Metronidazole cream: what it treats and how it works

Metronidazole cream is a topical antibiotic people use for skin conditions like rosacea and some local bacterial infections. It comes as a cream or gel (often 0.75%) and there’s also a 0.75% vaginal gel used for bacterial vaginosis. The medication reduces bacteria and calms inflammation, so redness, bumps, and irritation often improve after a few days to weeks.

How to apply metronidazole cream

Use a thin layer on clean, dry skin—usually twice a day for rosacea unless your doctor says otherwise. For vaginal use, it’s commonly a once-nightly application for five days using the provided applicator. Wash your hands before and after applying. Don’t mix it with other strong topical treatments (like exfoliating acids) unless your provider okays it. If you miss a dose, apply it when you remember but don’t double up the next time.

Be consistent. Many people stop when they feel better, but finishing the prescribed course helps prevent a return of symptoms. If you don’t see improvement after 2–4 weeks, check in with your clinician—your diagnosis or treatment plan may need a change.

Common side effects and warnings

Expect mild local effects: dryness, stinging, burning, or itching where you apply the cream. These usually fade after a few days. A rash or severe irritation means stop and call your doctor. Systemic side effects (like dizziness or nausea) are rare with topical use because absorption is low, but report anything unusual.

If you’re allergic to nitroimidazole antibiotics, don’t use it. Tell your prescriber if you have liver problems, are pregnant, or breastfeeding—topical metronidazole is often preferred over oral options in pregnancy, but your provider will decide what’s safest. Also, avoid sharing tubes or applicators with others.

Note about alcohol: the disulfiram-like reaction (flushing, nausea) is linked to oral metronidazole. Topical treatment rarely causes this, but if you’re using oral metronidazole too, avoid alcohol and check with your provider.

Alternatives depend on the condition: azelaic acid or topical ivermectin can work for rosacea; for bacterial vaginosis, topical or oral clindamycin and oral tinidazole are options. Don’t switch medicines without medical advice.

Buying and storage tips: many places require a prescription for metronidazole. If you order online, use a licensed pharmacy, confirm contact information, and keep the packaging and leaflet. Store the cream at room temperature away from heat and light. Toss it after the expiration date.

Quick practical tips: apply as directed, don't use on deep open wounds unless told to, stop if severe reaction happens, and follow up if symptoms persist. If you’re unsure whether metronidazole cream is right for you, a short chat with your healthcare provider clears things up fast.