Sudden P&P rosacea flare- should I stop metrogel? (Photo)

This type of rosacea needs permanent treatment with isotretinoin for best results.  Topical creams rarely help and oral antibiotics are only short lived.  Laser treatments like pulsed dye laser can help with the redness. I suggest you see a cosmetic dermatologist who specializes in acne and rosacea.  Best, Dr. Emer.

Metrogel is pretty benign and not likely to
cause this flare. Sometimes when people start doxycycline they experience a
flare in their acne. Your doctor can keep you on doxycycline and add a stronger
topical medication, such as Aczone or Finacea. Alternatively, if you prefer to
be treated more aggressively, you can go on Accutane.

You should call your doctor about this.  It's hard for others to comment without knowing an entire history.  Ivermectin and metrogel and the most commonly used topical antibiotic and anti-inflammatory medications for subtype 2 or papulopustular rosacea while doxycycline and clinda amongst others are used for acne. It is not uncommon to have reactions to these medications.  Some physicians add azelaic acid and other topicals as well to help aid in the process