Azelaic acid is a topical treatment that helps with inflammatory rosacea and facial redness. It is most frequently prescribed as a 15% gel (often under the brand name Finacea), though lower strength over-the-counter formulations exist.
Azelaic acid works primarily as an antioxidant and anti-inflammatory agent. This soothes the skin reducing redness and swelling.
Azelaic acid can be used continuously over the long term without any risk of creating bacterial resistance. An advantage is that it is gentle on the skin which makes it better tolerated by sensitive skin which is common in rosacea.
When first applying azelaic acid, it is common for patients to experience mild, transient stinging, itching, or a tingling sensation. This is a temporary reaction that usually settles after a few weeks. Applying a gentle moisturiser before the azelaic acid can help minimize this.
