A 40 year old lady presents with a 2 month history of facial flushing and spots coming up on her cheeks. She denies using any new skin products and works in a bakery. She tells you she used to suffer with acne in her teens. Her BMI is 32 and she has no other medical history other than Polycystic Ovary Syndrome. She has recently seen her optician for gritty eyes which have now settled.

On examination, you observe papules and pustules on her forehead and cheeks but no obvious comedones.

What is the most likely diagnosis?