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Well here you are, one of the frequently asked questions about rosacea topicals has been answered.
Does it matter whether I apply my rosacea prescription topical before or after I use a moisturizer ?
This recently available abstract suggests that in fact it doesn’t matter.
The study looked at the absorption of finacea before and after moisturizer lotions were applied and was unable to find a significant difference.
So now you know; you can apply your topicals before or after you moisturize and it won’t make any difference.
Cutis. 2009 Mar; 83(3):119-24., Del Rosso JQ, Lehman PA, Raney SG., Valley Hospital Medical Center, Las Vegas, Nevada, USA.
The medical management of rosacea increasingly has involved not only the appropriate selection of topical medication but also patient education and specific recommendations regarding appropriate skin care.
The recognition that epidermal barrier dysfunction and transepidermal water loss (TEWL) play a pathophysiologic role in rosacea and that skin moisturization may help to mitigate signs and symptoms of the disease has led to a deeper appreciation of the importance of proper skin care in the treatment of rosacea.
Data from a percutaneous penetration study performed using human skin suggest that any of the tested moisturizer lotions may be applied either before or after azelaic acid gel 15% without a major change in the percutaneous absorption profile of azelaic acid.
[Update]: a quote from Dr. Powell’s excellent book: Rosacea Diagnosis and Management says that the medicine should always go on first; Drugs have priority-they go on first ! he tells us in italics.
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I’ll agree, my dermatologist said I could apply my metrogel before or after a moisturizer and it wouldn’t make any difference. I experimented with it either way, and it seemed to make no difference in effectiveness. I personally find it easier to apply the moisturizer just after the metrogel.
I always apply Finacea first before moisturising. It’s worth mentioning that Finacea gel is actually a white cream and I find that it soaks into the skin immediately leaving a very matte finish, sometimes slightly chalky or leaving some white powder residue.
For this reason I think applying Finacea first is best as it allows the moisturiser to help cover the whiteness left behind. You may also find Finacea really helpful if you are prone to oily skin due to its slightly matte finish.
David,
This is good to hear, because I am worried about which one to apply first. However, I am wondering about what Todd Davidson posted on the Rosacea Support Group back in April. Is it a legit study?
He said:
“There were studies performed in 2007 by a US renowed dermatologist (James Q. DelRossa) who studied the penetration of medications into the viable skin before and after applying a moisturizer. The results were for finacea (azelaic acid gel 15%) the drug penetrated into the skin better if a moisturizer was applied before the actual medication. He also found the same result with Tazorac (an acne and psoriasis medication-as well as the most potent retinoid anti-aging med). He used Cetaphil, CeraVe, and Dove moisturizer in the study and found the CeraVe to work the best.
Many people find Finacea very itchy, tingly, burning to the skin applied to dry cleansed skin. When applying a moisturizer first rather then after, these sensations seem to disappear for many people. So not only is it ok to applyFinacea to moisturized skin, it has been shown that the medication is actually penetrating better into the skin once it has been moisturized rather than dry.”
Any thoughts?
Thanks,
Eric