FDA-filed SPL labeling · retrieved through openFDA

Azelaic Acid Topical

Azelaic acid is a topical skin treatment used for the inflammatory bumps and pimples of mild to moderate rosacea.

Brand names Azelex CreamFinacea FoamFinacea GelFinaceaAzelex +1 more
Drug class Decreased Protein Synthesis
Rx/OTC Forms 2 Routes Topical · Cutaneous
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 10 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveNov 11, 2021
Clinical labels in scope 10
AvailabilityRx/OTC
Earliest approval/marketing year 1995
FDA-listed product records 22
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Other forms & routes:
Azelaic Acid Topical at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Azelaic acid is an effective topical treatment for the red bumps and pimples of mild to moderate rosacea. Mild skin irritation in the first few weeks is common and usually fades, but stop use and seek help for any signs of a serious allergic reaction or significant skin changes. Use it consistently as directed, and check with your prescriber if you have asthma or a darker skin tone.

📖 Azelaic Acid Topical: Patient Information Guide

A plain-language walkthrough of Azelaic Acid Topical — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Azelaic acid topical products are used to treat rosacea on the face. Specific approvals depend on the product:

  • Azelaic Acid Gel 15% is indicated for the topical treatment of the inflammatory papules and pustules (red bumps and pimples) of mild to moderate rosacea.
  • Finacea Foam is also indicated for the topical treatment of the inflammatory papules and pustules of mild to moderate rosacea.
  • Neither product has been evaluated for treating the general facial redness (erythema) of rosacea when bumps and pimples are absent, even though some redness reduction was observed in clinical studies when both types of symptoms were present.
⚙️How it works

Azelaic acid works locally within the skin, though its exact mechanism in rosacea is not fully known. It has demonstrated antimicrobial activity against bacteria like Propionibacterium acnes and Staphylococcus epidermidis, possibly by interfering with their protein production. It may also help normalize how skin cells grow and shed, reducing the formation of clogged pores. Studies with Azelex cream showed a reduction in the thickness of the outer skin layer and key proteins involved in pore-clogging.

💊How it's taken

Azelaic acid is applied directly to the skin — never taken by mouth. The general schedule is twice daily, morning and evening. Cleanse the affected area with a gentle, mild cleanser and pat dry before applying a thin layer. Wash your hands right after use.

  • Finacea Foam should be shaken before use and applied to the entire facial area
  • Avoid occlusive (airtight) dressings, harsh cleansers, astringents, and exfoliating products
  • Cosmetics may be applied after the product has dried
  • Follow your prescriber's instructions and your specific product's label for complete guidance
🤒Side effects — in detail

The most common side effects with azelaic acid gel affect the skin at the application site:

  • Burning, stinging, or tingling (reported in about 29% of users in clinical trials)
  • Itching (pruritus) — about 11%
  • Dry, flaking, or scaling skin — about 8%
  • Redness or irritation — about 4%

These reactions are usually mild and most common in the first few weeks of treatment. If you develop severe or persistent irritation, stop using the product and contact your doctor. Serious allergic reactions — including facial swelling, difficulty breathing, or hives — are rare but require immediate medical attention.

⚠️Warnings & precautions
  • Serious allergic reactions: Cases of angioedema (deep swelling under the skin), facial and eye swelling, difficulty breathing, and hives have been reported. Stop use immediately and get medical help if these occur.
  • Skin irritation: Burning, stinging, and itching are common early in treatment. If irritation is severe or lasting, discontinue use and talk to your doctor.
  • Skin lightening (hypopigmentation): Rare cases of lightened skin have been reported. Patients with darker complexions should be monitored closely for early signs.
  • Eye and mucous membrane irritation: Keep the product away from your eyes and mouth. If it contacts your eyes, rinse well with water and see a doctor if irritation persists.
  • Asthma worsening: Worsening of asthma has been reported. If you notice your asthma getting worse, consult your physician.
🔀What it interacts with

The FDA label for azelaic acid topical does not identify specific drug, food, or supplement interactions. However, certain skin product combinations may increase irritation:

  • Alcoholic cleansers, tinctures, and astringents — may worsen skin irritation; avoid while using azelaic acid
  • Abrasive cleansers and peeling agents — may increase skin sensitivity; avoid during treatment

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Allergy: Do not use if you are allergic to azelaic acid or any ingredient in the product
  • Asthma: Tell your doctor if you have asthma; worsening has been reported with azelaic acid use
  • Darker skin tones: Rare skin lightening (hypopigmentation) has been reported — your doctor should monitor for early signs
  • Pregnancy: Topical azelaic acid is minimally absorbed and not expected to reach the baby in meaningful amounts, but discuss with your healthcare provider before use
  • Breastfeeding: Azelaic acid is naturally found in human milk; topical use is not expected to meaningfully change milk concentration or expose the infant — discuss with your doctor
  • Children: The safety and effectiveness of Finacea Foam have not been established in pediatric patients
  • Older adults: Clinical studies included adults 65 and older with no overall differences in safety or effectiveness, though some older individuals may be more sensitive
📡Pharmacodynamics — effects in the body

Azelaic acid works through local effects within the skin. Clinical studies of Finacea Foam indicate that its effectiveness in reducing rosacea symptoms is driven by these local skin-level actions rather than by systemic (whole-body) effects. After topical application, plasma concentrations and urinary excretion of azelaic acid are not meaningfully different from normal background levels.

🔬Pharmacokinetics — how your body processes it

Only a small amount of azelaic acid is absorbed through the skin after topical use — approximately 3–5% reaches the outer skin layer (stratum corneum) and up to 10% penetrates into deeper skin layers, with about 4% absorbed into the bloodstream. The body processes and eliminates it mainly through the urine, largely unchanged. The half-life (time for the body to clear half the absorbed amount) is roughly 12 hours after topical dosing, compared to about 45 minutes after oral dosing — meaning absorption through the skin is the rate-limiting step. Azelaic acid is also a natural dietary component found in whole grains and animal products, and the body produces small amounts on its own.

📦How to store it

Store at 25 ◦ C (77 ◦ F); excursions permitted between 15–30 ◦ C (59–86 ◦ F) . store at temperatures above 120°F (49°C).

📄 Written from Azelaic Acid Topical’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Azelaic Acid Topical — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is azelaic acid used for?
It's used to treat the red bumps and pimples that come with mild to moderate rosacea — a chronic skin condition that mainly affects the face. It's applied directly to the skin, not taken by mouth. It hasn't been studied specifically for treating the general facial redness of rosacea when bumps aren't present, so it's best suited for the active bumpy flare-ups.
My skin is burning and stinging after I apply it — is that normal?
Yes, that's actually one of the most commonly reported side effects, especially in the first few weeks of use. It usually settles down as your skin adjusts. That said, if the irritation is severe, getting worse rather than better, or just not improving at all, stop using it and give your doctor a call — you shouldn't have to tough it out through significant discomfort.
How do I apply Finacea Foam correctly?
Shake the can well before each use. Gently wash your face with a mild cleanser, pat it dry, then apply a thin layer of foam to your whole face — cheeks, chin, forehead, and nose — twice a day, morning and evening. Wash your hands right after. Once it's dried, you can apply makeup or other cosmetics on top. Avoid using harsh or exfoliating cleansers, astringents, or alcohol-based toners while you're on this treatment.
Can I use this if I'm pregnant or breastfeeding?
Only a tiny amount of azelaic acid is absorbed through the skin, so it's not expected to reach your baby in meaningful amounts during pregnancy or breastfeeding. Azelaic acid is also naturally present in breast milk to begin with, so topical use isn't expected to change that. Still, it's always a good idea to check with your doctor or midwife before starting any skin treatment during pregnancy or while nursing.
I have asthma — should I be worried about using azelaic acid?
It's something to be aware of. There have been reports of asthma getting worse in some people using azelaic acid products. Make sure your prescriber knows about your asthma before you start. If you notice your breathing or asthma control getting worse after you begin treatment, contact your doctor right away.
How long does it take to see results, and how long do I need to use it?
Clinical studies typically run 12 to 15 weeks, and that's generally the timeframe doctors use to assess whether it's working for you. Your prescriber should check your progress around the 12-week mark — if you're not seeing improvement by then, they may want to revisit your diagnosis or treatment plan. It's meant to be used continuously during that period, not just on days when your skin flares up.
Is Azelaic Acid Topical available over the counter?
Both — Azelaic Acid Topical is sold both over the counter and by prescription, according to its FDA labeling. Lower strengths or certain forms are often available without a prescription, while higher strengths or specialized forms still require one. Ask your pharmacist which version is right for you.
When was Azelaic Acid Topical first available?
Azelaic Acid Topical has been available in the United States since at least 1995, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Azelaic Acid Topical?
Azelaic Acid Topical is supplied by 14 manufacturers listed in the FDA NDC Directory, including A-S Medication Solutions, Almirall, LLC, Actavis Pharma, Inc..

💬 Answers drafted from Azelaic Acid Topical’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Azelaic Acid Topical comes

Azelaic Acid Topical is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Topical cream, ointment or gel

On the skin
Brands 14% Azelaic Acid Acne Azelex Finacea
How this form is used
What it may be used for
  • Azelaic Acid Gel 15% is indicated for the topical treatment of inflammatory papules and pustules of mild to moderate rosacea
  • Azelex cream: clinical studies showed antimicrobial activity and reduction of skin-layer changes associated with rosacea and acne-related conditions
Important instructions
  • Apply to affected skin areas twice daily (morning and evening) in a thin layer
  • Cleanse skin gently and pat dry before applying; avoid alcoholic cleansers, astringents, abrasives, and peeling agents
  • Avoid contact with eyes, mouth, and mucous membranes — rinse with plenty of water if contact occurs
  • For external use only — not for oral, eye, or intravaginal use
Available strengths 4 strengths
21 FDA-listed product records

Inhaler

On the skin
Brands Finacea Foam
How this form is used
What it may be used for
  • Finacea Foam is used for the topical treatment of the inflammatory papules and pustules of mild to moderate rosacea
Important instructions
  • Finacea Foam: Shake well before use
  • Finacea Foam: Cleanse the face with a mild soap or soapless cleanser and pat dry before applying
  • Finacea Foam: Apply a thin layer twice daily (morning and evening) to the full face — cheeks, chin, forehead, and nose
  • Finacea Foam: Wash hands immediately after applying; cosmetics may be applied once the foam has dried
Available strengths 1 strength
1 FDA-listed product record

📊 Azelaic Acid Topical across the U.S. market

How Azelaic Acid Topical appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

2
Dose forms
14
Manufacturers
8
Brand names
22
FDA-listed product records
1995
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

A-S Medication Solutions14%
Almirall, LLC14%
Actavis Pharma, Inc.9%
Glenmark Pharmaceuticals Inc., USA9%
Guangzhou Ariel Medical Technology Co., Ltd.9%
LEO Pharma Inc.9%
Other makers36%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Azelaic Acid Topical is used

A general measure of how commonly Azelaic Acid Topical is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Azelaic Acid Topical is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

94,548
Medicaid prescriptions filled (Q1–Q4 2025)
$4.1M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Azelaic Acid Topical prescribed? Of the 1,596 medications we measure, Azelaic Acid Topical ranks #519 by Medicaid prescriptions — more than 67% of them.

Where Azelaic Acid Topical ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Azelaic Acid Topical product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

azelaic acid 0.15 MG/MG Topical Gel

94,548 Medicaid prescriptions (Q1–Q4 2025) 100% of Azelaic Acid Topical prescriptions shown $4.1M gross reimbursement (before rebates) ≈ $43 per prescription (gross)

Summed across the 5 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1041518

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Azelaic Acid Topical, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 5 of 6 listed Azelaic Acid Topical NDCs with Medicaid activity.

🔍 Compare Azelaic Acid Topical products

A representative set of FDA-listed product records for Azelaic Acid Topical — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 22 of 22 products — FDA National Drug Code Directory. See every product, package size and price: browse all 22 Azelaic Acid Topical NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Azelaic Acid Topical RxCUI 618278 3 dose forms · 5 strengths
  1. Dose form (SCDF) Topical Foam RxCUI 1659799 In current FDA listings
    Clinical drug / strength (SCD) azelaic acid 150 MG/ML RxCUI 1659800
  2. Dose form (SCDF) Topical Gel RxCUI 618283 In current FDA listings
    Clinical drug / strength (SCD) azelaic acid 0.15 MG/MG RxCUI 1041518

Look up RxCUI 618278 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Azelex Cream Finacea Foam Finacea Gel Finacea Azelex 14% Azelaic Acid Acne

🏭 Manufacturers & labelers

A-S Medication Solutions 3 Almirall, LLC 3 Actavis Pharma, Inc. 2 Glenmark Pharmaceuticals Inc., USA 2 Guangzhou Ariel Medical Technology Co., Ltd. 2 LEO Pharma Inc. 2 Amneal Pharmaceuticals of New York LLC 1 Bryant Ranch Prepack 1 Encube Ethicals Private Limited 1 Encube Ethicals, Inc. 1 Guangdong Bisutang Biotechnology Co., Ltd. 1 Sandoz Inc. 1 Sun Pharmaceutical Industries, Inc. 1 Taro Pharmaceuticals U.S.A., Inc. 1

RxNorm drug class

Azelaic Acid Topical belongs to the Other anti-acne preparations for topical use class.

Drug family (ATC) Other anti-acne preparations for topical use

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Nov 11, 2021
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Azelaic Acid Topical.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Azelaic Acid Topical after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
10
NDC products indexed
22
Distinct labelers/manufacturers represented
14
Linked representative label
Sandoz Inc.
Linked label effective
Nov 11, 2021
Composite sections available
22
Linked SPL Set ID
66178511-5c1a-4ecd-bc98-2ceb54e710ac
Linked SPL Document ID
d6c8343f-d169-4924-9fa2-4fbf097a32a7
Open the linked representative label on DailyMed ↗
NDC package records associated with this linked SPL 1

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 10 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Sandoz Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.