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 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.
- Finacea Prescribing Information
- Rosacea News: metrogel less irritating than finacea
- Rosacea News: patent: water soluble azelaic acid (aka finacea)
- Rosacea News: adding `Licochalcone A’ to finacea and metrogel
- Rosacea News: focus on metronidazole
- Rosacea News: finacea available OTC in Australia