Treatment for mild rosacea, seborrheic dermatitis

I have been diagnosed as having (mild) rosacea and seborrheic dermatitis, for which I’ve been prescribed MetroGel and Noritate cream to use simply as I feel necessary.  This obviously gives me a lot of discretion in how I approach treatment for myself.  Currently, I am simply applying a small amount of MetroGel on my nose (which is red, has enlarged pores around it, and sometimes feels a little warm), and on any red bumps that develop on my cheeks (I do not have many and they tend to easily go away).  I really only “flare up” and turn unusually red after sun exposure, though I sometimes feel irritation in the face (oddly enough, more often in colder air conditioned rooms).

Do you have an opinion on how extensively and frequently someone such as myself with mild rosacea should use MetroGel or Noritate?  Should I be spreading it all over my face once a day, as suggested on the packaging, or continuing to take a more conservative approach?

On the one hand, I have read that rosacea frequently becomes progressively worse and treating it early can be very helpful in halting it, so I could spread the MetroGel all over my face as a preventative measure.  Plus, I wonder if it would improve the irritation.  On the other hand, I understand there can be a risk of developing anti-biotic resistance, plus I fear increasing the number of “flare ups.”  (I have found emollients and topical medicines can have that effect on me.)

[Alan Rockoff, MD]

Noritate and Metrogel both contain the same active ingredient, metronidazole.  My feeling is that it is not necessary to use creams like these as preventives.  They're not harmful, so by all use them when you have outbreaks, but feel free to hold off when you're OK.  As to which cream you use, it doesn't matter much, since as I mentioned they're basically the same.

Take care.

Dr. Rockoff