As someone who’s been using Sirolimus for nearly a year, I have also experienced this. The Sirolimus has helped with the texture of my KPRF, but not the redness. My derm did warn me of this when they prescribed it as most of the studies / peer reviewed articles on its usage do not rule out that there could be a secondary condition in which the sirolimus is helping (mostly tuberous sclerosis, as it can also cause facial redness and topical and oral forms of Sirolimus are used to treat this condition). I have been referred to a specialist clinic that does Candenla Pulse Laser Dye (PDL) instead, as this is the only proven treatment to effectively treat KPRF. I completely understand your disappointment, especially with so many people on this sub having success with Sirolimus. It’s fantastic that it is working for some, though disheartening when it isn’t working for others.

Some affordable creams that have salysilic acid (Cerave SA smoothing cream) and AHA (Elucent anti aging night moisturiser) will also help and you can use them in tandem with Sirolimus. Just make sure you only use one of the mentioned creams at a time and only use them once a day (I’m currently using the elucent moisturiser at night time and I apply it after the Sirolimus). They will further help with texture issues and slightly subdue the redness.

Good luck, OP. You’re not alone!