Metronidazole Topical Cream 0.75% (RX)
Metronidazole Topical Cream 0.75% (RX)
Product Description
Product overview
Fougera Metronidazole Topical Cream 0.75% is a prescription (Rx) antibacterial and anti-inflammatory cream FDA-approved for the treatment of inflammatory papules and pustules of rosacea. Formulated by Fougera Pharmaceuticals with 7.5 mg/g of metronidazole USP in a gentle emollient base, this dermatologist-prescribed cream calms persistent redness, reduces breakouts, and helps maintain long-term symptom control on facial skin.
Anti-Inflammatory Action
Reduces facial erythema (redness) and calms inflammatory papules and pustules associated with rosacea.
Texture & feel
SENSORYAnti-Inflammatory Action
Reduces facial erythema (redness) and calms inflammatory papules and pustules associated with rosacea.
Antimicrobial Activity
Targets bacteria and Demodex-related inflammation believed to contribute to rosacea flare-ups.
Emollient Base
Gentle cream with glycerin and sorbitol soothes dry, sensitive rosacea-prone skin during treatment.
Long-Term Maintenance
Approved for chronic use to maintain remission and prevent recurrence of rosacea symptoms.
Sensitive-Skin Friendly
Free of fragrance, parabens, lanolin, and dyes — well tolerated by reactive complexions.
Gold-Standard Therapy
First-line topical option for papulopustular rosacea per international dermatology guidelines.
Safety & compatibility
SAFEFormer FDA Category B. Topical absorption is minimal, but use only if clearly needed and under physician guidance.
Discuss with your doctor. Topical blood levels are low, but some labels recommend avoiding use during nursing.
No fatty acid esters, ferments, or polysorbates that typically feed Malassezia yeast.
Low pore-clogging risk (rated 2/5). Suitable for combination and acne-prone skin.
Topical metronidazole has been reported to cause tearing. Keep cream away from eyes, mouth, and nostrils.
Minimize strong sun and UV light exposure on treated areas. Daily broad-spectrum SPF is recommended.
Oral metronidazole may potentiate warfarin. Inform your physician if on blood thinners, even with topical use.
Safety and effectiveness in children have not been established. For adult use only.
Ingredient breakdown
INGREDIENTSMetronidazole 0.75%Proven
The active prescription ingredient — a nitroimidazole antimicrobial with potent anti-inflammatory effects. Approved by the FDA in 1988 for rosacea and considered a first-line topical therapy by dermatologists worldwide.
- Mechanism: Reduces reactive oxygen species and modulates neutrophil activity to lower facial inflammation.
- Clinical evidence: Multiple randomized trials show ~50–65% reduction in inflammatory lesions over 8–12 weeks of twice-daily use.
- Absorption: Minimal systemic absorption — serum concentrations are typically undetectable after topical application.
- Guidelines: Recommended as first-line treatment for papulopustular rosacea by British and international rosacea guidelines.
Emulsifying Wax NF ~5–10%Proven
A pharmaceutical-grade blend (typically cetostearyl alcohol with polysorbate 60) that forms the smooth, stable emulsion holding the cream together. Functions as both a thickener and skin-conditioning agent.
- Function: Creates a uniform, easy-to-spread cream texture and helps form a protective lipid layer on skin.
- Skin compatibility: Recognized as low-irritation and broadly tolerated by sensitive skin.
Sorbitol ~5%Proven
A sugar-alcohol humectant derived from corn or fruit. Draws moisture into the skin and provides a soft, conditioned feel without occlusion.
- Function: Humectant — binds water to the upper skin layers for hydration support.
- Bonus: Acts as a gentle co-solvent and stabilizer, helping keep the active dispersed evenly.
Glycerin ~3–5%Proven
One of the most well-studied humectants in skincare. Strengthens the moisture barrier and helps prevent the dryness commonly triggered by active rosacea treatments.
- Mechanism: Attracts water from deeper skin layers and the atmosphere into the stratum corneum.
- Barrier support: Improves skin hydration and reduces transepidermal water loss (TEWL).
Isopropyl Palmitate ~2–4%Proven
A lightweight ester used as an emollient. Gives the cream its silky slip and helps the active spread evenly across rosacea-affected zones.
- Function: Emollient and skin-softener; improves cream glide and absorption.
- Note: Mildly comedogenic in isolation (rating 4/5), but used at low percentages in well-balanced Rx formulas with no reported pore-clogging in rosacea trials.
Benzyl Alcohol ~1%Proven
A widely used preservative and mild solvent. Keeps the formulation microbiologically safe across its shelf life without parabens.
- Function: Broad-spectrum preservative against bacteria and fungi.
- Safety: Generally well tolerated below 1% in topical leave-on products per cosmetic safety reviews.
Lactic Acid traceProven
Used here strictly as a pH adjuster, not as an exfoliant. Helps maintain the skin-friendly, slightly acidic pH needed for both stability and tolerability.
- Function: pH balancing buffer (works alongside sodium hydroxide).
- Concentration: Far below exfoliating levels — no AHA-type effect, no sun-sensitivity from this ingredient.
Sodium Hydroxide traceProven
A pH-adjusting agent paired with lactic acid. Neutralizes the formula to a safe, skin-compatible pH.
- Function: Buffers acidity to reach a target pH around 5.0–6.0.
- Safety: Used in trace amounts; fully neutralized in the final product.
Purified Water ~75–80%Proven
The aqueous base of the cream — pharmaceutical-grade purified water that disperses the active and water-soluble ingredients evenly.
- Function: Solvent and primary vehicle of the emulsion.
9 ingredients
Metronidazole 0.75% (active), Emulsifying Wax NF, Sorbitol Solution, Glycerin, Isopropyl Palmitate, Benzyl Alcohol, Lactic Acid, Sodium Hydroxide, Purified Water.
Where it fits in your routine
ROUTINEApply twice daily (morning and evening) on cleansed, dry skin. Wait a few minutes before layering moisturizer or makeup. Always finish your AM routine with broad-spectrum SPF.
How to use
HOW TO USECleanse Gently
Wash the affected area with a mild, fragrance-free cleanser. Avoid harsh scrubs or hot water that can trigger rosacea.
Pat Dry Completely
Use a soft towel to pat skin dry. Wait 1–2 minutes to ensure skin is fully dry — applying to damp skin reduces efficacy.
Apply a Thin Layer
Squeeze a pea-sized amount onto fingertips and gently rub into affected areas of the face. Avoid eyes, mouth, and inside the nose.
Wash Hands
Always wash hands thoroughly after applying to prevent eye contact or spreading the medication.
Layer With Moisturizer + SPF
Once absorbed (2–3 minutes), follow with a calming moisturizer. In the morning, finish with broad-spectrum SPF 30+.
Be Consistent
Use twice daily as prescribed. Improvement is typically noticeable after 3 weeks; full benefits appear at 8–12 weeks.
Who is it for?
WHOPerfect for you if:
- You have dermatologist-diagnosed papulopustular rosacea
- You experience persistent facial redness with bumps and pustules
- You want a gentle, fragrance-free Rx option for sensitive skin
- You need a long-term maintenance therapy for chronic rosacea
- You prefer a cream texture over gel (better for dry skin)
- You've struggled with harsher actives like benzoyl peroxide or retinoids
Consider alternatives if:
- You don't have a prescription — this is Rx-only
- You have only erythematotelangiectatic (redness-only) rosacea without bumps
- You have severe rosacea that hasn't responded to topicals (oral therapy may be needed)
- You have a known allergy to metronidazole or nitroimidazoles
- You're pregnant or breastfeeding (consult your physician first)
- You need faster results — azelaic acid or ivermectin may work quicker
Skin type compatibility
SKIN TYPESCream base is heavier than the gel version — oily skin may prefer Metronidazole Gel 0.75% for a lighter feel.
The emollient base with glycerin and sorbitol minimizes the dryness and tightness common with rosacea treatments.
Balanced cream texture works on both drier cheeks and oilier zones without exacerbating either.
Fragrance-free, paraben-free, and free of top 11 allergens. Among the gentlest topical Rx options for rosacea.
Targets inflammatory rosacea papules; not a treatment for hormonal or cystic acne. Low comedogenic risk overall.
Rosacea is more common after age 30. The hydrating cream base supports mature skin during long-term use.
Results timeline
3–4 MONTHSSkin Settles In
Mild tingling on first applications is normal. Some users see a slight reduction in redness; bumps are still present.
~30% notice early calmingFirst Visible Improvement
Per dermatology guidelines, noticeable reduction in inflammatory papules and pustules typically begins around three weeks of consistent twice-daily use.
~55% notice visible changeSignificant Reduction
Clinical trials show ~50–65% reduction in inflammatory lesions and meaningful improvement in facial erythema by 8–10 weeks.
~75% see clear improvementFull Clinical Benefit
Maximum reduction in lesions and redness. Continued use helps maintain remission and prevent flare-ups.
~80% achieve maintenanceLong-Term Maintenance
Dermatologists may recommend continued therapy beyond 4 months for chronic rosacea control. Discontinuation often leads to gradual relapse.
~60% relapse if stoppedRatings by platform
1K+ REVIEWSPros & cons
BALANCEDPraised
- Gold-standard, FDA-approved for inflammatory rosacea
- Significantly reduces facial redness and bumps
- Gentle emollient base — better for dry/sensitive skin than gel
- Free from fragrance, parabens, and common allergens
- Safe for long-term, chronic use
- Minimal systemic absorption
- Affordable compared to ivermectin and azelaic acid Rx options
- Generic versions widely available
Criticized
- Requires a prescription (cannot purchase OTC)
- Slow onset — full results take 8–12 weeks
- Symptoms often return when discontinued
- May cause initial stinging or dryness
- Less effective than ivermectin or azelaic acid in head-to-head trials
- Twice-daily application required (vs once-daily for some alternatives)
- Not approved for use in children
- Caution advised in pregnancy/breastfeeding
Budget-friendly alternatives (dupes)
DUPESTherapeutically equivalent generic versions of the same active. Identical clinical efficacy at a fraction of the brand cost. Still requires a prescription.
Same active at a higher concentration in a once-daily gel format. Better for oily skin; may feel drier than the cream version.
Over-the-counter azelaic acid at a sub-Rx strength. Helps with redness and bumps but less potent than prescription Finacea 15%. No prescription required.
Affordable OTC azelaic acid in a more elegant cream texture. Useful for mild rosacea or as a maintenance step, but not a true Rx replacement.
Comparison with competitors
SIDE-BY-SIDE
Soolantra (Ivermectin 1% Cream)
Mirvaso (Brimonidine 0.33% Gel)
Storage & shelf life
12 MONTHS12 months after opening. Discard before the printed expiration date.
Store at controlled room temperature 20–25°C (68–77°F). Protect from freezing. Keep tightly closed.
45 g aluminum tube with screw cap. Hygienic and prevents formula contamination.
Yes — under 100ml/100g and TSA-compliant. Carry the original Rx label when flying internationally.
Frequently asked questions
FAQUse with caution. Topical metronidazole was formerly classified as FDA Pregnancy Category B, with minimal systemic absorption after skin application. However, current labeling recommends avoiding use during pregnancy unless considered essential by your physician, and some sources advise against breastfeeding while using it. Always consult your dermatologist or OB-GYN before continuing treatment if you are pregnant, planning pregnancy, or nursing.
Yes. The formula contains no fatty acid esters above C13, no ferments, no polysorbates, and no oils that typically feed Malassezia yeast. Isopropyl palmitate is the only ester present and is generally considered Malassezia-safe. The cream is suitable for those managing both rosacea and fungal acne concerns.
Generally yes, but with care. Metronidazole itself is not an exfoliating active and can be combined with most ingredients. However, rosacea-prone skin is reactive — pairing it with retinoids, high-strength vitamin C, or strong AHAs/BHAs can cause irritation. Many dermatologists recommend alternating nights or applying actives at different times of day. Always run combinations by your prescribing physician.
It is best suited for adults with dermatologist-diagnosed papulopustular rosacea, especially those with dry, sensitive, or combination skin. The emollient cream base is more comfortable than the gel form for drier complexions. Oily skin types may prefer the metronidazole gel formulation for a lighter feel.
Initial improvement is typically noticeable after about 3 weeks of consistent twice-daily use. Significant reduction in inflammatory bumps and redness usually appears at 8–10 weeks. Maximum benefit is reached at 12 weeks, and many dermatologists recommend continued use for 3–4 months and beyond to maintain remission.
Apply it after cleansing and patting skin dry, but before moisturizer and sunscreen. Wait 1–2 minutes for skin to be fully dry, apply a thin layer to affected areas, let absorb for a few minutes, then layer your moisturizer. In the morning, always finish with broad-spectrum SPF 30+.
The overall formula has a low comedogenic rating of 2/5. While isopropyl palmitate is rated higher in isolation, it is used at low levels in this medical-grade emulsion and clinical trials have not flagged pore-clogging as a notable side effect. Most acne-prone and combination skin users tolerate it well.
The Period After Opening (PAO) is approximately 12 months, and you should always discard it before the printed expiration date on the tube. Store at controlled room temperature (20–25°C / 68–77°F), protect from freezing, and keep the cap tightly closed. Do not transfer to another container.
Verdict: Fougera Metronidazole Topical Cream 0.75% remains a trusted, dermatologist-favorite first-line treatment for inflammatory rosacea. Its gentle emollient base, fragrance-free formula, and proven safety profile make it especially valuable for sensitive and dry skin. While newer alternatives like ivermectin and azelaic acid may offer slightly faster or stronger results, metronidazole's affordability, tolerability, and long-term track record keep it a gold-standard choice — particularly for chronic rosacea maintenance. Best for users seeking a mild, well-tolerated Rx option with decades of clinical evidence behind it.
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 2 ingredient(s):
Promotes Wound Healing 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 |
|---|---|---|---|
| 0 |
Metronidazole
|
|
|
| 0 |
Emulsifying Wax Nf
|
|
|
| 1 |
Sorbitol
Skin Conditioning, Fragrance, Humectant, Flavoring Agent, Plasticizer, Masking
|
Hydrating
|
|
| 2 |
Glycerin
Solvent, Perfuming, Fragrance, Humectant, Viscosity Decreasing Agent, Hair Conditioning, Skin Protecting, Denaturant, Skin Conditioning
|
Brightening
Promotes Wound Healing
Hydrating
|
|
| 1 |
Isopropyl Palmitate
Solvent, Skin Conditioning, Perfuming, Emollient, Fragrance, Antistatic Agent, Binding Agent, Binding, Masking
|
|