Metro Cream is a prescription topical medication used to treat inflammatory bumps and pimples associated with rosacea.
It contains metronidazole, an antimicrobial ingredient that helps reduce skin inflammation and improve certain symptoms of rosacea.
Metro Cream is commonly applied to the affected areas of the face, including the cheeks, nose, forehead, and chin.
Although Metro Cream is generally well tolerated, it may cause skin irritation, allergic reactions, or other unwanted effects in some patients.
Because the medication is applied directly to the skin, only small amounts usually enter the bloodstream.
For this reason, serious side effects associated with metronidazole taken by mouth are generally much less likely with Metro Cream.
Before starting treatment, tell your healthcare provider about any medication allergies, existing skin conditions, blood disorders, pregnancy, breastfeeding, or other medications you currently use.
For External Use Only
Metro Cream should only be applied to the skin.
Do not apply this medication directly into your eyes, mouth, inside your nose, or other sensitive areas.
Metro Cream is specifically formulated to treat inflammatory skin lesions associated with rosacea.
It is not intended to treat infections inside the body, vaginal infections, or eye conditions.
Avoid applying the medication to open wounds or severely damaged skin unless your healthcare provider specifically recommends it.
Before using Metro Cream, gently wash the affected area with a mild cleanser and allow your skin to dry.
Apply a thin layer to the affected skin, following your prescribed treatment schedule.
Avoid using more medication than recommended because excessive application may increase irritation.
If Metro Cream accidentally gets into your eyes, rinse them immediately with plenty of cool water.
Contact your healthcare provider if irritation continues.
Do not swallow Metro Cream. If someone accidentally swallows the medication, contact a poison control center for advice.
Use Metro Cream only on the affected areas of your skin and follow the application instructions provided by your healthcare provider.
Skin Irritation and Local Reactions
Metro Cream may cause mild skin irritation in some patients.
This is particularly important for people with rosacea because their skin is often more sensitive than usual.
Rosacea can weaken the skin’s protective barrier, making it more likely to react to certain medications, cleansers, and cosmetic products.
Possible reactions to Metro Cream include burning, stinging, itching, dryness, redness, and skin discomfort.
Some patients may notice these symptoms shortly after applying the medication.
Others may experience irritation after several days of treatment.
Mild irritation may improve as treatment continues.
However, worsening redness, severe burning, or persistent discomfort may indicate that your skin is not tolerating the medication.
Avoid applying Metro Cream more frequently than prescribed.
Using additional cream will not make rosacea improve faster and may increase skin irritation.
Your healthcare provider may recommend reducing the application frequency or temporarily stopping treatment if significant irritation develops.
If you experience severe burning, persistent redness, swelling, or worsening skin irritation, contact your healthcare provider before continuing treatment.
Allergic Reactions to Metro Cream
Do not use Metro Cream if you have a known allergy to metronidazole or any other ingredient in the medication.
Before starting treatment, tell your healthcare provider if you have previously experienced an allergic reaction to metronidazole or other nitroimidazole medications.
Metro Cream contains active and inactive ingredients that may cause allergic reactions in sensitive individuals.
An allergic reaction can develop when the immune system responds to a substance it considers harmful.
Possible symptoms include itching, hives, skin rash, redness, or swelling.
These symptoms may resemble rosacea-related irritation, making it important to recognize changes that occur after applying the medication.
Some people may develop contact dermatitis, which causes inflammation after the skin comes into contact with an irritating or allergy-causing substance.
Contact dermatitis may cause redness, itching, swelling, or a rash at the application site.
In rare cases, a serious allergic reaction may cause swelling of the face, lips, tongue, or throat.
Difficulty breathing or swallowing may also occur.
Stop using Metro Cream and seek emergency medical attention if you develop difficulty breathing or swelling of the tongue or throat.
If you develop a new rash or persistent itching, contact your healthcare provider for an evaluation.
Avoid Contact With the Eyes
Metro Cream is not intended for use in or directly around the eyes.
The eyes contain delicate tissues that may become irritated when exposed to topical skin medications.
Metronidazole applied to the skin has been associated with excessive tearing and eye irritation.
Accidental eye contact may cause burning, redness, watering, or discomfort.
When applying Metro Cream to your face, avoid placing the medication too close to your eyelids, eyelashes, or inner corners of the eyes.
Apply the cream carefully using clean fingertips.
Wash your hands after application to reduce the risk of transferring medication into your eyes.
If Metro Cream accidentally gets into your eyes, rinse them immediately with plenty of cool water.
Avoid rubbing your eyes because this may make irritation worse.
If you develop persistent redness, eye pain, or blurred vision, contact your healthcare provider.
Some patients with rosacea also develop ocular rosacea, which affects the eyes and eyelids.
Metro Cream should not be used as a substitute for treatment specifically prescribed for ocular rosacea.
Seek prompt medical attention if you experience significant eye pain, sensitivity to light, or changes in vision.
Medication and Supplement Interactions
Tell your healthcare provider about all medications and supplements you currently use before starting Metro Cream.
This includes prescription medications, over-the-counter products, vitamins, herbal supplements, and other topical skin treatments.
Although Metro Cream is applied to the skin, a small amount of metronidazole may enter the bloodstream.
For this reason, certain medication interactions may still need to be considered.
Metronidazole taken by mouth can increase the effects of certain blood-thinning medications, including warfarin.
Warfarin helps prevent harmful blood clots by reducing the blood’s ability to clot.
When its effects become too strong, the risk of bruising and bleeding may increase.
However, it is not known whether topical Metro Cream causes the same interaction because systemic absorption is much lower.
If you take warfarin or another anticoagulant, inform your healthcare provider before using Metro Cream.
Your healthcare provider can determine whether additional monitoring is necessary.
Other topical products, including medicated acne treatments, exfoliating creams, and alcohol-based skin preparations, may increase irritation when used alongside Metro Cream.
Do not combine Metro Cream with other prescription skin treatments without discussing their use with your healthcare provider.
Pregnancy and Metro Cream
Tell your healthcare provider if you are pregnant, planning to become pregnant, or think you may be pregnant before using Metro Cream.
There is limited information about the safety of topical metronidazole during human pregnancy.
Metronidazole is absorbed into the bloodstream in much smaller amounts when applied to the skin than when taken by mouth.
However, limited absorption does not establish that the medication is completely risk-free during pregnancy.
Your healthcare provider will consider the severity of your rosacea, the expected benefits of treatment, and any potential risks.
Rosacea may become more noticeable during pregnancy because hormonal changes can affect skin sensitivity and blood vessels.
Some patients may experience increased facial redness, flushing, or inflammatory breakouts.
Your healthcare provider can determine whether Metro Cream is an appropriate treatment or whether another approach would be preferable.
Use Metro Cream during pregnancy only after discussing its benefits and potential risks with your healthcare provider.
If you become pregnant while using Metro Cream, contact your healthcare provider to review your treatment plan.
Breastfeeding and Metro Cream
Consult your healthcare provider before using Metro Cream if you are breastfeeding.
Metronidazole taken by mouth is known to pass into human breast milk.
However, the amount that may enter breast milk after topical application is expected to be much lower because relatively little medication reaches the bloodstream.
The available information is limited, so the safety of Metro Cream during breastfeeding has not been fully established.
Your healthcare provider will consider the importance of rosacea treatment, the amount of medication used, and any potential risks to your baby.
If Metro Cream is prescribed during breastfeeding, avoid applying it directly to your nipples or surrounding breast area.
This helps prevent your baby from accidentally swallowing medication during feeding.
Wash your hands thoroughly after applying Metro Cream.
Avoid allowing your baby to come into direct contact with skin where the medication has recently been applied.
Breastfeeding does not automatically need to stop during Metro Cream treatment, but you should discuss its suitability with your healthcare provider.
Blood Disorders and Metro Cream
Tell your healthcare provider if you have a history of blood disorders before using Metro Cream.
Blood disorders are conditions that affect the number or function of blood cells.
These include conditions involving red blood cells, white blood cells, or platelets.
Red blood cells carry oxygen throughout the body, while white blood cells help protect against infections.
Platelets help the blood clot and prevent excessive bleeding.
Metronidazole taken by mouth has occasionally been associated with changes in blood cell counts, including a reduction in certain white blood cells.
This condition is called leukopenia.
A low white blood cell count may make it harder for the body to fight certain infections.
However, these effects are not established as common side effects of Metro Cream.
Because Metro Cream is applied to the skin, exposure throughout the body is much lower than with oral metronidazole.
Even so, the prescribing information recommends caution in patients with current or previous blood disorders.
Your healthcare provider may review your medical history before recommending treatment.
Tell your healthcare provider if you have a blood disorder or have previously experienced abnormal blood cell counts while taking medication.
Neurological Symptoms and Nerve Problems
Metronidazole taken by mouth or given through injection has occasionally been associated with neurological complications.
These complications may affect the brain, spinal cord, or peripheral nerves.
Peripheral nerves carry signals between the brain, spinal cord, and other parts of the body.
Damage to these nerves is called peripheral neuropathy.
Symptoms may include numbness, tingling, burning sensations, or pain in the hands and feet.
More serious neurological complications, including seizures and confusion, have been reported with systemic metronidazole treatment.
However, these effects are much less likely with Metro Cream because only small amounts of medication enter the bloodstream.
Rare reports of tingling or numbness have occurred during topical metronidazole use.
Tell your healthcare provider if you have an existing neurological condition or a history of nerve problems.
If you notice unusual numbness, tingling, or other new neurological symptoms, stop using Metro Cream and contact your healthcare provider promptly.
Your healthcare provider can determine whether the symptoms may be related to treatment or another medical condition.
Seek emergency medical attention if you experience seizures, sudden severe confusion, or other serious neurological symptoms.
Alcohol Consumption During Metro Cream Treatment
Tell your healthcare provider if you regularly consume alcohol while using Metro Cream.
Metronidazole taken by mouth has traditionally been associated with a possible unpleasant reaction when combined with alcohol.
This is sometimes called a disulfiram-like reaction.
Possible symptoms include facial flushing, headache, nausea, vomiting, and abdominal discomfort.
However, evidence that metronidazole consistently causes this reaction is limited and conflicting.
The interaction has not been clearly established with topical Metro Cream.
Because only small amounts of metronidazole enter the bloodstream after skin application, the risk of a systemic interaction is expected to be much lower than with oral treatment.
Alcohol may also trigger rosacea flare-ups in some patients.
For example, drinking alcohol may cause facial flushing, increased redness, or a warm sensation in the cheeks.
These reactions may occur because alcohol can affect blood vessels near the skin’s surface.
If alcohol regularly worsens your rosacea symptoms, avoiding or limiting it may help reduce flare-ups.
Ask your healthcare provider whether you should avoid alcohol while using Metro Cream, especially if alcohol triggers your rosacea symptoms.
Existing Skin Conditions and Sensitive Skin
Tell your healthcare provider if you have eczema, psoriasis, contact dermatitis, or another skin condition before using Metro Cream.
Some inflammatory skin conditions can resemble rosacea.
For example, eczema may cause red, dry, itchy patches, while contact dermatitis may develop after exposure to irritating skin care products.
Rosacea can also cause burning, stinging, redness, and skin sensitivity.
Because these conditions may share similar symptoms, an accurate diagnosis is important.
Metro Cream is specifically prescribed to treat inflammatory lesions associated with rosacea.
It does not treat every condition that causes facial redness or irritation.
Using Metro Cream for an unrelated skin condition may delay appropriate treatment.
Patients with sensitive skin may also react more easily to certain ingredients in topical medications.
Avoid applying Metro Cream to severely damaged skin or open wounds unless your healthcare provider specifically recommends it.
Contact your healthcare provider if your skin becomes increasingly irritated or develops unusual symptoms during treatment.
Sun Exposure and Rosacea Flare-Ups
Sunlight is a common trigger for rosacea flare-ups.
Exposure to ultraviolet radiation and heat may increase facial redness, flushing, and inflammation.
Some patients notice that their rosacea becomes worse after spending time outdoors, especially during hot or sunny weather.
Metro Cream helps treat inflammatory rosacea lesions, but it does not protect the skin from ultraviolet radiation.
For this reason, sun protection remains important during treatment.
Use a broad-spectrum sunscreen with SPF 30 or higher when appropriate.
Choose a sunscreen suitable for sensitive or rosacea-prone skin.
Wear a wide-brimmed hat and seek shade when sunlight is strongest.
Avoid tanning beds and excessive exposure to sunlamps.
If sunscreen or another skin care product causes burning or stinging, ask your healthcare provider about gentler alternatives.
Protecting your skin from excessive sunlight may help reduce rosacea flare-ups while using Metro Cream.
Use in Children
The safety and effectiveness of Metro Cream have not been established in pediatric patients.
Rosacea is more commonly diagnosed in adults, although similar inflammatory skin conditions may occur in children.
Facial redness, bumps, or irritation in children can have several causes.
These may include acne, eczema, allergic reactions, and certain skin infections.
Because treatment depends on the underlying condition, a proper medical evaluation is important.
Do not use Metro Cream on a child without consulting a healthcare provider.
Your healthcare provider can determine whether the medication is appropriate or whether another treatment is needed.
Keep the medication out of reach of children to prevent accidental swallowing or misuse.
Do not give Metro Cream to children unless a healthcare provider specifically recommends it.
Complete the Recommended Treatment
Use Metro Cream exactly as prescribed by your healthcare provider.
Metro Cream 0.75% is commonly applied twice daily, in the morning and evening.
Before each application, gently wash and dry the affected skin.
Apply a thin layer of medication to the areas affected by inflammatory rosacea.
Some patients may begin to notice fewer bumps and less inflammation after approximately three weeks.
However, more noticeable improvement may take six to nine weeks or longer.
Rosacea is a chronic condition, meaning symptoms may return even after successful treatment.
Your healthcare provider may recommend continued treatment to help keep inflammatory breakouts under control.
Do not stop applying Metro Cream simply because your skin looks better.
Similarly, do not increase the application frequency or use more cream than recommended.
Excessive use may increase skin irritation without improving treatment results.
Follow your prescribed treatment schedule and do not stop, extend, or change treatment without medical advice.
Avoid Irritating Skin Care Products
People with rosacea often have sensitive skin that reacts easily to certain ingredients.
Harsh cleansers, exfoliating scrubs, fragranced products, and alcohol-based skin preparations may worsen irritation.
These products can affect the skin’s protective barrier, making it more sensitive to environmental triggers.
Using several medicated products at the same time may also increase dryness, burning, or redness.
Choose gentle, fragrance-free skin care products whenever possible.
Wash your face with lukewarm water rather than very hot water.
Avoid rubbing or scrubbing the affected skin.
If you use makeup, allow Metro Cream to absorb before applying cosmetic products.
A gentle moisturizer may help reduce dryness and support the skin barrier.
Tell your healthcare provider if you are using prescription acne treatments, retinoids, exfoliating acids, or other medicated creams.
Your healthcare provider can help determine which products are suitable for use alongside Metro Cream.
Stop using skin care products that cause significant burning, stinging, or worsening redness, and seek medical advice if the irritation continues.
When to Contact Your Healthcare Provider
Contact your healthcare provider if your rosacea symptoms become worse or do not improve after several weeks of Metro Cream treatment.
You should also seek medical advice if you develop persistent burning, severe dryness, increasing redness, swelling, or an unusual rash.
These symptoms may indicate skin irritation, an allergic reaction, or another condition that requires evaluation.
If you develop persistent numbness, tingling, or other unusual neurological symptoms, stop using Metro Cream and contact your healthcare provider promptly.
Your healthcare provider may recommend adjusting the application frequency, temporarily stopping treatment, or using another medication.
Seek emergency medical attention if you experience difficulty breathing, swelling of the tongue or throat, seizures, or sudden severe confusion.
Continue using Metro Cream according to your healthcare provider’s instructions unless you develop symptoms that require stopping the medication.
Keep your skin care routine gentle, avoid known rosacea triggers, and attend recommended follow-up appointments to monitor your response to treatment.
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