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What are the Different Uses for Metronidazole Cream?

By Robyn Clark
Updated Mar 03, 2024
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Metronidazole cream is a topical antibiotic used to treat the symptoms of rosacea, an inflammatory condition that primarily affects the skin on the cheeks and nose. Symptoms of rosacea can include patches of visible blood vessels, lesions, and small, pimple-like bumps. Research has shown that metronidazole cream is effective for treating the lesions and redness associated with rosacea, and in preventing recurrence of symptoms. Topical metronidazole is also available as a lotion and as a gel. The emollient cream preparation is less drying than the gel form, and it is recommended for individuals with dry or sensitive skin.

There is no cure for rosacea, and the underlying causes of the condition are unknown. The goal of treatment is to manage symptoms by reducing their severity and frequency. In 1983, the first study demonstrating the efficacy of metronidazole cream as a treatment for rosacea was published. It has since become the leading prescribed treatment for moderate to severe rosacea. Clinical trials have demonstrated that that the different topical preparations of metronidazole appear to be equally effective at reducing symptoms, and that this medication is more effective than other rosacea treatments.

It remains unclear exactly how metronidazole cream works to reduce the symptoms of rosacea, as the condition is not caused by bacteria. This antibiotic is also a strong anti-inflammatory, and it is thought that this property is the mechanism that reduces redness and other symptoms. The antimicrobial properties of metronidazole may also play a role. In severe cases, treatment with topical metronidazole may be combined with oral antibiotics, such as tetracycline.

Several manufacturers produce topical metronidazole, and it is marketed under different brand names. Different strengths of cream are available, with the 0.75% and 1.00% concentrations being the most common. There is also a brand that contains added sunscreen, which may further help to reduce symptoms. All of the forms of metronidazole are available only by prescription, including metronidazole cream. The gel formulation is also prescribed to treat bacterial vaginosis.

As a treatment for rosacea, metronidazole cream is usually applied once or twice a day. Effective treatment plans will typically include an accompanying skin care regimen with gentle, non-drying products like soap and moisturizer. It may take up to nine weeks to see significant improvement in symptoms. The side effects associated with metronidazole cream are typically mild, and can include stinging, burning, or worsening of rosacea symptoms. A physician should be consulted if side effects are experienced, or if symptoms do not improve with treatment.

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Discussion Comments
By anon994033 — On Jan 08, 2016

Wheat and gluten cause it.

By irontoenail — On Apr 02, 2013

I have to say, I was actually kind of relieved to find out that I probably have rosacea rather than acne. Being able to use something like metronidazole cream to clear it up is a real relief.

I can't believe how common it is, when it never seems to be talked about the way acne is. I had never heard about it before my dermatologist explained it to me.

By umbra21 — On Apr 02, 2013

@pleonasm - Well, one of the leading theories at the moment, as far as I know, is that it's got something to do with the balance of bacteria in the gut. They've noticed when some rosacea patients are put on certain kinds of antibiotics, they either get better or worse and have determined that this is probably because the medications change the balance.

I know there are also lists out there where they've asked people what makes their rosacea worse, then noted the most common replies, but I don't really trust that kind of research, since people might not know what is actually the cause.

By pleonasm — On Apr 01, 2013

I wish they would figure out what causes rosacea already. I have had it on my nose for a long time and it's a real pain. It just makes my face look bad, like I haven't washed it properly, or like I've got sunburn.

In fact I had a friend who was constantly telling me that I had sunburned my nose, until I pointed out that it was actually rosacea.

Unfortunately, even though it's annoying, it's not bad enough to justify using this cream, since it's localized and even my flare-ups aren't that bad.

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