Despite quite a lot of activity in the marketing and development of the metronidazole treatments (lotion, cream, gel, generic equivalents, metrogel 1%, once per day, twice per day) this research suggests that the formulation and treatment frequency make little difference to the treatment outcome. So if you can tolerate one of the available formulations, there is likely marginal benefit from changing to another.
Metronidazole in the treatment of rosacea: do formulation, dosing, and concentration matter? Yoo J, Reid DC, Kimball AB., Clinical Unit for Research Trials in Skin, Harvard Medical School, Boston, MA 02114, USA.
BACKGROUND: Topical metronidazole is commonly used in the management of rosacea. No consensus on the optimal formulation, concentration, or dosing regimen exists.
PURPOSE: To assess the relative efficacy of metronidazole cream, gel, and lotion at concentrations of 0.75% and 1%, in dosing regimens of once and twice daily.
METHODS: A meta-analysis of published metronidazole efficacy rates was performed.
RESULTS: In non-weighted analysis, the mean efficacy was 28.2% (95% confidence interval [CI], 22.0%-34.4%) for the cream, 38.4% (95% CI, 18.4%-58.4%) for the gel, and 35% for the lotion. Confidence intervals for QD versus BID dosing and 0.75% versus 1% concentrations also overlapped. In weighted analysis, the mean reduction was 31.3% for the cream, 22.1% for the gel, and 35% for the lotion.
CONCLUSIONS: Metronidazole cream, gel, and lotion vehicles have similar efficacies. There were no substantial differences between concentrations of 0.75% and 1%, or between once daily and twice daily regimens.
12 comments ↓
Please answer me on my e-mail though you may include my question in the website if you wish. I will get the answer more quickly via e-mail.
Is metrocream helpful to seborrheaic dermatitis of rosacia? Can it irritate the seborrhea? My doctor prescribed a steroid for my seborrhea related to rosacia. It clears it up completely but if I stop it, the seborrhea returns. I would rather use metrocream for which I have now gotten a prescription. It may be a better long term treatment for all of the rosacia related problems. I have some pimples occasionally but do not have lasting redness. I used to flush but no longer do.
Thanks,
Stephanie
Hi Stephanie,
Here is one study that found that metrogel also works for seborrheic dermatitis.
You are right that steroids are not a viable long term treatment for rosacea.
Have you tried any of the antifungal treatments like ketoconazole to treat your seborrheic dermatitis ?
hope this helps,
davidp.
I used Noritate while I was in USA. Now I live in Qatar, I searched most pharmacies for any metronidazol cream, they can’t find it. 2 tears ago I was able to find Dumazol in Qatar.
Can you supply a name of the product in this region?
thanks
I thought I noticed a significant difference b/n metrogel and metrolotion, with the lotion being more helpful.
Seems to make sense that different people will have different efficacy based on delivery.
I can’t seem to find it now though.
Hi
I have suffered from Rosacea for about 2 years and managed it quite well (with metrogel and lycene) and haven’t had an outbreak for at least 5mths. I have tooth infection and the dentist gave me metronidazole tablets to clear it up and I have had now got the most severe outbreak I ever had (swelling of my face particularly around the nose and very red and itchy). We also have very cold weather here at the moment. Could it all be co-incidence?
Thanks for anyone’s help
Comment via email;
Janice,
I have also taken the medication that your dentist prescribed for you and it did not affect my rosacia. I do think that cold weather is a problem because mine was under control with nortate cream mixed with ketocnizole for several months. I thank those who made suggestions via the site. However, when the cold strikes, I get a spot or two of either rosacia or seborrhea or some mix. My doctor says it rosacia. When this happens, I use a little of the mild steroid foam that my doctor prescribed when this first broke out. It gets it under control in a couple of days.
Hope this helps.
Stephanie
HELLO, MY DOCTER JUST PRESCRIBED ME (FOUGERA) METRONIDAZOLE 0.75% TOPICAL CREAM. PLUS DOXYCYCLINE HYCLATE 100MG CAPSULES, THAT I TAKE TWICE A DAY FOR MY ROSACEA. I STARTED TAKING THIS YESTERDAY AND THIS MORNING MY NOSE AND CHEEKS ARE REDDER, IS THIS NORMAL? AND HOW LONG WILL IT STAY SO RED. IT DOES FEEL A LITTLE DRY. THANK YOU FOR LISSONING. LINDA
Hi, hope you can help. I recently got diagnosed with Rosacea (type with pustules). My doctor prescribed Rosex Metronidazole 00.75% gel. After a week of using 2 x daily I got welts, more bumps with broken capilliaries… I got some on my lips and they also swelled up with welts, etc. I think the condition was made worse. My doctor then prescribed benzoyl peroxide. Will this really help in the long run? Could I use a metronidazole cream rather then a gel, or is it likely to cause the same sort of reaction? What alternative topical treatment could I use?
Thank you.
Hi! I have had rosacea for the past 3 years although i was formally diagnosed a year ago. My doctor prescribed metronidazol gel and doxycylcine. I’m struggling to find metronidazol gel over here but the doxycycline helps a lot. My question is: can metronidazole tablets help in any way with my rosacea? I will appreciate any information.
Hello Pakiso,
You wouldn’t normally take oral antibiotics and oral metronidazole (flagyl) together they do the same thing. There are potentially more side effects when taking Flagyl so be sure to check with your doctor.
davidp.
Thanks for the information David. I will talk to my doctor. I guess my primary question was whether or not metronidazole tablets help in treating rosacea. Thanks again for the info.
Hi,
Following on from David’s comment. I took Metronidazol as prescribed by my dentist for a tooth infection and my faced swelled up and took 4 days to calm down, leaving me with a much worse attack of rosacea than previously experienced.
Hope that helps
JH
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