Azelaic Acid

About Azelaic Acid

Azelaic acid is a naturally occurring dicarboxylic acid. On the skin it reduces inflammation, acts against the bacteria involved in acne and normalizes the way skin cells shed. The 15 percent gel and foam are approved for the inflammatory papules and pustules of mild to moderate rosacea; the gel label says the effect on rosacea redness without bumps has not been studied. The 20 percent cream is approved for mild to moderate inflammatory acne.

Burning, stinging, tingling, itching, dryness and scaling are common, mostly in the first weeks. All three labels warn that azelaic acid can lighten skin, so people with darker complexions are watched for early color changes, and all warn to keep it out of the eyes and mouth. Worsening of asthma has been reported with the gel and foam. The foam’s propellant is flammable: no smoking, flames or heat during and right after applying it.

Improvement takes time: the Azelex label says acne usually improves within four weeks, and the foam label says to reassess the diagnosis if rosacea has not improved after twelve weeks. Because the strengths, bases and approved uses differ, a prescription names one product, and the pharmacist cannot swap the acne cream for the rosacea gel or the reverse.

Taking Azelaic Acid

How to take it

Twice a day, morning and evening. Wash with a mild cleanser, pat dry, rub a thin layer gently into the affected skin and wash your hands. Keep it away from the eyes and mouth, and let it dry before applying makeup.

If you miss a dose

Apply it as soon as you remember unless it is almost time for the next application; then skip it. Do not apply extra to make up.

Storage

At room temperature, away from moisture; do not freeze the gel or cream. Keep the foam can away from flames and heat. MedlinePlus says to discard the gel pump and the foam eight weeks after opening.

Interactions to know about

The labels list no drug interactions, but the gel and foam labels say to avoid alcohol-based cleansers, tinctures, astringents, abrasives and peeling agents on treated skin and not to cover it with dressings. Tell the prescriber if you have asthma. If it gets into the eyes, rinse with plenty of water.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Azelaic Acid differs from pharmacy to pharmacy

The 15 percent gel is where the choice is: generic tubes from several manufacturers cost pharmacies far less than Finacea, so a prescription that allows substitution is quoted on the generic and one that names Finacea on the brand. Even for the generic, a tube is a single item that pharmacies mark up differently.

Finacea Foam and Azelex have no generic, so every pharmacy pays a similar wholesale price and quotes differ by margin alone; moving from a brand price to a generic one means a new prescription for the gel, if the prescriber agrees it suits the condition.

Ways to pay less for Azelaic Acid without insurance

• For rosacea, ask the prescriber whether the generic gel would suit you instead of the foam, and make sure the prescription allows substitution.
• If Finacea Foam or Azelex is prescribed, ask the manufacturer whether it offers a savings or patient assistance program.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Azelaic Acid

1. 1.Is this the gel, the foam or the cream my prescriber intended?
2. 2.How much should I use, and can I put moisturizer or sunscreen over it?
3. 3.What should I do if the burning or stinging does not settle?
4. 4.Should I watch for lighter patches on my skin?

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