Topical anti-acne / anti-rosacea

Azelaic acid

Brand names: Skinoren (cream 20%), Finacea (gel 15%)

Azelaic acid is a topical dicarboxylic acid used for mild-to-moderate acne and for the papulopustular lesions of rosacea.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It has antimicrobial activity against Cutibacterium acnes, normalises keratinisation and reduces inflammation, with an additional effect on excess pigmentation.

Prescribing in practice

Transient burning, stinging and itching at the application site are common and patients should be warned to expect them.
Avoid contact with the eyes, mouth and other mucous membranes, washing with water if accidental contact occurs.
Benefit develops over several weeks of regular twice-daily use.

Monitoring

No laboratory monitoring is required; review skin response and tolerability clinically.

Counselling the patient

Apply to clean, dry skin and a mild tingling or stinging at first is normal.
Avoid getting the product in the eyes or mouth.
Continue regular use for several weeks before judging benefit.

Evidence & guidelines

Topical azelaic acid is recommended by NICE as an option in the management of acne and rosacea.

Reference: SmPC Skinoren / Finacea; NICE NG198 (Acne 2021); BAD Rosacea Guideline 2021; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways