This is a difficult variant to treat.
Brenda Dintiman is a dermatologist who has broad experience in this area. Here are her thoughts.
These patients are definitely challenging. We actually see a fair amount of this erythematous only rosacea.
I like to switch them to Vanicream products - preservative free, fragrance free, lanolin free. and their sunscreen
I also use Noritate cream instead of Metrogel since many of my patients say that Metrogel stings.
I would use doxycyline for about 6 weeks also to calm the inflammation.
We will also use the VBeam pulse dye laser on non-purpuric settings and treat the entire red area.
Cold seems to be an important factor and dryness can be a trigger.
Citrus is the other biggest trigger we see.
We also inquire about any meds that could be producing flushing.
Rule out carcinoid syndrome and photosensitivity from medication.