Hi all, just wanted to write a (long!) post that may be helpful to those who didn't have much luck with Metrogel or diet changes.
My back story: female, 34, started getting very early signs of rosacea in late 20's but it only really flared up after spending a few months in a very sunny country and a prolonged period of pretty heavy boozing (6 months). The flare up were concentrated over my right cheek only (redness, broken caps and lots of papules), where I have sustained more injuries and sun damage than the left cheek.
I was prescribed Metrogel a year ago which helped a little, but it took a long time to take down the spots and actually increased the redness and dryness. It also left a film over the skin which made it impossible to wear under make up during the day. It didn't completely take the rosacea away either, as I'd have frequent flare ups. I had two sessions of dual yellow laser to help with caps - small but marked improvement with no side effects (stay AWAY from IPL I beg all of you, that thing caused me massive damage and trauma). After a particularly bad breakout I then tried to manage my diet, firstly cutting out the booze completely, then histamine rich foods and all rosacea triggers. I also started supplements including Oregano Oil, Tumeric and probiotics to balance any yeast overgrowth. I still got some breakouts, but I could see that booze was a massive trigger as well as tomatoes and avocados. I then was prescribed Skinoren (finacea in the US) cream about 2 months ago, which I didn't have much faith in tbh, but this stuff has helped hugely. No more papules, redness gone down, its like I don't have rosacea any more, apart from some broken caps and a little diffuse redness across my right cheek. I can even have a few drinks and no problems the next morning. I still take the supplements, but don't follow a strict restrictive diet apart from avoiding tomatoes and avocados. The cream itself has a nice, non greasy texture and is can be worn under make up to problem. Fingers crossed this keeps working for me, as the NHS doesn't exactly treat cosmetic skin conditions as a priority and the attitude of my GPs have been pretty dismissive. Hope this helps guys!