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Azelaic Acid

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Finacea (USA) and Azelex (Europe) are two brand name prescription azelaic acid formulas that rosaceans are reporting works to control rosacea. Finacea comes in a gel or a foam. Azelex cream is made by Allergan. Both products are made by Bayer Healthcare. According to OptimRx "Sandoz launched an authorized generic version."


Bayer Healthcare is offering a savings coupon for Finacea by clicking here (For US audiences only) or you may try the Bayer Savings Card (For US audiences only)

There are a number of over the counter azelaic acid treatments:

Azelaic Acid Fine Powder 25 Grams

Azelaic Acid Micro Powder 150 Grams 99%

Ecological Formulas Strata Melazepam Emollient Cream

GIGI Bioplasma Azelaic Cream 15% For Oily Skin

The Ordinary Azelaic Acid Suspension 10%

In 2007 here was the status of Azelaic acid: 

Rosacea 101 page 53-4

by permission of author

There are conflicting reports about azelaic acid. Consider the first report reported in April 2007:

“Results of this study demonstrated a significantly greater potential for irritation from azelaic acid compared with metronidazole gel.” [275]
With this report done in August 2006:

“Azelaic acid in 20% cream and 15% gel formulations appears to be effective in the treatment of papulopustular rosacea, particularly in regard to decreases in mean inflammatory lesion count and erythema severity. Compared with metronidazole, azelaic acid appears to be an equally effective, if not better, treatment option.” [276]

However, some rosaceans may report irritation with azelaic acid while others report it is effective in controlling rosacea. Azelaic acid appears to be an accepted treatment so you should be aware of it use in rosacea.

“Data pooled from three between-patient trials showed a clear improvement in the azelaic acid group.” [277]

“Azelaic acid (AzA) initially was released in a 20% cream formulation, which has been shown to be effective in the treatment of mild to moderate rosacea. Recently, a 15% gel formulation was developed that vastly improved the delivery of AzA and has been proven by multiple studies to be effective in the treatment of rosacea. We present studies that examine both of these formulations, first in comparison with their vehicles and then in contrast with other well-accepted topical treatments of rosacea, such as metronidazole cream and gel.” [278]

End Notes

275 Cumulative irritation potential among metronidazole gel 1%, metronidazole gel 0.75%, and azelaic acid gel 15%.
Colón LE, Johnson LA, Gottschalk RW; Cutis. 2007 Apr;79(4):317-21.

276 Azelaic acid in the treatment of papulopustular rosacea: a systematic review of randomized controlled trials.
Liu RH, Smith MK, Basta SA, Farmer ER; Arch Dermatol. 2006 Aug;142(8):1047-52.

277 Interventions for rosacea. van Zuuren EJ, Graber MA, Hollis S, Chaudhry M, Gupta AK, Gover M.
Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003262.

278 A clinical overview of azelaic acid.
Elewski B, Thiboutot D; Cutis. 2006 Feb;77(2 Suppl):12-6.

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It has been a few years since I had health insurance to cover Finacea, but I did use it for several months. For me it helped mildly and caused no irritation, which I find odd because my skin is quite sensitive to most things. I also do not have any negative effects with the Metrogel that I am kind of stuck with until I am covered by insurance. I think my results were better overall with the Finacea, however there was no dramatic results.

I am completely unable to use any moisturizers or cosmetics from regular store shelves, so I wonder why my skin tolerates Finacea so well when others have issues? I know every body is a little different in its sensitivities, like taking the antibiotics makes my nail beds lift, however for a prescription preparation designed for people with highly sensitive skin, it is distressing that it could make some cases worse.

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