My doctor prescribed finacea and I have been using it twice a day for about a week. First few days we good. Now I am experiencing redness and burning. My face sometimes get warm and looks like I have wind burn. It has never looked like this before so I am not sure what to do. Should I continue with txt or stop? Thank you for your time and help.
Hi Jenn, these are common adverse effects. It would be best to return to the doc to advise whether to try to continue or not.
I have been using finacea for three weeks and see a big difference. I was diagnosed with rosacea about 10 years ago and have been getting photoderm treatments about twice a year since. They helped somewhat but in the three weeks since I have been using finacea my redness is greatly reduced. My pore size has shrunk and my skin is much smoother.
I can actually get through my workout without my face turning beet red.
Do you know if it is safe to use finacea indefinitely?
Hi, I’ve been using Finacea for about a year now. On my perscription bottle it has a discard date of November, 15, 2008… is it still safe to apply it to my skin even though its past that date?
I am 58 years old, my dermertologist says I have roscea. However, I never had the “symptoms” of roscea, I went to the Dr. because of an acne problem - at my age!! I’ve been using finacea for over a year. I find that my skin is thin (from age?) that when I attempt to press out a blackhead or postule under the skin - I end up wih the area being so bruised and red that it’s look like I’ve been burned with a cigarette, because it then scabs over. I take good care of my skin, but the pores seem to be larger than ever and makeup just don’t fill the “pits”. Any suggestions out there? Do I need a different treatment? Why am I still having acne at 58, when my mother told me at 14, I’d outgrow it!!
Thanks
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