Finacea Is Backordered: Azelaic Acid Demand Outstrips Supply
Prescription Finacea is backordered as TikTok-driven demand for azelaic acid surges. Dermatologists weigh in on efficacy, strengths and pairings.
Updated
The takeaway
- Finacea, the 15 percent prescription azelaic acid gel, is backordered, with suppliers reporting patient delays, per Dr. Kiran Mian
- Azelaic acid is FDA-approved for rosacea and acne; OTC formulas typically contain 10 percent, while Skinoren Cream reaches 20 percent
- Dermatologists name azelaic acid a go-to for pregnant patients (Category B) and a retinoid alternative for sensitive skin
The prescription-strength azelaic acid gel Finacea is backordered, with suppliers reporting delays for patients waiting on it, according to New York dermatologist Dr. Kiran Mian. Over-the-counter versions, typically 10 percent concentrations at Ulta and Sephora, remain easy to find.
The shortage tracks the ingredient's surge in demand, driven largely by TikTok. But dermatologists are quick to point out this is no overnight discovery. "Experts have been using it in practice for decades," Dr. Mian says.
Azelaic acid occurs naturally in barley, rye and wheat, and belongs to the carboxylic acid family. It is FDA-approved for rosacea and acne, though dermatologists have long used it off-label for melasma and post-inflammatory hyperpigmentation.
New Orleans dermatologist Mary Lupo, MD calls it "a Swiss Army knife" of skin care. "I wish more people knew about azelaic acid," adds Rochester, MI dermatologist Mariana Atanasovski, MD. "It can help with acne and clogged pores, redness and inflammation, hyperpigmentation, melasma and overall uneven skin tone and texture."
What it treats
For acne, the ingredient's antimicrobial properties do the work. Boston dermatologist Dennis A. Porto, MD, notes it also treats the hyperpigmentation that follows breakouts. Shenandoah, TX dermatologist Lana Hawayek, MD, recommends it for darker skin types dealing with blemishes and scarring.
Columbus, GA dermatologist Tanda Lane, MD, says it "decreases abnormal follicular keratinization so it helps with comedones much like tretinoin does, but without the peeling." Laguna Hills, CA dermatologist Jennifer Channual, MD, frames the positioning plainly: "azelaic acid is great for patients who have sensitive skin and have a hard time tolerating topical retinoids or other strong topicals."
On pigmentation, Dr. Lane explains the mechanism: azelaic acid "inhibits tyrosinase, so it's helpful for pigmentary concerns without the irritation hydroquinone can cause." New York dermatologist Marisa Garshick, MD, and Miami Beach, FL dermatologist Melissa Lazarus, MD, both report success evening skin tone and lightening melasma.
For redness, Wilmington, NC dermatologist Kendall Egan, MD, confirms its efficacy in treating rosacea. Dr. Lazarus has found it especially useful "in patients with rosacea that will not tolerate some of the other bleaching agents." Dr. Mian adds that it "can help to decrease the reactivity of sensitive skin."
Not a retinol replacement
"Azelaic acid and retinol are very different in their mechanism of action and thus their roles—they're often paired rather than compared," says Washington, D.C. dermatologist Nina Hartman, MD. Retinol increases cell turnover and stimulates collagen, making it the better choice for fine lines and long-term anti-aging. Azelaic acid works as a multitasker with anti-inflammatory and antimicrobial properties that normalize keratinization and reduce pore-clogging.
The skeptics and the misconceptions
Not every dermatologist is a believer. Algonquin, IL dermatologist Vic Khanna, MD, calls the ingredient weak. Dr. Hartman hears that critique often, alongside the opposite worry—that anything labeled "acid" must be harsh.
"It's true that azelaic acid is a gentler active, but there's strong evidence supporting its efficacy for rosacea, acne and pigmentation," she says, noting it is often used alongside other products for best effect. "In reality, it's one of the best-tolerated actives we have, including for sensitive and reactive skin types."
Usage, pregnancy and strength
Daily use is generally well tolerated. "If patients follow the recommended regimen of using [azelaic acid] twice daily, along with a moisturizer and a sunblock, it is extremely effective," says Harrison, NY dermatologist Jennifer Silverman Kitchin, MD. Dr. Mian tells patients visible changes take at least four weeks.
For pregnant and breastfeeding patients, it is a first-line option. Dr. Lazarus: "I use it often in acne patients and melasma patients that are pregnant, as it is Category B and safe during pregnancy." Orange County, CA dermatologist Daniel Chang, MD, tempers expectations: "it is not as potent as other options such as retinoids."
On strength: OTC formulas run 10 percent, which Dr. Mian calls "very effective" for most people. Finacea Gel is 15 percent (also available as a foam—Dr. Lupo's favorite) and Skinoren Cream goes up to 20 percent. "15 to 20 percent azelaic acid will give you the most robust results," Dr. Mian says, though higher concentrations sting more. Beverly Hills, CA dermatologist Natanel Jourabchi, MD, is blunt: "If you're serious about results, I'd skip the lower strength OTC versions and ask your dermatologist about prescription-strength 15 percent azelaic acid."
Pairings
Niacinamide "works very synergistically with azelaic acid," per Dr. Mian. Dr. Hartman suggests vitamin C for brightening and hyaluronic acid for hydration; "sunscreen, of course, is non-negotiable." Retinol is another strong partner—some compounding pharmacies combine tretinoin and azelaic acid into one formula. She advises against layering it with high-percentage exfoliating acids; Dr. Mian recommends alternating, one in the morning, the other at night.
With demand now colliding with prescription supply constraints, the OTC 10 percent segment—stocked across drugstore, Ulta and Sephora shelves—looks positioned to absorb the spillover while patients wait on Finacea backorders to clear.
Source: NewBeauty
Daniel Okafor
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News editor covering business strategy at Eurasian Beauty Journal.
