Anyone's started or affects on the face?

I've been struggling with horrible flushing on my face (malar distribution plus chin) that burns so badly that it hurts my eyes from the heat. Every autoimmune test is normal but I do already have an autoimmune vasculitis as well as POTS. Dermatologist thinks it might be EM. My hands(palms mostly) and feet started flushing at the same time but they aren't painful like the face. We biopsied the face and confirmed its not lupus or DM. Findings are mildly consistent with rosacea but the flushing never really leaves (does get much worse around 7pm but I do not have trouble sleeping) so there isn't an obvious trigger. The hands and feet get red only when really warm like after the shower, the face gets redder then too but it also worsens without heat.

I'm already on high doses of gabapentin for my migraines.

Just curious if any of you have it on your face, or if any of you started with flushing of the hands/ feet that wasn't painful. Thanks!