I’ve been struggling with rosacea and acne for years now and honestly I feel completely lost at this point. My skin is oily but also super dehydrated and extremely sensitive. I get redness, flushing, bumps, pustules, irritation, and acne all at the same time. Sometimes my skin burns for no reason and every treatment feels like a gamble.  
Over the past months/years I’ve tried so many things:  
Differin  
Skinoren / azelaic acid  
Soolantra  
Tetralysal (lymecycline)  
Retacnyl / tretinoin  
Metronidazole creams  
A compounded cream with prednisolone + metronidazole  
Another compounded cream with crotamiton + benzyl benzoate  
Oral metronidazole (currently on it)  
Some treatments helped temporarily, others completely destroyed my skin barrier, made me purge, or caused insane dryness. At one point my skin became so dry and textured that it felt grainy everywhere. I also started getting huge inflamed pimples that left marks and scars. Every time I think something is finally improving, my skin flares up again.  
I’ve also noticed that hydration is really complicated for me because a lot of moisturizers seem to break me out, so I ended up becoming scared of using creams altogether. At the same time, if I don’t hydrate, my skin gets even more irritated.  
I’ve seen dermatologists and honestly some experiences made me lose hope because I kept being prescribed the same things again and again without real improvement.  
Right now I’m on oral metronidazole, but it honestly doesn’t seem to be doing much. My next step is PDL laser and I have my first session soon. I’m really hoping this will finally help with the redness and inflammation because mentally this whole situation is exhausting.  
Has anyone here dealt with both rosacea AND acne like this? Especially persistent bumps/pustules, damaged skin barrier, sensitivity to moisturizers, and treatments that stop working? What actually helped you in the long term?

I’ve Tried Everything for My Rosacea and Acne and I’m Losing Hope