Finacea (Azelaic Acid) - Topical

What Is Finacea?

Finacea (azelaic acid) is a topical prescription medication that treats a chronic skin condition called rosacea. It fights skin bacteria that cause boils (painful infection of a hair follicle), acne (hair follicles become plugged with oil and dead skin), and swelling.

It is available as a topical gel or foam to apply to the skin.

Drug Facts

Generic Name: Azelaic acid

Brand Name(s): Finacea, Azelex

Drug Availability: Prescription

Therapeutic Classification: Antiacne antibacterial

Available Generically: Yes

Controlled Substance: No

Administration Route: Topical

Active Ingredient: Azelaic acid

Dosage Form(s): Cream, gel, foam

What Is Finacea Used For?

The Food and Drug Administration (FDA) approved Finacea to treat rosacea, a skin condition characterized by redness and/or bumps on the face. This medication prevents skin infection, redness, and swelling from rosacea.

How to Take Finacea

Wash your hands before and after applying the drug. Before applying Finacea, wash your face with mild soap or soapless cleansing lotion. Apply a thin layer to the affected area of the face. Gently massage foam or gel into clean and dry skin. 

Apply twice daily or as directed. If used twice a day, apply in the morning and at night. Do not cover with dressings or wrappings.

If using foam, make sure to shake it well before applying it.

This medication is for the skin only. Do not use it vaginally or place it in your mouth or eyes.

While using Finacea, try to stay away from:

  • Cleansers with isopropyl alcohol
  • Peeling agents
  • Astringents (products often containing alcohol that shrink skin tissue)
  • Abrasives (such as scrubs)
  • Tinctures (extracts often made with alcohol)

Wait until the foam or gel has dried before using any skin care products or makeup.

Storage

Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet. Do not store your medicines in the bathroom.

Finacea should be stored at around 25 degrees Celsius (77 degrees Fahrenheit); brief exposures to 15 to 30 degrees Celsius (59 to 86 degrees Fahrenheit) are permitted. Discard any leftover medication after eight weeks from opening.

Azelaic acid is flammable. Therefore, avoid flame or fire. Do not smoke during or right after applying. Do not try to put a hole in the container, and do not set it on fire.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. Visit the FDA's website to know where and how to discard all unused and expired drugs. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you travel with Finacea, get familiar with your final destination's regulations. In general, be sure to make a copy of your Finacea prescription. Keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

How Long Does Finacea Take to Work?

Finacea begins to work within four weeks. If there is no improvement after 12 weeks of use, your healthcare provider may need to reevaluate your symptoms.

What Are the Side Effects of Finacea?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Many people who use Finacea have minor or no side effects. The most common side effect is skin irritation. Although others may occur, signs of skin irritation are:

Skin irritation occurs in the first few weeks of starting the drug, but it usually goes away. Let your healthcare provider know if it becomes intolerable or does not go away.

Severe Side Effects

Example text: Contact your healthcare provider immediately if you develop signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Severe side effects of Finacea may include but may not be limited to:

  • Rash
  • Itching, swollen and red skin
  • Peeling skin
  • Anaphylaxis (severe, possibly life-threatening allergic reaction that can cause difficulty breathing and shock, a sudden drop in blood flow)
  • Change in color of skin

Report Side Effects

Finacea may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Finacea Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage form (cream):
    • For acne:
      • Adults and children 12 years of age and older—Apply a thin layer to the affected area(s) two times a day, in the morning and evening.
      • Children younger than 12 years—Use and dose must be determined by your doctor.
  • For topical dosage forms (foam, gel):
    • For mild to moderate rosacea:
      • Adults—Apply a thin layer to the affected area(s) two times a day, in the morning and evening.
      • Children—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Finacea:

Severe allergic reaction: Avoid using Finacea if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Breastfeeding: Azelaic acid is present in breast milk. We don't know enough about the safety of Finacea in human breast milk and nursing babies. Talk with your healthcare provider if you plan to breastfeed, to weigh the benefits and risks of taking Finacea while nursing and the different ways to feed your baby.

Adults over 65: Clinical studies haven't included a large enough number of people in this age group to see whether they respond differently from younger adults. However, older adults might also be more sensitive to Finacea's side effects.

Children: The safety and effectiveness of Finacea have not been established in children.

Missed Dose

If you accidentally forgot to apply your Finacea dose to your skin, apply it as soon as you remember. If it's already close to your next scheduled dose, skip the missed application and apply the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed application.

Try to find ways that work for you to help yourself remember to routinely keep your appointments and take your medication. If you miss too many doses, Finacea might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Finacea?

Azelaic acid is not toxic. If you apply too much of it to your skin, wipe off the excess. If it gets in the eyes, rinse it with lots of water.

If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

What Happens If I Overdose on Finacea?

If you think you or someone else may have overdosed on Finacea, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Finacea, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits for any unwanted effects that may be caused by this medicine.

If your acne does not improve within 4 weeks, or if it becomes worse, check with your doctor.

If your rosacea does not improve within 12 weeks, or if it becomes worse, check with your doctor.

Hypopigmentation may occur while you are using this medicine. Check with your doctor right away if your skin color is lighter in the treated areas, especially if you have dark skin.

This medicine may cause allergic reactions, including angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have itching skin, trouble breathing, or large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs after using this medicine.

This medicine may cause skin reactions. Check with your doctor right away if you have a skin rash, burning, dryness, redness, peeling, stinging, swelling, or irritation on the skin.

What Are Reasons I Shouldn’t Take Finacea?

If you're allergic to Finacea or any of its ingredients, avoid using it. Ask your pharmacist or healthcare provider for a full list of the ingredients if you're unsure.

What Other Medications Interact With Finacea?

There are no known significant drug interactions with Finacea.

What Medications Are Similar?

There are medications similar to Finacea that also treat rosacea, including:

  • Sklice (ivermectin) 
  • Metrogel (metronidazole) 
  • Amzeeq (minocycline)
  • Rhofade (oxymetazoline)
  • SulfaCleanse (sulfur and sulfacetamide)

While all of these medications treat rosacea, some have multiple uses. For example, Sklice can also treat lice, and Metrogel treats some sexually transmitted infections (STIs).

Frequently Asked Questions

  • How long does it take for Finacea to work?

    It may take several weeks to see the full effects of this drug. Be patient. Contact your healthcare provider if you do not see any improvement after 12 weeks. They may have to reassess your symptoms.

  • Can I smoke while using Finacea?

    Although smoking is not a preferred habit, you can smoke while on Finacea. However, do not smoke right after or while applying the medicine. Azelaic acid is flammable and may catch on fire. Always wash your hands after using this medication.

  • Is it normal for my skin to change color while on Finacea?

    No. It is not normal for your skin to change color. Contact your healthcare provider as soon as you notice a change in skin color while using Finacea. This may be a sign of a severe side effect.

  • What type of soap should I use to cleanse my face while on azelaic acid?

    Use only mild soaps or soap-free cleansing lotions. Do not use harsh soaps or chemicals on your face.

  • How long is the drug good for after opening?

    After opening, throw away whatever you do not use after eight weeks or as indicated on the label.

How Can I Stay Healthy While Taking Finacea?

Patience is key when using Finacea. Unlike other topicals such as Hydrocorte (hydrocortisone), you may not see results immediately. You have to give it time to work. Sometimes, that can be as long as four weeks. However, contact your healthcare provider if you don’t see any improvement after 12 weeks. 

Living with rosacea can be stressful and overwhelming. In addition to using a medication, you can also find ways to manage what triggers your condition. Triggers may include but are not limited to:

  • Diet choices (including spicy food)
  • Sun exposure
  • Alcohol
  • Physical exercise
  • Stress

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Del Rosso JQ. Azelaic acid topical formulations: differentiation of 15% gel and 15% foam. J Clin Aesthet Dermatol. 2017;10(3):37-40.

  2. Bergman D, Luke J. Azelaic acid. Journal of the Dermatology Nurses’ Association. 2017;9(3):157-160. doi:10.1097/JDN.0000000000000309

  3. Food and Drug Administration. Finacea (azelaic acid) Gel, 15% label.

  4. Kang CN-Y, Shah M, Tan J. Rosacea: an update in diagnosis, classification and management. Skin Therapy Lett. 2021;26(4):1-8.

  5. Searle T, Al-Niaimi F, Ali FR. RosaceaBr J Hosp Med (Lond). 2021;82(2):1-8. doi:10.12968/hmed.2020.0417

By Queen Buyalos, PharmD
Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.