This paper found that 0.75% metrogel worked just as well as ketoconazole 2% cream in treating SD. The study found that both were able to offer significant improvement with similar side effects. The authors suggest that because there is so little evidence of anti fungal activity of metronidazole, it is difficult to speculate that this is the reason for its efficacy in treating SD. Patients with rosacea were excluded from this study, so there is a good finding here that even if you only suspect that you have seborrheic dermatitis, metrogel is a good opening treatment option.
Metronidazole 0.75% gel vs. ketoconazole 2% cream in the treatment of facial seborrheic dermatitis: a randomized, double-blind study, D Seckin, O Gurbuz, O Akin, JEADV, Volume 21 Issue 3 Page 345-350, March 2007.
Background: Recently, two placebo-controlled studies have shown that topical metronidazole was effective in the treatment of seborrheic dermatitis.
Objective: To compare the efficacy and safety of metronidazole 0.75% gel with that of ketoconazole 2% cream in the treatment of facial seborrheic dermatitis.
Methods: A total of 60 consecutive patients with facial seborrheic dermatitis were included. Patients were randomized into two groups. One group used ketoconazole 2% cream with metronidazole gel as vehicle; the other group used metronidazole 0.75% gel with ketoconazole cream as vehicle for a 4-week treatment period. Main outcome measures were change in clinical severity scores, patients’ and investigator’s global evaluation of improvement and frequency of side-effects.
Results: All the assessments were made by an investigator who was unaware of which group the patients were allocated to. Mean percentage decrease in clinical severity scores from baseline to last available visit was 63.4% (95% CI 57.7–69) and 54.4% (95% CI 47.9–61) in the ketoconazole- and metronidazoletreated patients, respectively (P = 0.31). Eighty-two per cent of patients in the ketoconazole group vs. 79% of patients in the metronidazole group rated their global improvement as significant or moderate (P > 0.05). No statistically significant difference in the frequency of side-effects was detected between the two groups. The results of this study need to be confirmed in further studies involving large numbers of patients.
Conclusion: Our data demonstrated that metronidazole 0.75% gel had a comparable efficacy and safety profile with that of ketoconazole 2% cream in the treatment of facial seborrheic dermatitis.
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I tried metro gel for my seb derm behind my ears and it drastically healed the scaling and redness down to a small area. It seemed to lose effectiveness over time, but I am very thankful for as much as it did help. Later I also tried it on other spots on my body and head without the same success.
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