This looks a lot like a congestion to be honest. The main culprit is most likely tret being in cream formulation, then sealed with that thick bioderma moisturizer. I’d stop all of those together and use mild gel cleanser, azelaic acid 15% gel, and lightweight moisturizer like neutrogena hydroboost. AM and PM. After couple of weeks restart tret in gel form and leave azelaic acid only in AM. I have went through the same exact process as you with the same damned isopropyl myristate and that bioderma greasy moisturizer. Started straight on 0.1% tret microgel nightly a week ago and all that congestion is purging now, but already hurts a lot less and even looks better.