Metrocream 2x day might be too much for him. Also, being a guy, he might be using too much product. Ask him to cut way down on the amt of product (except sunscreen, he needs that) and possibly cut back the metrocream to 1x day. I'm DSPW with rosacea and have never been able to use Metrocream. It also comes in a gel and a lotion formula, see if his doc has samples before buying. That's when it's good to see a derm--they have samples. There are other rosacea meds too. For me, just following Dr B's basic skincare regimen with no meds has improved my rosacea, but my case was not severe. I have read that it takes quite awhile to see improvement from Metrocream. Also, be sure he is using something gentle as shave cream.