Finacea (Azelaic Acid 15% Gel) in Canada

Updated September 10, 2026

Finacea is prescription azelaic acid 15% gel, approved in Canada for rosacea. Acne and pigmentation uses are off-label. It is a different product from an over-the-counter azelaic acid cosmetic.

Below are the practical answers about getting Finacea, cost and coverage, uses, application and safety. A physician decides whether it is appropriate for you.

Prescription access and cost · Uses and evidence · Other treatments · How to use it · Safety · Common questions

Finacea Cost, Coverage, and Access in Canada

What Finacea costs and whether it is covered depend on your province, insurance plan, and pharmacy. Here’s the general picture, plus the specifics for British Columbia.

Cost

As of September 9, 2026, Ontario’s formulary lists Finacea at $0.8763 per gram, or about $43.82 for 50 g before pharmacy markup and dispensing fees. This is a provincial ingredient-price reference, not a national retail quote. Ask your pharmacy for its current price.

Insurance and BC Coverage

Ask your pharmacist to check whether Finacea is covered under your specific BC PharmaCare or private insurance plan and what you would pay. Coverage rules, deductibles and dispensing charges can affect the final cost.

How to Get Finacea in Canada

Finacea requires a prescription in Canada. A physician can assess whether it is appropriate. Walk In connects eligible patients in selected Metro Vancouver communities with physicians for phone or video appointments; check eligibility and appointment availability before booking.

An Overview of Finacea

Finacea is the brand name for azelaic acid 15% gel, a topical prescription medication made by LEO Pharma and registered with Health Canada. Azelaic acid is a naturally occurring acid, and at this prescription strength, it’s applied to the skin to treat certain inflammatory skin conditions.

Officially, Finacea is approved for just one condition — rosacea, which causes facial redness and small inflamed bumps. It’s also widely used for acne and for dark spots (pigmentation), but those are “off-label” uses. A doctor can legally prescribe Finacea for acne or skin pigmentation, but this sits outside its official approval.

Finacea is a gel you apply yourself at home, usually twice a day, to the affected area of skin. Improvement tends to build gradually over several weeks rather than days. Because conditions like rosacea and acne are controlled rather than cured, Finacea and azelaic acid are generally used as an ongoing, longer-term treatment rather than a short course.

Prescription Finacea vs Over-the-Counter Azelaic Acid

You may have seen azelaic acid on the shelf at 10% in cosmetic serums. Finacea has a stronger 15% concentration of azelaic acid, and unlike over-the-counter options, it’s a regulated prescription drug rather than a cosmetic.

How Does Azelaic Acid Work?

Azelaic acid has anti-inflammatory activity, although its mechanism in rosacea is not fully understood. A proposed mechanism does not establish how well a particular formulation will work or how your skin will tolerate it. The clinical evidence below distinguishes Finacea 15% gel from other azelaic acid products.

What Skin Conditions Finacea Treats

Finacea is commonly prescribed for three skin concerns: rosacea, acne, and hyperpigmentation.

Azelaic Acid (Finacea) for Rosacea

Rosacea is the one condition Finacea is approved to treat in Canada, and it’s where the evidence is strongest. 

A 15-week randomized trial in 251 adults compared azelaic acid 15% gel with metronidazole 0.75% gel. At the last available assessment, inflammatory lesion counts fell by an average of 72.7% versus 55.8%. These percentages describe changes in lesion counts, not the proportion of people cured.

In that study, facial skin signs or symptoms occurred in 26% with azelaic acid and 7% with metronidazole; most were transient and mild to moderate. Neither treatment appreciably improved visible small blood vessels. The results concern these formulations and this study population, rather than every form of rosacea.

Azelaic Acid (Finacea) for Acne

Finacea is sometimes prescribed off-label for acne. Evidence for azelaic acid varies with the formulation, comparator and outcome studied.

A Cochrane review found that azelaic acid probably produced less improvement than benzoyl peroxide and similar improvement to tretinoin on participants’ overall treatment assessments. The comparison with clindamycin had lower-certainty evidence. These findings do not make Finacea interchangeable with every retinoid or antibiotic.

In two four-month trials, 15% azelaic acid gel produced median reductions of 70% and 71% in inflamed lesions, with similar effectiveness to 5% benzoyl peroxide gel and 1% clindamycin gel, respectively. Local irritation was less pronounced than with benzoyl peroxide but more pronounced than with clindamycin. Those results concern specific products and outcomes.

Azelaic acid is not an antibiotic. This can be useful when choosing an acne regimen that avoids prolonged antibiotic use.

Azelaic Acid (Finacea) for Hyperpigmentation

Finacea may be prescribed off-label for hyperpigmentation, including melasma and dark marks left after acne. These uses are outside its Canadian approval for rosacea.

The formulation matters when interpreting the evidence. A 24-week melasma trial compared 20% azelaic acid cream with 4% hydroquinone cream and found no significant difference in the assessed pigment outcomes. It did not test Finacea 15% gel, so it does not establish that Finacea works as well as hydroquinone.

A 2023 review included 43 randomized trials across acne, rosacea and melasma; its melasma findings concerned 20% azelaic acid. Ask your clinician which treatment is appropriate for the cause of your pigmentation and your skin’s tolerance.

Finacea vs Other Skin Treatments

People weighing up Finacea usually want to know how it compares to the other topicals a doctor might mention (most often tretinoin and BenzaClin). Which one fits depends on what you’re treating and how well your skin tolerates it.

Finacea vs Tretinoin

Tretinoin is a retinoid (a vitamin A derivative); Finacea’s azelaic acid is a dicarboxylic acid. They cover some of the same ground — treating acne and dark spots — but they aren’t interchangeable. 

Discuss the diagnosis and treatment evidence with your clinician:

• Rosacea: Finacea is an approved option; this does not make it the best choice for everyone.
• Acne: Azelaic acid and tretinoin are both used for acne. Research comparisons depend on the formulation and outcome, and do not establish that Finacea 15% gel is interchangeable with every tretinoin product. Your clinician can help choose based on your acne and tolerance.
• Dark spots: Both may be considered for pigmentation, but the diagnosis, formulation and your skin’s tolerance affect the choice. Finacea’s use for pigmentation is off-label.

Pregnancy and breastfeeding require a prescribing discussion; do not choose Finacea merely because it is not a retinoid. See the safety guidance below.

For more on the retinoid side, see our guide to tretinoin cream in Canada.

Finacea vs BenzaClin

BenzaClin is a combination acne gel. It contains an antibiotic (clindamycin) plus benzoyl peroxide, aimed at treating active, inflammatory acne. Finacea may be prescribed off-label for acne. Studies comparing azelaic acid with either ingredient alone do not establish that it is equivalent to the combined BenzaClin product. The key practical difference is that Finacea is not an antibiotic.

The studies described above do not justify ranking BenzaClin as universally stronger or Finacea as universally gentler. Ask your prescriber about the intended duration and all products in your skincare routine before combining treatments.

How to Use Finacea

The instructions below follow Finacea’s Health Canada product monograph. This may not be suitable for everyone, so it’s important to use the regimen your own doctor or pharmacist gives you.

• How much, how often: Follow your prescribed directions. The Canadian monograph describes a thin layer—0.5 g, approximately 2.5 cm of gel—applied to the affected areas morning and evening after gentle washing and drying. Massage it in gently, wash your hands afterward, and avoid airtight dressings.
• If it irritates: For irritation, your prescriber may advise less gel, once-daily use or a brief pause. Stop for severe or persistent irritation and contact your prescriber.
• When to expect results: Rosacea improvement generally starts within four to eight weeks. Off-label treatment timelines need an individual review.
• What to avoid: Steer clear of alcohol-based cleansers, astringents, and harsh scrubs while using Finacea. Keep the gel away from your eyes, mouth, and other mucous membranes.
• Sunscreen still matters: Discuss sun protection and a tolerable skincare routine with your clinician.

Finacea Side Effects and Safety

The Canadian product monograph describes burning, stinging, itching and dryness. Avoid Finacea if allergic to its ingredients. Report unexpected skin lightening or worsening asthma.

Stop and seek urgent medical help for trouble breathing or swelling of the face, lips, tongue or throat.

Pregnancy use requires weighing potential benefit against risk; breastfeeding needs caution. Safety and effectiveness under age 18 have not been established.

If you miss a dose, skip it rather than doubling. Rinse accidental eye contact with water; seek care if irritation persists. These points do not replace your prescription instructions.

Frequently Asked Questions About Finacea 

Is Finacea available in Canada? Finacea 15% gel is the Canadian prescription product discussed here. Ask a pharmacy about current stock. Information about a foam or a 20% cream should not be treated as information about this gel.

Is azelaic acid available over the counter in Canada? Yes, but only at lower strength. The 10% version is sold over the counter as a cosmetic serum; the 15% strength (Finacea) is prescription-only.

Does Finacea cause purging? Breakouts after starting Finacea should not automatically be treated as a normal “purge.” The Canadian product monograph reports acne flares. If symptoms worsen or irritation persists, ask your prescriber or pharmacist to review the treatment.

Can I use azelaic acid with tretinoin or retinol? Ask your prescriber or pharmacist to review the complete products and regimen before combining them. Findings for an individual ingredient do not establish that every combination or formulation is suitable.

Can Finacea treat melasma? A clinician may prescribe Finacea off-label for melasma. The often-cited comparison with 4% hydroquinone tested 20% azelaic acid cream, not Finacea 15% gel. It therefore does not establish equal results with Finacea. Discuss the options with your clinician.

How long does Finacea take to work? Rosacea improvement generally begins within four to eight weeks. Discuss a review date for your condition with your prescriber.

Is Finacea Right for You?

Finacea is a prescription azelaic acid gel, approved in Canada for rosacea, and also used off-label for acne and dark spots. Whether it fits depends on your diagnosis, treatment history and tolerance.

An important point to remember about Finacea is that it isn’t an overnight fix. Results usually build over several weeks, and it works best as part of a steady skincare routine, with daily sunscreen.

You can discuss rosacea, acne or pigmentation with a physician through Walk In if you meet the service’s location and eligibility requirements. The physician decides whether Finacea, another treatment or an in-person assessment is appropriate.

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