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Topical dicarboxylic acid (anti-acne / anti-rosacea)

Azelaic Acid 15–20%

Brand names: Finacea (15% gel — rosacea), Skinoren (20% cream — acne), Azaduo (20% gel)

Azelaic acid is a naturally occurring dicarboxylic acid used topically 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 and normalises follicular keratinisation, and additionally exerts anti-inflammatory effects useful in rosacea.

Prescribing in practice

  • Transient local irritation, burning, stinging and itching are common on initiation, particularly in the first few weeks; advise patients to persevere and reduce application frequency if troublesome.
  • It is a useful option in pregnancy and breast-feeding where many other acne agents are avoided, and does not cause photosensitivity.
  • Avoid contact with the eyes, mouth and other mucous membranes, and apply to clean, dry skin.

Monitoring

No laboratory monitoring is required; assess treatment response and tolerability clinically over several weeks.

Counselling the patient

  • Apply a thin layer to the affected area and rub in gently after washing.
  • Some tingling or burning is normal at first and usually settles with continued use.
  • Allow adequate time for benefit, as improvement may take several weeks.

Evidence & guidelines

Topical azelaic acid is recommended in current dermatology guidance as a treatment option for acne and rosacea.

Reference: BAD Acne Guidelines 2021; BAD Rosacea Guidelines; NICE CG184; 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).

Related

Curated clinical cross-links plus same-class fallbacks.

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