Azelaic acid 15% gel in the treatment of rosacea

Expert Opin Pharmacother. 2008 Oct;9(15):2699-706. doi: 10.1517/14656566.9.15.2699.


Rosacea represents a chronic inflammatory dermatosis of uncertain pathophysiology. There are several associated risk factors and the need for long-term treatment is well recognized. This diverse disease is frequently difficult to manage and has a significant impact on quality of life. There are several topical and oral treatments available, of which azelaic acid 15% gel (Finacea) is the first new treatment for rosacea in more than a decade. Azelaic acid per se has multiple modes of action in rosacea, but an anti-inflammatory effect achieved by reducing reactive oxygen species appears to be the main pharmacological action. Clinical studies have shown that azelaic acid 15% gel is an effective and safe first-line topical therapeutic option in patients with mild-to-moderate papulopustular rosacea. Significant continuous improvement in the number of inflammatory lesions and in erythema has been shown over a period of 15 weeks. Adverse effects associated with azelaic acid 15% gel are mostly mild or transient and do not usually necessitate discontinuation of therapy.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Dermatologic Agents / adverse effects
  • Dermatologic Agents / pharmacokinetics
  • Dermatologic Agents / pharmacology
  • Dermatologic Agents / therapeutic use*
  • Dicarboxylic Acids / adverse effects
  • Dicarboxylic Acids / pharmacokinetics
  • Dicarboxylic Acids / pharmacology
  • Dicarboxylic Acids / therapeutic use*
  • Gels
  • Humans
  • Randomized Controlled Trials as Topic
  • Rosacea / drug therapy*


  • Dermatologic Agents
  • Dicarboxylic Acids
  • Gels
  • azelaic acid