Rosacea or not?

Dear Doctor Rockoff,
3 months ago I posted a question - "Rosacea vs. skin irritation". I've been using MetroGel for 3 months, but can see only a very slight improvement. Actually, my eruptions fluctuate as before - sometimes I have clear face, sometimes red bumps and tiny whiteheads (pustules?) appear on my cheeks. I have no idea what triggers those eruptions - they are not related to flushing, always get worse before my period, almost disappear right after it, may be somehow related to alcohol consumed, but I am not sure; get worse if I irritate my skin... they are itchy and a bump can appear in a minute...
Is it really rosacea? If not, what else can it be?
Thank you for you time!
Natasha

[Alan Rockoff, MD]

Natasha:

Metrogel is quite helpful, but is not sufficient for everyone if used alone.  You may want to ask your doctor to consider prescribing an oral antibiotic such as a tetracyclien derivative for a period of time, or else adding or substituting a different topical cream.

As to the fluctuations you describe, they are par for the rosacea course, and you're not likely to find a "trigger" which is consistently present.  My advice is not to look too hard: just bring it under control.  Ask your dermatologist how.

Best.

Dr. Rockoff