Finacea Gel for Rosacea and Redness?

Finacea can in fact help with the redness or erythema associated with rosacea, to a certain degree. Finacea is better with the bumps or papules and pustules that comes with rosacea. If redness is more of your concern, an alternate topical is Mirvaso gel. Mirvaso has the indication to reduce the redness. Other treatment options include oral antibiotics and laser treatments.

for the flushing/blushing type...and a 50 gm tube lists for more than $220...and for that price you've almost paid for half a laser treatment that will offer better, longer lasting results...personally think finacea is one of those often prescribed drugs that may not be as helpful as many assume...here is a section of the FDA approved package insert for finacea...so be careful of what type of rosacea you have before you pay for your Rx...

"---INDICATIONS AND USAGE---------------------------

FINACEA Gel is indicated for the topical treatment of inflammatory papules and pustules of mild to moderate rosacea/ Efficacy for treatment of erythema in rosacea in the absence of papules and pustules has not been evaluated."

 

Finacea is one of my favorite prescriptions.  It works really well for rosacea pimple-type breakouts.  It will not help redness at all.  Some patients can't tolerate it because it can be irritating. 

Most of my patients that have Rosacea do very well with Finacea gel. This is a prescription product that contains azelaic acid, which significantly reduces redness and bumps.

As this is a prescription medication, you will need to see your doctor for an evaluation to find out if it is right for you.

Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)

To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. A good website that educates you about rosacea is rosacea dot org 

To help treat your rosacea a detailed history, together an examination is needed. Once this is established a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -

1. Lasers (to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL- BBL  can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness. 

2. Creams - anti inflammatory- Rozex, Azalelic acid, Solantra. Creams are effective in 30% of cases. 

3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. Vitamin A cream can be used in very low concentration and gradually titrated. See a medical dermatologist for this. 

4. For females- Mineral make up is recommend- paraben and preservative – talc free. 

For the best results, be holistic in your approach, start off with the foundations of rosacea management, - avoiding flare factors, use of anti- inflammatory agents, and then progress to 

consult a dermatologist for both medical and laser treatment options,

Kind regards.

Dr Davin S. Lim.

Laser Dermatologist.

Brisbane, Australia. Real Self Advisory Board. 

Azelaic acid is one of the more fascinating drugs in dermatology. It is a dicarboxylic acid, (two carbon-oxygen groups) which is interestingly produced by the same yeast  organism ( Malassezia Furfur) that causes "sun  spots", the all too common Tinea Versicolor. It can be found in wheat, rye, and barley.

 Like  a college student who keeps switching majors, this is a drug which has long been seeking  its niche in the dermatology armamentarium. At first it was to be a drug for acne, for which it was approved. Its use in acne is only mildly praised by most of my dermatology colleagues. ( Except in pregnancy where it is one of our few safe options). It then seemed to become popular as a bleaching agent, especially for melasma. Though off label for this indication, it does work, but not to an overwhelmingly impressive degree.

   Finally, it seems to have found its role in the treatment of Rosaea. Some very recent work by the outstanding researcher Dr. Richard Gallo, the chairman of the dermatology department at the University of California, San Diego underscores this. His study showed that Azelaic Acid inhibits the Toll-like Receptor 2 ( has nothing to do with tolls like such as in a toll road, but is actually  from the German word Toll which roughly means "wow" according to my friend Dr. Helmut Tilch), kallikrein 5,  cAMP ( cyclic adenosine monophosphate, the favorite of biochem teachers everywhere), pathway. Many dermatologists, including myself, regard this pathway activation  as the cause of Rosacea.

   This action downregulates cathelicidins, normally a crack part of the skin's defense mechanisms, Cathelicidins are at a much higher level in the skin of those with Rosacea. It is the cathelicidins that cause the redness, edema, and irritation characteristic of this blushing disorder.  Azelaic acid ( in  Finacea), can specifically target those proteins that spark the signs and symptoms of rosacea.

  One interesting side note in Dr. Gallo's study was that lower levels of azelaic acid (AZA) seem to work better than higher levels. Most dermatologists feel that finacea gel (15% AZA) is superior to Azelex cream ( 20% AZA). I had always thought the rational for this was that gels penetrate better than creams. However, it may be that the lower concentration found in Finacea, may, per se, be more efficacious.