What Is Zilxi? Uses, Dosage, and What You Need to Know in 2026

What Is Zilxi?

Zilxi (Minocycline topical foam 1.5%) is a prescription topical antibiotic foam used to treat the inflammatory lesions — red bumps (papules) and pus-filled bumps (pustules) — of rosacea in adults.

It is the first and only topical Minocycline product approved by the FDA for rosacea. Unlike oral Minocycline, which is taken as a pill and can cause more systemic side effects, Zilxi is applied directly to the skin, delivering the active ingredient where it's needed most.

Key Facts About Zilxi

• Brand name: Zilxi
• Generic name: Minocycline topical foam 1.5%
• Drug class: Tetracycline antibiotic (topical)
• Manufacturer: Journey Medical Corporation
• FDA approved: Yes, for inflammatory lesions of rosacea in adults
• Controlled substance: No
• Generic available: No (as of 2026)
• Formulations: 30g canister and 60g canister

What Is Zilxi Used For?

Zilxi is specifically approved for treating the inflammatory lesions (papules and pustules) of rosacea in adults. Rosacea is a chronic skin condition that causes redness, visible blood vessels, and bumps on the face — most often on the cheeks, nose, chin, and forehead.

Zilxi targets the bumps and pustules specifically. It is not designed to treat the redness or flushing component of rosacea, though reducing inflammation may improve overall appearance.

Some dermatologists may consider Zilxi for other inflammatory skin conditions, but it is only FDA-approved for rosacea.

How Is Zilxi Taken?

Zilxi is applied once daily to the affected areas of the face. Here's how to use it:

1. Wash your hands before applying.
2. Dispense a cherry-sized amount of foam into the palm of your hand.
3. Gently rub the foam into the affected areas of your face.
4. Avoid contact with your eyes, lips, and mouth.
5. Wash your hands after applying.

Important safety notes:

• Zilxi foam is flammable. Avoid fire, flame, and smoking during and immediately after application.
• Do not store above 120°F (49°C).
• Do not puncture the canister.

For best results, use Zilxi consistently every day as directed by your doctor. It may take several weeks to see the full benefits.

Who Should Not Take Zilxi?

Zilxi should not be used by people who:

• Are allergic to Minocycline, other tetracycline-class antibiotics, or any ingredient in Zilxi
• Are pregnant — tetracyclines can harm a developing fetus, affecting bone growth and causing tooth discoloration
• Are under 18 years old
• Are taking Isotretinoin (Accutane) — the combination increases the risk of intracranial hypertension (dangerous pressure in the brain)

If you have kidney problems, talk to your doctor before starting Zilxi. For a full list of potential interactions, see our guide on Zilxi drug interactions.

How Much Does Zilxi Cost?

Zilxi is a brand-name medication with no generic available, which makes it expensive:

• Without insurance: $400 to $600 per 60g canister
• With insurance: Coverage varies. Many plans require prior authorization and step therapy (you may need to try other rosacea treatments first). Copays vary by plan tier.
• With the Zilxi Savings Card: Eligible commercially insured patients may pay as little as $25 per prescription. Call 888-786-5876 for details.

The savings card is not valid for patients with government insurance (Medicare, Medicaid, Tricare). If you're uninsured or underinsured, Journey Medical Corporation may offer patient assistance — check our full savings guide for more options.

You can also check prices at different pharmacies near you using Medfinder.

What Are the Side Effects?

The most common side effects of Zilxi include:

• Diarrhea
• Headache
• Skin irritation at the application site
• Nausea

Serious side effects are uncommon but possible. They include C. difficile-associated diarrhea, liver injury, autoimmune reactions, intracranial hypertension, serious skin reactions, photosensitivity, and tissue discoloration. For a detailed breakdown, read our guide on Zilxi side effects.

How Does Zilxi Compare to Other Rosacea Treatments?

Zilxi is one of several prescription options for rosacea. Here's how it compares to common alternatives:

• Metronidazole (MetroGel, MetroCream) — A first-line topical treatment available as a generic. Less expensive than Zilxi but works through a different mechanism.
• Ivermectin (Soolantra) — A topical cream that targets Demodex mites associated with rosacea. Also brand-name and expensive, though a generic may become available.
• Azelaic Acid (Finacea) — A topical gel or foam that reduces inflammation. Available as a generic and typically more affordable.
• Doxycycline (Oracea) — A low-dose oral tetracycline antibiotic for moderate-to-severe rosacea. Taken by mouth, which means more potential systemic side effects.

Final Thoughts

Zilxi is a unique treatment option for rosacea — it's the only topical Minocycline foam on the market, and it offers the anti-inflammatory benefits of a tetracycline antibiotic without the systemic side effects of oral formulations. The biggest barrier for most patients is cost and availability, since there's no generic and not every pharmacy stocks it.

If you're considering Zilxi, talk to your dermatologist about whether it's right for your rosacea. And when you're ready to fill your prescription, use Medfinder to find a pharmacy near you that has it in stock.