Metronidazole Topical Cream 0.75%
Metronidazole Topical Cream 0.75%
Product Description
Product overview
A prescription-strength emollient cream by Prasco containing 0.75% metronidazole, clinically proven to treat the inflammatory papules and pustules of rosacea. This fragrance-free, paraben-free formula is applied twice daily to reduce redness, bumps, and flare-ups, delivering visible improvement within 3 to 9 weeks of consistent use.
Calms Inflammatory Lesions
Clinically shown to reduce papules and pustules of rosacea by 48–65% over 7–12 weeks.
Texture & feel
SENSORYCalms Inflammatory Lesions
Clinically shown to reduce papules and pustules of rosacea by 48–65% over 7–12 weeks.
Targets Persistent Redness
Anti-inflammatory action calms the flushing and erythema tied to inflammatory rosacea.
Moisturizing Cream Base
Emollient base with sorbitol and emulsifying wax — gentler on dry, sensitive rosacea skin than gel versions.
Maintains Remission
Long-term use helps prevent flare-ups after achieving clearance, keeping rosacea under control.
Minimal, Focused Formula
Just 8 ingredients — no fragrance, no parabens, no silicones, no essential oils.
Daytime & Nighttime Use
Applied twice daily — thin layer morning and evening, safe to layer under sunscreen and makeup.
Safety & compatibility
SAFELimited human data. Metronidazole crosses the placenta; use only if clearly needed and under medical supervision.
Oral metronidazole passes into breast milk. Topical absorption is minimal but discuss with your provider.
No fatty acids, esters of fatty acids, or oils that feed Malassezia. Safe for fungal-acne-prone skin.
Isopropyl palmitate rates 2/5; overall cream is well-tolerated by most acne-prone users.
Compatible with most routines. Avoid strong AHAs/BHAs and retinoids in the same application window to prevent irritation.
Topical metronidazole can cause tearing and eye irritation. Do not apply near eyes, lips inside, or mucous membranes.
Sun exposure is a major rosacea trigger. Daily broad-spectrum SPF 30+ is essential while using this cream.
Oral metronidazole potentiates warfarin. Topical effect unknown — inform your doctor if on anticoagulants.
Ingredient breakdown
INGREDIENTSMetronidazole 0.75%Proven
The star active — a nitroimidazole antibacterial with potent anti-inflammatory properties. First approved for rosacea in the 1980s and still a gold-standard topical treatment four decades later.
- Mechanism: Reduces reactive oxygen species and neutrophil-driven inflammation in the skin; exact pathway still being researched.
- Clinical Data: Reduces inflammatory lesion counts by 48–65% over 7–12 weeks in placebo-controlled trials.
- Tolerability: Topical absorption is minimal — systemic side effects are very uncommon.
Emulsifying Wax NF ~5–10%Proven
A blend of roughly two-thirds cetearyl alcohol and one-third polysorbate 60. Acts as the structural backbone of the cream, stabilizing oil and water phases.
- Function: Emulsifier and thickener — delivers the smooth, creamy texture.
- Skin feel: Adds softness and helps reinforce the skin barrier.
Sorbitol ~3–5%Proven
A plant-derived sugar alcohol that attracts and binds water to the skin. Works as a gentle humectant suited for sensitive, reactive rosacea skin.
- Humectant: Pulls moisture from the environment into the stratum corneum.
- Non-irritating: Well-tolerated alternative to propylene glycol.
Isopropyl Palmitate ~3–6%Promising
A lightweight emollient ester of isopropyl alcohol and palmitic acid. Gives the cream its glide and helps delivery of metronidazole into the skin.
- Texture enhancer: Creates the silky, non-greasy feel.
- Comedogenic rating: Rated 2/5 — low to moderate pore-clogging potential.
Lactic Acid <1% (pH adjuster)Proven
Present in trace amounts as a pH buffer, not as an exfoliant. Keeps the formula at a skin-friendly pH so metronidazole remains stable and effective.
- Role here: pH adjustment only — does not deliver AHA exfoliation at this concentration.
Benzyl Alcohol <1%Proven
A mild preservative that prevents microbial contamination of the cream. At this low concentration it is generally well-tolerated, though those with very reactive skin may notice slight tingling.
- Preservative: Extends shelf life and product safety.
- EU-approved: Permitted up to 1% as a preservative.
Sodium Hydroxide traceProven
Used in tiny amounts alongside lactic acid to adjust the final pH of the cream. Once neutralized, it poses no concern for the skin.
- pH balance: Keeps the formula at a skin-compatible pH.
Water (Purified) ~75–85%Proven
The primary vehicle that carries metronidazole and humectants into contact with the skin. Purified water is essentially inert and provides the hydrating base of the cream.
- Base: Typical for water-in-oil pharmaceutical creams.
8 ingredients
Benzyl Alcohol, Emulsifying Wax NF, Isopropyl Palmitate, Lactic Acid, Metronidazole (0.75%), Sodium Hydroxide, Sorbitol, Water (Purified).
Where it fits in your routine
ROUTINEApply to clean, dry skin as the treatment step — before moisturizer, sunscreen, and makeup. Use twice daily (morning and evening) on affected areas.
How to use
HOW TO USECleanse Gently
Wash affected areas with a mild, non-soap cleanser. Pat dry — do not rub. Wait about 5 minutes so skin is completely dry before applying.
Apply a Thin Layer
Dispense a pea-sized amount and rub a thin layer over the entire affected area (not just on visible bumps). Most users need only a small amount per application.
Use Twice Daily
Apply morning and evening, or as directed by your physician. Consistency matters more than quantity — results build over weeks, not days.
Follow With Moisturizer & SPF
Lock in with a fragrance-free moisturizer. In the morning, always finish with broad-spectrum SPF 30 or higher — sun is a major rosacea trigger.
Wash Hands & Avoid Eyes
Wash hands before and after application. Keep away from eyes, lips, and inside of the nose. If contact occurs, rinse thoroughly with cool water.
Be Patient
Allow 3 weeks for early changes and 9–12 weeks for full results. If no improvement after 12 weeks or if irritation occurs, check back with your doctor.
Who is it for?
WHOPerfect for you if:
- You've been diagnosed with papulopustular rosacea
- You have inflammatory bumps, pustules, and redness on cheeks, nose, chin, or forehead
- You have dry or sensitive skin (cream base is more nourishing than the gel)
- You want a long-term, gentle maintenance therapy
- You prefer a minimalist, fragrance-free pharmaceutical formula
- You've tried gel versions and found them too drying
Consider alternatives if:
- Your main concern is flushing or visible broken capillaries (telangiectasia)
- You have only erythematotelangiectatic rosacea without papules
- You've had allergic reactions to nitroimidazole antibiotics (e.g., tinidazole)
- You're pregnant — speak with your doctor first
- You need an over-the-counter option (this is prescription only)
- You want rapid overnight results (this works gradually)
Skin type compatibility
SKIN TYPESCream base is slightly richer than the gel — works well, but oily-skin users may prefer the gel formulation.
Emollient base with sorbitol is far more comfortable than gel alternatives, and much less likely to cause stinging.
Balanced, cushiony texture fits well across drier cheeks and oilier T-zone areas affected by rosacea.
Fragrance-free, paraben-free, short ingredient list — one of the gentlest Rx options for reactive rosacea skin.
Fungal-acne safe and generally non-comedogenic. A minority of users report clogging from isopropyl palmitate — patch test first.
Gentle, moisturizing base is ideal for older skin with rosacea that also tends to be drier and thinner.
Results timeline
ONGOINGInitial Adjustment
Some users notice a reduction in redness or stinging within 2–7 days. Others experience mild dryness or tingling as skin adapts.
~25% see early changesBumps Begin to Fade
Existing papules and pustules start shrinking; new breakouts slow noticeably. Skin texture may look clearer even before redness fully calms.
~50% see visible improvementVisible Clearing
Clinical studies show most of the overall benefit appears in the first 3 weeks, with continued improvement in lesion count through week 6.
~65% see significant clearingPeak Clearance
Lesion counts drop by 48–65% in controlled trials. Erythema reduces 26–30%. Skin feels smoother, calmer, and more even-toned.
~70–80% reach optimal resultsMaintenance & Remission
Continued twice-daily use keeps flare-ups away. At 6 months, 77% of metronidazole users remain clear vs 58% on vehicle — long-term control is the goal.
77% maintain remission at 6 monthsRatings by platform
372+ REVIEWSPros & cons
BALANCEDPraised
- Decades of clinical evidence in rosacea treatment
- Dramatically reduces inflammatory bumps and pustules
- Gentler cream base ideal for dry and sensitive skin
- Fragrance-free, paraben-free, silicone-free
- Generic Prasco version is far more affordable than brand-name MetroCream
- Fungal-acne safe and compatible with most routines
- Helps maintain long-term remission
Criticized
- Does not help with flushing or telangiectasia
- Requires 6–12 weeks of consistent use to see peak results
- Some users experience initial dryness, stinging, or purging
- Rare reports of metallic taste and tearing near eye area
- Prescription-only — needs a doctor's visit
- Does not cure rosacea (suppresses symptoms; relapse can occur)
Budget-friendly alternatives (dupes)
DUPESEssentially identical active and formulation to Prasco version. Different manufacturer, interchangeable for most patients.
Original brand-name 0.75% metronidazole cream. Same active; Prasco is the authorized generic equivalent at a fraction of the price.
Same active at same concentration but in a gel base. Better for oily skin, but drier, thinner, and sometimes more stinging than the cream.
Different active but similar indication. Slightly superior for maintaining remission and also addresses redness. Can cause more tingling.
Comparison with competitors
SIDE-BY-SIDE
Soolantra (Ivermectin 1% Cream)
Mirvaso (Brimonidine 0.33% Gel)
Storage & shelf life
12 MONTHS12 months after opening. Discard any unused product after the expiration date printed on the tube.
Store at controlled room temperature 68–77°F (20–25°C). Protect from freezing. Keep away from heat and direct sunlight.
45 g aluminum tube — hygienic, opaque, and squeezable. Keeps the formula stable and protected from light.
Yes — at 45 g, well under the 100 ml TSA carry-on limit. Bring your prescription label when traveling internationally.
Frequently asked questions
FAQMetronidazole is classified as FDA Pregnancy Category B. There are no well-controlled human studies, and the drug crosses the placenta. Topical absorption is minimal, but the manufacturer advises use during pregnancy only when clearly needed. While breastfeeding, oral metronidazole passes into breast milk in amounts similar to plasma levels; topical blood levels are much lower, but you should discuss with your OB-GYN or dermatologist whether to continue use or pause during nursing.
Yes. This cream contains no fatty acids, no esters of fatty acids longer than C13, no polysorbates that feed Malassezia yeast, and no oils. The 8-ingredient formula (benzyl alcohol, emulsifying wax NF, isopropyl palmitate, lactic acid, metronidazole, sodium hydroxide, sorbitol, water) is considered fungal-acne safe and is used by many individuals managing both rosacea and pityrosporum folliculitis.
Yes, but spacing is important for sensitive rosacea skin. Apply metronidazole cream morning and evening as directed, and use retinol at a different time (many use it at night over a moisturizer buffer). Vitamin C can be layered in the AM before metronidazole. Stronger AHA/BHA exfoliants (glycolic, salicylic acid) should be used sparingly, or on alternating days, to avoid compounding irritation. If you notice burning or increased redness, simplify your routine and consult your dermatologist.
It's best suited for dry, sensitive, combination, and mature skin types diagnosed with papulopustular rosacea. The emollient cream base is more comfortable than gel versions and less likely to sting. Oily skin types can use it too but may prefer the gel formulation. Acne-prone users should patch test, as a minority of people are sensitive to isopropyl palmitate.
Early users often notice some calming within the first 1–2 weeks. Clinical trials show most of the overall improvement appears in the first 3 weeks, with continued reduction of papules and pustules through weeks 7–12. Peak results (48–65% reduction in lesion count) typically show by week 9–12. Commit to a full 12-week course before judging effectiveness, and continue use long-term to maintain remission.
Apply after cleansing and toning (if used), on completely dry skin, before moisturizer and sunscreen. Wait about 5 minutes after washing your face so the product goes onto dry skin. In a simplified routine, the order is: cleanser → metronidazole cream → moisturizer → SPF 30+ (morning). Cosmetics can be applied on top once the cream has absorbed.
Overall the formula is low-to-moderate on the comedogenic scale (around 2/5). The one ingredient that can be an issue for very acne-prone skin is isopropyl palmitate, rated 2/5 for comedogenicity. Most users do not experience clogged pores; however, if you're prone to closed comedones, patch test for 5–7 days before full face use. The formula is free of silicones, mineral oil, and heavy occlusives.
Once opened, use within approximately 12 months and always before the expiration date printed on the aluminum tube. Store at controlled room temperature between 68–77°F (20–25°C), protect from freezing, and keep away from direct sunlight and excessive heat. If the cream changes color, separates, or develops an unusual odor, discard it and ask your pharmacist for a replacement.
Verdict: Prasco's Metronidazole Topical Cream 0.75% is a proven, decades-old pharmaceutical cornerstone for treating papulopustular rosacea. With just eight ingredients, no fragrance, and a gentle emollient base, it's one of the most tolerable prescription options for sensitive, reactive skin. Clinical trials confirm 48–65% reductions in inflammatory lesions over 7–12 weeks, and long-term use is particularly effective for maintaining remission. It won't address flushing or visible capillaries — for those, pair it with brimonidine or in-office treatments — but for the bumps, pustules, and inflammatory redness that define papulopustular rosacea, it remains a first-line therapy trusted by dermatologists worldwide.
Product Overview
What are Quick Product Notes?
Quick product notes are a great way to check if a product is free from commonly avoided ingredients by skincare enthusiasts. These preferences come about for different reasons depending on the ingredient such as personal experiences, sensitivities, health preferences & etc.
Pro Tip Alert!
Just because a product is not free from a common preference does not mean it's a bad product! You can make a personal decision whether or not you want to use a product that contains these ingredients or not - click the labels of the preference to read more about them.
Quick Product Notes
Paraben-Free
Paraben-Free
Understanding Parabens
Parabens are a large group of preservatives which are used to prevent bacteria growing in cosmetic formulations. There has been some healthy controversy surrounding them due to a few studies finding paraben presence in breast tumours and breast tissue. However, the majority of the scientific community have deemed these findings non-conclusive due to the limitations of these studies. There's still a lot of support for avoiding parabens following the better safe than sorry route. If you do we completely support you! If you are concerned about the health safety of parabens, then feel free to avoid them by looking out for the Paraben-Free icon. If not, don't worry about it - they do have had one of the longest safety records as preservatives!
Which Ingredients are classified as Paraben?
A product will be paraben-free if it does not contain any of the following parabens:
- Sodium Isobutylparaben
- Sodium Ethylparaben
- Sodium Butylparaben
- Propylparaben
- Isopropylparaben
- Isobutylparaben
- Sodium Propylparaben
- Butylparaben
- Ethylparaben
- Sodium Methylparaben
- Methylparaben
Sulfate-Free
Sulfate-Free
Understanding Sulfates
Sulfates are a large group of ingredients which act as cleansing agents in Cosmetics. They help loosen up the dirt and grime from your skin and hair to allow for water to wash it away with ease. However some sulfates are so good at their job, they can wash off your skin’s own natural oils that keep it moisturised and protected which can lead to dryness and irritation. Most people will find no issues with sulfate, however if you find your skin doesn't like sulfates then free feel to avoid them by looking out for the sulfate-free icon on Skincarisma.
Which ingredients are classified as sulfates?
We've taken the Sulfates which are considered more harsh for our Sulfate-Free status. A product will be Sulfate-Free if it does not contain any of the following Sulfates:
- TEA-Dodecylbenzenesulfonate
- Ammonium Laureth Sulfate
- Sodium Lauryl Sulfate
- PEG-15 Cocamine
- Sodium Laureth Sulfate
- Sodium Cocoyl Sarcosinate
- Sodium C14-16 Olefin Sulfonate
- Dioctyl Sodium Sulfosuccinate
- Ammonium Xylenesulfonate
- Ammonium Lauryl Sulfate
- Sodium Xylenesulfonate
- Sodium Myreth Sulfate
- Sodium Lauryl Sulfoacetate
Alcohol-Free
Alcohol-Free
Understanding Simple Alcohols
Alcohol ingredients are widely used in cosmetics and come in different types. For the most part alcohols are not problematic at all. However one type of alcohols, simple alcohols can be quite drying to the skin because it evaporates very quickly. This can cause irritation which can also lead to other skin complications. These alcohols should never be used alone on your skin, but combined with other cosmetic ingredients, they are normally without issue. However, for some people with sensitive and easily irritable skin, avoiding products with these simple alcohols may be beneficial. If you find your skin doesn't like these simple alcohols, then free feel to avoid them by looking out for the Alcohol-Free icon.
Which Ingredients are classified as Alcohol?
A product will be alcohol-free if it does not contain any of the following alcohol ingredients:
- SD Alcohol
- Alcohol Denat
- Isopropyl Alcohol
- Alcohol
Silicone-Free
Silicone-Free
Understanding Silicones
If you've ever used a skincare, makeup or beauty product that's made your skin look and feel smoother tempoarily - it's likely contained Silicone. They are a popular class of ingredients found in cosmetics due to their smooth, soft, easy-to-spread and smooth properties that help creates an artificial layer/barrier on top of skin or hair (commonly found in conditioners).
For the same reasons they are popularly used, they are also commonly avoided. Anecdotally, many individuals have reported that Silicones cause/excerbate breakouts, irritation, cause a feeling of skin being unable to breathe, cause clumping of cosmetic products and find it difficult to wash off. As a result, those who find them problematic are avoiding them and increasingly, cosmetic companies are avoiding them as well.
If you have had bad experiences with Silicones in the past, or suspect they are problematic then look out for the tick on the Silicone-free label.
Disclaimer
The Silicone-free label only includes the most common Silicone ingredients that have indentified been reported by individuals that could potentially cause issues.
These include: Amodimethicone, Behenoxy Dimethicone, Bis-Aminopropyl Dimethicone, Cetearyl Methicone, Cetyl Dimethicone, Cyclomethicone, Cyclopentasiloxane, Dimethicone, Dimethicone Copolyol, Dimethiconol, Methicone, Phenyl Trimethicone, Phenyl Trimethicone, Stearoxy Dimethicone, Stearyl Dimethicone, Trimethylsilylamodimethicone.
Note, that this does not include all ingredients part of the Silicone class of ingredients.
EU Allergen-Free
EU Allergen-Free
Understanding the Identified Contact Allergens
The EU's Scientific Committee on Consumer Safety (SCCS) has identified and established 26 cosmetic ingredients that are likely contact allergens (potential to cause skin allergies) as demonstrated in clinical or epidemiological studies. The EU's SCCS have recommend cosmetic companies to disclose them on the labels if used and in cases where the concentration exceeds 0.001% in leave-on products and 0.01% in rinse-off products, then they must be labelled.
Look out for the tick on the EU-Allergen free label to know your cosmetic is free from any of the 26 identified cosmetic ingredients.
For more information regarding the EU's Scientific Committee on Consumer Safety, please visit their official website.
Disclaimer
The EU Allergen Free label is for the 26 ingredients identified by the EU SCCS and products will be only flagged if a suspected ingredient is on it's ingredient list. It is possible for cosmetics to contain one of the suspect ingredients without it appearing on the ingredient list due to it not reaching the concentration threshold to disclose it and cosmetic manufacturers choice to not disclose it.
Also note, the EU Allergen Free label is not personalized for your own allergies you may have and it does not constitute as medical advice. For your specific case, always consult your medical professiona such as dermatologist, physician, pharmacist, or health care provider - please read our medical disclaimer for more information.
Fungal Acne (Molassezia) Safe
Fungal Acne (Molassezia) Safe
Understanding Fungal Acne (Pityrosporum Folliculitis/Malassezia Folliculitis)
Pityrosporum Folliculitis/Malassezia folliculitis or simply known as Fungal Acne is a persistent acne-like condition that commonly responds poorly to traditional acne-treating methods. Unlike most cases of Acne where bacteria is the culprit, Fungi is the culprit of Fungal Acne (Hence the name!). There are certain classes & groups of ingredients that have been shown to promote and feed the growth of the Fungal Acne, Fungi such as fatty acids, oils, esters, polysorbates and fermented ingredients.
For more information regarding Fungal Acne, please visit Simple Skincare Science (f.c) - #3 of our Recommend Skincare Resources for an amazing comprehensive guide!
Please Read: How to use the Fungal Acne (Malassezia) Label
At SkinCarisma, we've done our best to identify as many ingredients as possible but note the fungal-free label may not be 100% accurate due to the complexconditions and combination of ingredients that malezzeria can thrive on.
Additionally, products that may contain ingredients that have shown to feed Malassezia may not neccessarily exacerbate the condition due to concentration of ingredient used in the product, this information is simply not available on the products.
As a result, please note this is only an experimental label that can be best used to possible identify problematic products you have used in the past. It is in no way a perfect identifier nor a predictor in whether or not it will exacerbate or cause fungal acne. It will continue to be worked on as more information and research comes to light.
If you find any ingredients you believe should be included, please email us at snails@skincarisma.com.
Disclaimer
Due to the lack of substantial research into this area it is very likely there are other ingredients and class/groups of ingredients that could feed Fungal Acne which have not been indentified.
The Fungal-Safe label does not constitute as medical advice. For your specific case, always consult your medical professiona such as dermatologist, physician, pharmacist, or health care provider - please read our medical disclaimer for more information.
What are Notable Effects & Ingredients?
Ever used a product that promised a certain effect but provided no results? It might not have contained any notable ingredients that could have been responsible for that promised effect. It doesn't matter what the marketing or packaging «promises» it can do, if it doesn't contain anything that can help - then the likelihood of it helping is low.
We help you identify key notable ingredients that have been shown to help with effects such as acne-fighting, brightening, UV-protection, wound healing & anti-aging to help you achieve your skincare goals smarter. Please note that different notable ingredients have varying levels of research behind them, some are extremely well proven yet some have mixed research in their efficacy.
Pro Tip Alert!
Just because a product doesn't contain any notable ingredients doesn't mean it's bad. And a product with notable ingredients (or even many) doesn't necessarily guarantee the efficacy of the product performing these effects either. There are other factors such as ingredient quality, concentration and formulation that will ultimately determine this.
Be smart and use this as just a starting point for you to make more informed and smarter choices and compare it with reviews to see if the product is right for you
Notable Effects & Ingredients
Anti-Aging from 1 ingredient(s):
Brightening from 1 ingredient(s):
What are Ingredients Related to Skin Type?
Why are some products great for some people and horrible for others? Well everyone has different skin types and different reactions to the same ingredients.
We've identified a range of ingredients that are commonly regarded as potentially good or bad for those with Dry, Oily/Acne-Prone or Sensitive skin.
Pro Tip Alert!
A product that contains good or bad ingredients for your skin type doesn't always flat out make the entire product good or bad for your skin. There are other factors such as ingredient quality, concentration and formulation that will ultimately determine your skins reaction.
One of the best ways to use this section is to troubleshoot products you've had bad experiences with in the past. Check if it contains any of the marked ingredients to point out suspect ingredients to avoid in the future!
Ingredients Related to Skin Types
Dry Skin
Oily/Acne-Prone Skin
Sensitive Skin
What is the Ingredient Safety Breakdown?
Ingredient Safety Breakdown refers to the percentage % of ingredients in different risk categories as classified by EWG (Environment Working Group) if they are available. There are almost endless cosmetic ingredients and they are one of the few organisations globally that have assigned ratings to a lot of the more commonly used ingredients which is why we reference them.
Pro Tip Alert!
EWG is seen by many to be more on the alarmist side in their assignment of health ratings resulting in rating ingredients as riskier than they actually are. We recommend using this a reference point rather than a strict guide of ingredient safety and to always do further research if into ingredients that you may find suspect.
Ingredient Safety Breakdown
Product ingredient list
| EWG | CIR | Ingredient Name & Cosmetic Functions | Notes |
|---|---|---|---|
| 5 |
Benzyl Alcohol
Solvent, Masking, Fragrance, Viscosity Decreasing Agent, Preservative, External Analgesic, Perfuming
|
|
|
| 0 |
Emulsifying Wax Nf
|
|
|
| 1 |
Isopropyl Palmitate
Solvent, Skin Conditioning, Perfuming, Emollient, Fragrance, Antistatic Agent, Binding Agent, Binding, Masking
|
|
|
| 0 |
Lactic Acid
|
Brightening
Anti-Aging
|
|
| 0 |
Metronidazole
|
|