# A-07 — Metronidazole

Decades of trial support and the class's standing question: an antibiotic dispensed monthly with no stated review point is a subscription, not a course.

- **Canonical:** https://www.30plusskin.care/actives/metronidazole
- **Site:** 30+/SKIN — Skincare, published as a spec sheet.
- **Issue:** ISSUE NO. 13 / REV. 2026.10
- **Standing terms:** INDEPENDENT · AFFILIATE-FUNDED · NOT MEDICAL ADVICE

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## Datasheet

- **INN / INCI:** Metronidazole
- **Family:** Nitroimidazole — topical antibiotic, anti-inflammatory
- **Molecular weight:** 171.15 g/mol
- **Layer reached:** EPIDERMIS
- **Prescription only:** yes
- **Evidence grade:** A
- **Controlled trials on file:** 0
- **Strength range recorded:** 0.75%–1.11%
- **Representative reference concentration:** 1%
- **Irritation (0–10):** 2
- **Onset:** 8–12 WK
- **Stability:** STABLE

## Mechanism

The concentration marker is not a recommended dose or a claim that other strengths are untested. Compare the vehicle, indication and trial population.

Long-standing first-line agent for inflammatory rosacea lesions. The precise mechanism in rosacea is unknown; the antioxidant and anti-inflammatory activity is thought to matter more than the antibacterial.

## Measured endpoints

_None on file._

## Layering

- **Do not layer with:** Indefinite use without review, Alcohol, for the oral form
- **Pairs with:** Azelaic acid, Ivermectin

## Notes

- Approved at 0.75% and 1%. This register has found it compounded at 1.11%, published honestly, and unstated elsewhere.
- No product in this register that dispenses it states a duration or a review point.
- Topical metronidazole is a far smaller stewardship concern than an oral antibiotic, and a sentence about how long the course runs would still be the difference between a treatment plan and a subscription.
- One company's ingredient page concedes that the precise mechanism of its action is unknown — an unusual piece of candour on a consumer page.

## Products in the register containing it

| No. | Product | Stance | Score | Document |
| --- | --- | --- | --- | --- |
| R-33 | Alloy Rosacea Face Cream Rx | CONDITIONAL | 70/100 | /reviews/alloy-rosacea-face-cream-review |
| R-24 | Dermatica Rosacea Treatment | CONDITIONAL | 71/100 | /reviews/dermatica-rosacea-review |
| R-45 | Skin + Me The Daily Doser | CONDITIONAL | 70/100 | /reviews/skin-and-me-daily-doser-review |

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## Elsewhere in the register

- [Review register](/reviews)
- [Active monographs](/actives)
- [Brand register](/brands)
- [Evidence register](/evidence)
- [The ledger](/ledger)
- [How we test](/how-we-test)
- [Agent guide](/llms.txt)
- [Sitemap](/sitemap.xml)

_SOURCE-BASED ASSESSMENTS. PUBLISHER PREFERENCES ARE IDENTIFIED SEPARATELY._