Finacea vs Soolantra

Finacea: The prescription strength of azelaic acid, made for the bumps and pustules of rosacea. It is the same ingredient sold at 10% over the counter, in a stronger and regulated formula. Soolantra: A once-daily cream for the bumps and pustules of rosacea. It calms inflammation and reduces the mites that live in facial follicles, but it does not treat flushing or fixed redness.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist

Which one?At a glance What it treats Diagrams How you take it Results Side effects Safety Cost When you stop Questions

Which one is right for you?

Choose Finacea if…

Choose for rosacea bumps and pustules, or acne with dark marks, when you want a gentle option that's often used in pregnancy.

Rosacea bumps and pustules
Dark marks after acne
Pregnancy, where many alternatives are off the table

Choose Soolantra if…

Choose for rosacea bumps and pustules as a once-daily cream that often clears them — it doesn't treat flushing or fixed redness.

Rosacea bumps and pimples
You want once-daily use
You'll give it 12–16 weeks

Alternatives, not combined

Can you take them together?

Both treat rosacea bumps. Most people use one; Soolantra is often a little more effective, Finacea also helps dark marks.

At a glance

● Finacea

● Soolantra

Type

Prescription azelaic acid (15%)

Topical antiparasitic and anti-inflammatory (ivermectin 1%)

What it does

Calms inflammation and slows pigment

Calms inflammation and reduces Demodex mites

Best for

Rosacea bumps and pustules

Prescription

Yes (10% over the counter)

Yes

Form

Gel or foam

Cream

How often

Twice daily

Once daily

Course length

Ongoing

Time to results

4–12 weeks

4–16 weeks

Main side effect

Stinging or tingling at first

Mild burning or dryness

Blood tests

None

Pregnancy

Generally considered OK

Check with your clinician

Cost

Moderate; generic available

What it treats

Compare uses by strength of evidence. Evidence level describes confidence in a benefit, not its size.

Evidence level

Finacea

Soolantra

Strong evidenceMost established uses

Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Reduces bumps and redness.

Rosacea

Reduces bumps and pimples.

Moderate evidenceSome supportive research

Acne

Clears breakouts.

Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Lightens patches.

Flat light-brown residual marks on a fair cheek.

Post-Inflammatory Hyperpigmentation

Fades dark marks.

—

Little evidence

—

The finger webs and wrist on fair light skin, with small red bumps, several thin gray burrow lines a few millimetres long, and scratch marks across the area.

Scabies

Scabies needs permethrin or ivermectin tablets.

Not effective

Acne Scarring

Doesn't change scars.

Spider Veins

Doesn't affect visible vessels.

Acne

Not an acne treatment.

Post-Inflammatory Redness

Doesn't fade redness alone.

How it works

Finacea. Azelaic acid acts on inflammation, pores, and pigment. 1. Calms inflammatory pathways: May reduce signals involved in rosacea inflammation. 2. Normalizes cell buildup: Helps reduce excess keratin inside follicles. 3. Limits acne bacteria: Has activity against susceptible C. acnes. 4. Can help fade dark marks: Can inhibit tyrosinase, an enzyme used to make pigment. — Open full-size diagram
Diagram explanation and sources
Calms inflammatory pathways: May reduce signals involved in rosacea inflammation. Normalizes cell buildup: Helps reduce excess keratin inside follicles. Limits acne bacteria: Has activity against susceptible C. acnes. Can help fade dark marks: Can inhibit tyrosinase, an enzyme used to make pigment.
Finacea 15% is labeled for rosacea inflammatory lesions; the full rosacea mechanism is unknown. Follicular, antimicrobial and pigment actions summarize azelaic-acid evidence across formulations, including 20%; acne and pigment use of this particular product may be off-label. KLK5/cathelicidin changes support a proposed inflammatory pathway. Tyrosinase inhibition is established in vitro; the complete clinical pigment mechanism is not established and 15% Finacea is labeled for rosacea rather than pigmentation.
Source 1 · Source 2 · Source 3 · Source 4 · Source 5

Soolantra. Ivermectin helps settle rosacea bumps and pimples. 1. Reduces Demodex mites: Kills mites that may contribute to rosacea inflammation. 2. May calm immune signals: Anti-inflammatory effects may also help skin settle. 3. Reduces bumps and pimples: Inflammatory rosacea lesions gradually improve. — Open full-size diagram
Diagram explanation and sources
Reduces Demodex mites: Kills mites that may contribute to rosacea inflammation. May calm immune signals: Anti-inflammatory effects may also help skin settle. Reduces bumps and pimples: Inflammatory rosacea lesions gradually improve.
The label states that the rosacea mechanism is unknown. Anti-parasitic and anti-inflammatory actions are supported by a small in-vivo pilot; clinical efficacy has randomized-trial support. Demodex is not the sole cause of rosacea.
Source 1 · Source 2 · Source 3

How you take it

Treatment plan

When to Apply: Twice a day on clean dry skin, a thin layer over the whole affected area, not on single spots. Moisturizer, sunscreen and makeup go on top once it has dried. Wash your hands afterwards.

How to Start: Once a day for the first week or two if your skin is reactive, then twice daily. Twice a day is what the trials did, and it is the part that quietly gets dropped.

If It Irritates: Stinging for a few minutes after applying is common in the first two weeks and usually stops. Moisturizer first, or back to once a day, settles it. The gel and the foam feel different, so switching form is worth asking about.

If It's Not Working: Give it twelve weeks of twice-daily use. There is no higher rosacea strength, so the next steps are ivermectin cream, an oral treatment such as doxycycline, or treating redness separately.

When to Apply: Once a day, usually at night, on clean dry skin. A pea-sized amount for the whole face, spread thinly rather than dabbed on bumps. Keep it off the eyes, lips and inside of the nose. Moisturizer and sunscreen go on top once it has dried.

How to Start: Once daily from day one. No build-up schedule, and twice a day speeds nothing up.

If It Irritates: Mild burning, stinging or dryness early on is common; moisturizer before or after usually settles it. A flare of bumps in the first two to four weeks happens and passes. It does not mean the cream is wrong.

If It's Not Working: Give it twelve weeks before judging, up to sixteen for the full effect. There is one strength, so the next step is adding something else, often azelaic acid or an oral antibiotic, not more cream.

Monitoring

No blood tests or lab monitoring. Very little is absorbed, and what is absorbed is handled like the same compound from food.

Monitoring is a review at around twelve weeks: have the bumps reduced, is the twice-daily schedule being kept, is anything separate needed for redness. People stay on this for years.

Watch skin color. Pale patches on treated skin are reported, rarely, and are more noticeable in deeper skin tones. Show new lighter areas to a doctor.

No blood tests or laboratory monitoring. Very little is absorbed through intact skin, far below the amounts involved with the tablets.

Monitoring is a conversation at around twelve weeks: have the bumps reduced, is the cream comfortable, is anything separate needed for redness. People stay on it for years without a dose change, because nothing accumulates.

Irritation after months of comfortable use usually points to a change in the routine or a second problem such as contact dermatitis, worth reviewing rather than pushing through.

When you’ll see results

Approximate windows, not promises.

● Finacea

● Soolantra

First few minutes

First few minutesApplying it: Stinging, warmth or itching for a few minutes is common at the start.

First few minutesApplying it: A pea-sized amount once a day, thinly over the whole face.

Weeks 1 to 2

Weeks 1 to 2Adjusting: Stinging settles, some dryness is normal, little visible change yet.

Weeks 1 to 2Adjusting: Mild burning, dryness or itching. Some get a short flare as mite numbers drop. Little visible change yet.

Weeks 4 to 8

Weeks 4 to 8Working: Fewer new bumps and pustules — the main target and the first thing to change. The face looks calmer before the count is obviously lower. Some background pink settles with it.

Weeks 8 to 12

Weeks 8 to 12Judge it here: Most of the benefit seen in trials is in by twelve weeks of twice-daily use.

Weeks 12 to 16

Weeks 12 to 16Dark marks: Brown marks left where spots healed start to fade. Slower than the bumps.

Weeks 12 to 16Judge it here: The point the trials measured, where most people were rated clear or almost clear.

Ongoing

OngoingMaintenance: People who continue hold their improvement. Bumps return within a few months of stopping.

Weeks 2 to 4

Weeks 2 to 4First change: Fewer new pustules, which clear before the firm red bumps. The face looks calmer before the count is obviously lower.

Weeks 4 to 12

Weeks 4 to 12Working: Steady reduction in bumps and pustules. Most of the gain happens here, and background pink fades as the inflammation settles.

Side effects

Sorted by what to do about them.

Finacea

Soolantra

Common

Stinging, tingling or itch in the first weeks
Dryness

Common

Mild burning or stinging
Dry skin

Tell your doctor

Lightening of skin color in darker skin

Tell your doctor

Rosacea worsening

Stop and get care

Swelling or trouble breathing

Stop and get care

Swelling or trouble breathing

Safety and who should avoid it

Pregnancy

Commonly considered when other treatments stop; confirm with your clinician.

Use care

Ask the doctor managing your pregnancy.

Breastfeeding

Keep it off the nipple.

Use care

Discuss with your clinician.

Children

12 and older

Approved from 12.

Not used

Adults only.

Monitoring

None

Judge at 12 weeks.

None

Judge at 12–16 weeks.

Key interactions

None known

—

None known

—

Other cautions

Use care

Keep out of eyes; can lighten darker skin.

Use care

Keep out of eyes.

Cost and getting it

Getting it and cost

Better than most rosacea options. The 15% gel has generics in many markets, which brings the price down a lot; the foam is more often brand priced. Coverage is easier than for the redness creams, because bumps and pustules count as medical rather than cosmetic.

Over-the-counter 10% costs less again and is a reasonable start for mild cases.

If cost is the issue, price the generic 15% gel first.

Sold as Soolantra, with generic ivermectin 1% cream now available in some markets. Price varies widely between pharmacies and plans, and many plans want metronidazole or azelaic acid tried first.

A tube lasts a while, since a pea-sized amount covers the whole face once a day. If cost is the barrier, price generic ivermectin cream, a pharmacy discount card, or generic metronidazole or azelaic acid.

When you stop

Comes back?

Rosacea bumps often return within months.

Bumps can return months after stopping.

Taper needed?

No.

After the last dose

Many keep it as maintenance.

Restarting usually works.

Common questions

Finacea:Is prescription 15% really better than the 10% I can buy?

For rosacea, the published evidence is at 15%. Ten percent is a reasonable start, but if three months has changed nothing, move to the prescription strength.

Finacea:Gel or foam, does it matter?

Both are 15% and studied for rosacea. The gel dries quickly and suits oilier skin; the foam spreads more easily and is more comfortable on dry or sensitive skin. Choose on feel.

Finacea:Why does it sting?

Expected in the first couple of weeks. It lasts a few minutes after applying and stops as the skin adapts. Starting once daily makes it easier.

Finacea:Will it help the redness in my cheeks?

Partly. As the inflamed bumps settle, the pink around them settles too. It does not narrow blood vessels, so flushing and visible capillaries need something else.

Finacea:Can I use it with other rosacea treatments?

Yes — routinely with a redness treatment, ivermectin cream, or oral doxycycline. Split them between morning and night to keep irritation down.

Finacea:Is it safe in pregnancy?

Doctors commonly consider azelaic acid when other treatments have to stop, but that decision belongs to the doctor managing your pregnancy.

Soolantra:Does it get rid of the redness in my face?

Not the kind most people mean. It reduces redness from inflamed bumps, so the face looks calmer. It does not stop flushing or remove visible vessels; those need brimonidine or oxymetazoline, or laser and light.

Soolantra:Why did my rosacea get worse in the first two weeks?

A short early flare is common, probably because dying mites release material the immune system reacts to. It settles within a few weeks.

Soolantra:Is this the same as taking ivermectin tablets?

Same drug, completely different medicine. The cream goes on the face, almost none enters the bloodstream, and it treats skin only.

Soolantra:How long will I need to use it?

Rosacea is managed, not cured, so most people use it long term. Bumps return within a few months of stopping.

Soolantra:Can I use it alongside other rosacea treatments?

Yes, and combinations are common: a redness treatment in the morning and ivermectin at night, or ivermectin with oral doxycycline.

Soolantra:Do I need to change my pillowcases because of the mites?

No. These mites live in the follicles of nearly every adult face. They are not caught from bedding, pets or people, and cleaning does not change their numbers.

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