Metrogel

What is Metrogel?

Metrogel is an effective topical treatment for rosacea, a common skin condition that affects the face and causes symptoms including redness, spots, and pimples. It contains 0.75% metronidazole, an antibiotic that targets the inflammatory features of rosacea and improves your symptoms over time.

Metrogel is a clear gel you apply directly to your face during a flare-up. It is only available with a prescription from a registered clinician. 

What is Metrogel Used For?

Metrogel is a topical treatment for rosacea, a skin condition characterised by red, itchy, and inflamed skin on the face. It usually affects your cheeks, nose, chin, forehead, and eyelids, causing redness (flushing) and acne-like outbreaks of spots and pimples.

Rosacea symptoms can differ from person to person, but can also include:

• Dry skin
• Yellow-orange skin patches
• Sore eyelids or crusts around your eyelash roots
• Thickened skin, especially on your nose
• Swelling

Metrogel is formulated for skin issues like rosacea, but you may have heard of generic metronidazole topical or vaginal gels used to treat bacterial infections like bacterial vaginosis. Metrogel is only suitable for rosacea.

You can learn more about rosacea, such as how it can affect you and how to get rid of the condition, in our dedicated articles. 

How Does Metrogel Work?

Metrogel's active ingredient is metronidazole, a potent antibiotic and antimicrobial agent in a group of medications called nitroimidazole antibiotics. It treats rosacea by reducing inflammation and preventing bacterial growth on your skin.

By calming your skin's immune response, Metrogel helps reduce swelling, inflammation, and flushing, and improves the appearance of pimples and pustules. Its antimicrobial effects can help slow the growth of skin bacteria, which may be linked to rosacea flare-ups.  

If you use Metrogel regularly, it can help prevent future rosacea flare-ups and keep your skin in remission. 

How Long Does Metrogel Take to Work?

It usually takes 3 to 4 weeks for Metrogel to noticeably improve your rosacea symptoms, but it can take up to 12 weeks to work fully. Keep applying Metrogel for as long as your clinician tells you to. This will ensure it has had enough time to work.

How Effective is Metrogel for Rosacea?

Metrogel is an effective first-line treatment that is prescribed for mild to moderate inflammatory rosacea. In a study on the effectiveness of 0.75% metronidazole gel for preventing rosacea flare-ups, 59% of people treated with a combination of oral tetracycline and metronidazole gel had no papules or pustules.

Patients who had achieved at least a 70% reduction in inflammatory lesions were then treated with 0.75% metronidazole gel or a placebo to see whether the metronidazole gel maintained rosacea remission. Of those given the placebo, 42% relapsed, compared with 23% of those treated with the metronidazole gel, showing that topical 0.75% metronidazole gel could maintain remission in moderate to severe rosacea after combination treatment with oral tetracycline and 0.75% metronidazole gel. 

How to Use Metrogel 0.75 Gel

Apply Metrogel directly to the affected area of your skin because it is a topical treatment. It must not be swallowed – if you do, you must seek medical advice. You should only use this medication exactly as your clinician has told you to. If you are unsure at any time, contact your clinician or pharmacist for more advice.

To apply Metrogel, you should:

1. Wash the affected areas with a mild cleanser and warm water, then dry thoroughly with a clean towel.
2. Apply a thin layer of gel to the affected areas, but be careful not to get it in your eyes.
3. Rub the gel in well.
4. After use, replace the cap back on the tube and wash your hands with warm, soapy water.

Metrogel is usually applied twice a day; once in the morning and once in the evening, or as your clinician has told you to. Your clinician will tell you how long you need to use Metrogel to keep your rosacea symptoms under control.

If You Get Metrogel in Your Eyes

If you get any of the gel in your eyes, rinse your eyes with warm water. If irritation persists after rinsing, seek medical advice.

If You Forget to Use Metrogel

Although Metrogel 0.75 gel works best when used regularly, don’t worry if you forget to use it on time. When you do remember, simply start using it again in the same way as before. Do not try to double-dose to make up for one you have forgotten. 

If You Use Too Much Metrogel 

If you apply more Metrogel than you should, wipe off any excess gel with a clean tissue or wash it off with warm water. It’s important that you do not use more Metrogel than prescribed. The NHS advises against using the medication more than twice a day, unless your prescriber has told you to do so. 

If You Stop Using Metrogel

Rosacea may respond slowly to antibiotics. It’s therefore important to keep using the medicine until you have been advised by your clinician to stop. 

Metrogel Side Effects and Cautions

Metrogel can cause side effects in some people. Familiarise yourself with the Patient Information Leaflet supplied with the medication to help you fully understand them. This can help you spot potential Metrogel side effects so you can manage them safely or seek medical advice if needed.

Side Effects of Metrogel for Rosacea 

Although Metrogel can cause side effects, not everyone will experience them. They are usually mild, temporary, and affect the skin area where you apply the gel. You can often manage them at home.

Potential adverse reactions include: 

If you do experience skin irritation when using Metrogel for rosacea, use it a little less often or even stop using it completely for a little while until things settle down. Seek medical advice from your clinician or doctor if necessary. 

Additional Side Effects

Metrogel 0.75 gel has been reported to cause additional side effects, though available data do not indicate how often they occur. These include:

• Contact dermatitis
• Swelling of the face
• Peeling skin

More details about possible side effects can be found within the Patient Information Leaflet enclosed with the medication. You can also report any adverse reactions you experience via the MHRA’s Yellow Card scheme or by speaking to your clinician. This can help provide more information about the treatment’s safety profile.  

Metrogel Warnings and Interactions

Despite Metrogel being an effective rosacea treatment, it may not be suitable for everyone. You must not use Metrogel if you are allergic to metronidazole or any other ingredients listed in the medication. It is also not suitable for you if you are affected by Cockayne syndrome, a rare, inherited disorder that causes growth failure, premature ageing, and extreme sun sensitivity. There have been reports of severe liver toxicity or failure in people with Cockayne syndrome who have used products containing metronidazole.

Metrogel is intended for external use only. If it accidentally contacts your eyes, mouth, or other mucous membranes, wash the affected area with water and contact your doctor if the irritation persists.    

What You Should Know Before Using Metrogel

Before using Metrogel for rosacea, tell your clinician about any other health conditions. This will help them check that Metrogel is safe for you. If you have any blood disorders, tell your clinician, as you may not be able to use Metrogel unless they tell you it is safe to do so. Metrogel is intended only for adults; it is not for children.

While using Metrogel, avoid strong sunlight, such as sunbathing, and ultraviolet (UV) light, such as sunbeds and sunlamps. Also avoid prolonged and unnecessary use of Metrogel. Your clinician will advise how long to use it.

Metrogel and Other Medicines

Before using Metrogel, tell the clinician about any prescribed, over-the-counter, or herbal medications you take, as they could interact with each other. You must tell the clinician if you are taking any blood-thinning medications (anticoagulants), such as warfarin or dicoumarin. 

Pregnancy and Breastfeeding

Metrogel is usually not suitable during pregnancy or breastfeeding unless your clinician considers it essential. If you are pregnant or breastfeeding, or think you might be pregnant or planning to conceive, speak to your doctor or pharmacist before using Metrogel. 

Frequently Asked Questions About Metrogel