I started using Skinoren during my teenage years. It was offered to me by my dermatologist as a maintenance treatment after topical antibiotics. Ever since then, I have always been using Skinoren.
What are Skinoren and Finacea? Both of these are the trade names of the same azelaic acid treatment produced by Bayer*, in many countries available as prescription-only (POM), in a few, it’s an over-the-counter (OTC) medicine. Azelaic acid is a potent agent proven to be anti-inflammatory, antibacterial, and fighting hyperpigmentation. It is used to treat both rosacea and acne as it attacks the same bacteria, P. acnes, which cause these skin conditions. It helps with hyperpigmentation by inhibiting the overproduction of melanin, in cases of melasma and post-inflammatory hyperpigmentation. (For more robust treatment against melasma, azelaic acid is usually combined with retinoids, such as tretinoin.) However, it does not affect natural skin pigmentation, which makes it an excellent treatment for all complexions. It fights acne by affecting changes in the skin that contribute to the formation of acne, such as dead skin cell buildup. It’s been found to have similar efficacy to benzyl peroxide without significant side effects like dryness or irritation.
Skinoren comes in two forms: gel and cream.
It has been found that the 15% gel version delivers 8% of the active ingredient to the skin, whereas, 20% cream version gives only 4% of azelaic acid. (Please read the update below) I use the gel version as maintenance and an anti-spot treatment. Skinoren helped me tremendously with my bacterial acne during my teens, but when I got a relapse afterwards, in my early 20s, it wasn’t enough. I still used it along with retinoids as it is a very gentle exfoliant giving none to little irritation. In my sulphur mask review, I mentioned that I use two spot treatments; one of them would be retinoids and the other — azelaic acid. I reach for it every time I get a spot, I put it on my entire face or just on the affected area. I would say that it works in 90% of instances overnight, but stubborn cases would need a day or two more, which is totally normal. Nothing disappears magically because nothing ever appears magically in the first place. It can take a couple of weeks for a spot to form.
I highly recommend trying azelaic acid as it’s a potent ingredient, perfect for people with sensitive skin. It has a lot of properties and does not irritate skin compared to other acne-fighting agents. All skin types can use it, regardless of the need; it can serve as a gentle exfoliant. It might be stinging at first, like with all acids, but your skin will get used to it. People with rosacea can introduce Skinoren slowly, for instance by mixing it with a moisturiser during the first few weeks. By doing this, you will allow for the skin to adjust to the active ingredient gradually. Products with azelaic acid found in chemist’s shops can also be effective. Overall, I recommend Skinoren to anyone with acne, rosacea, or hyperpigmentation, as it gives excellent results proven by scientific data.
Now, there are two types of the gel, a regular one and for rosacea sufferers, the latter being slightly different in the formulation — the carrier ingredients are shifted a bit.
Ingredients of the regular gel version: 15% azelaic acid as the active ingredient; propylene glycol, polysorbate 80, lecithin, polyacrylic acid, medium-chain triglycerides, sodium hydroxide, disodium edetate, benzoic acid, purified water. (packaging)
I know that some people shop prescription drugs online from unknown sources. I would caution against that. Here are a few pharmacies from countries in which you can get the Skinoren/Finacea gel without a prescription, thus from a trusted source easily.
Italy: farmacialoreto.it €19.90; worldwide delivery;
Poland: aptekazdrowie-24.pl €14; worldwide delivery.
Update 07/04/19: I added additional information about how azelaic acid is used for melasma treatment, i.e. it’s combined with tretinoin. I also included a different pharmacy to the list.
Update 14/03/21: This post is one of my most read reviews ever, and I am embarrassed to admit that there was a mistake in it. While researching before writing the review, I read a few papers about the Skinoren products and the different vehicles and the differences between them. During my research, I came across an article stating that the gel version delivers double the amount of azelaic acid compared to the cream version. However, I had failed to save the paper, and I did not include it in my review. The truth is that the cream vehicle containing 20% of the active ingredient provides about 3.6% of azelaic acid (depending on the amount you apply), and the gel gives eight-fold the amount, so much more than I originally wrote. It doesn’t change much for anyone who bought the product based on my review, but I shouldn’t make claims without providing evidence. I promise not to do this again. Another paper says a similar thing, but the absorption of azelaic acid from the cream vehicle is said to be 3.4%. Did I understand around 4% and eight times more as 4% and 8% while doing my research? Let’s hope not because it would mean that I struggle with comprehending what I read. I thank Lisa for her comment because I wouldn’t like to mislead anyone.
*Bayer have sold their topical treatment portfolio to LEO Pharma.