Rosacea erythema formula guide
How to use the prescribed metronidazole, niacinamide, azelaic acid and allantoin compounded cream safely.
How to use
- 01
Step 1
What it is and how it works
This validated compounded cream contains metronidazole 0.75%, niacinamide 4%, micronised azelaic acid 10% and allantoin 0.5%. It is prescribed for a rosacea pattern dominated by persistent facial redness.
- 02
Step 2
Apply it as prescribed
Apply a thin layer once daily to clean, dry skin over the prescribed area. Avoid the eyes, mouth, mucosa and broken skin, and wash your hands afterwards. Use only the labelled 30 g preparation supplied by the pharmacy.
- 03
Step 3
Skin care and interactions
Tell the prescriber about warfarin, coumarins or other anticoagulants and any history of blood disorders. Do not add another metronidazole or facial medicine without review. Use gentle skin care, daily sunscreen and avoid known rosacea triggers.
Dose schedule
- 01
Step 1
Timing and review
Apply once daily for the prescribed 3-month course. Review tolerance and response at 6–12 weeks. Do not continue beyond 3 months or request a repeat preparation without clinical reassessment.
- 02
Step 2
If you miss an application
Apply it when you remember unless the next scheduled application is near. In that case, skip it and continue as usual. Do not apply extra product to make up for it.
Side effects
Local irritation
Mild redness, dryness, stinging or peeling can occur, especially at the start. Use a gentle moisturiser and follow the prescribed adjustment plan. Stop and seek advice if the reaction is marked or persistent.
Allergy or unusual bleeding
Stop and seek advice for a spreading rash, marked swelling or severe burning. If you take an anticoagulant, report unexpected bruising or bleeding promptly.
04 · Do not use if
Do not use this treatment if
- You are allergic to metronidazole, azelaic acid, niacinamide, allantoin or the final vehicle
- A blood disorder or anticoagulant treatment has not been reviewed
- You are pregnant, trying to conceive or breastfeeding and the formula has not been individually reviewed
05 · When to contact your doctor
Contact your doctor if
- Facial swelling, breathing difficulty, widespread blistering, eye pain, light sensitivity or altered vision — seek urgent medical care
- Unexpected bruising or bleeding, particularly while taking an anticoagulant
- There is no satisfactory response at the 6–12-week review or the redness is worsening
Storage
Keep the compounded preparation in its labelled container, out of children's reach. Follow the pharmacy's storage conditions and beyond-use date; these depend on the final vehicle. Do not transfer it to another container.
What to expect
The formula is reviewed after 6–12 weeks and is limited to the prescribed 3-month course. Redness can fluctuate with triggers, so use dated photographs in similar lighting rather than day-to-day impressions.