TLDR: basically everything I’ve tried has made my type 2 rosacea worse. Derm recently gave me triple cream to try and I am wondering if anyone else has had success with that?

Long version:

I developed type 2 rosacea 2 years ago and it got significantly worse while pregnant with my daughter last year. It has not improved since having her in January. 

The only thing that has ever helped was prescription azelaic acid, and even that was minimal. 

Most things I have tried have made it worse:  
\- sulfur soap/washes: dried me out   
\- prescription ketoconazole wash: incredibly drying and ruined my skin barrier and caused a huge flare   
\- prescription sodium sulfacetamide: caused flaking and disrupted barrier + more redness and a flare   
\- hypochlorous acid spray: did nothing 

I am not able to use anything with niacinamide, fragrance, shea butters or heavy oils. I am also not able to try an antibiotic (although that would certainly help) since I am still breastfeeding.

Triggers seem to be my food allergies (dairy and gluten) and hot showers. Sun/UV and spicy foods don’t seem like as much of a problem. Hormones likely are a trigger, but I do not have a regular cycle yet as I am still breastfeeding, so that is harder to track.

I will attach pictures to show how significantly my face has been impacted. (1) how it started, (2) the worst it got during pregnancy, (3) the best it got using azelaic acid, (4) the reactions/flares in late April from the prescription face washes, (5) current state as of yesterday. 

I finally saw a new derm who took more than 3 minutes to talk with me. He did a biopsy to confirm rosacea diagnosis and has written me a prescription for triple cream (15% azelaic acid, 1% metrogel, 1% ivermectin). It’s from a compound pharmacy called skin medicinals, specifically the strive pharmacy. 

My current routine is:  
Face wash: good molecules hydrating facial cleansing gel  
Serum: IUNIK beta glucan serum   
AM: prescription azelaic acid  
PM: .75% metro gel (I think this is helping, but it is very drying)  
Moisturizer: coco kind electrolytes water cream

My questions are:  
\- has anyone had rosacea this severe before and were you able to clear it up at all? It hurts, the skin on my nose is thickening, and it’s killing my confidence   
\- have you had success with triple cream? If so, how long did it take and did it cause a purge/get worse before it got better?  
\- are there any other pharmacies or places I should ask for the medicine to be compounded? I’ve heard the skin medicinals has had a recent formula change and it makes me nervous 😩

Any and all advice or encouragement would be greatly appreciated   
 

Type 2 rosacea - experience with triple cream?