Too Much for Just One Treatment
There's lots that could be done to give you dramatic improvements, but the multiple problems you describe could not possibly be covered in just one treatment with just one modality (type of laser or peel). Different lasers work best for different problems.
Fractional laser is a great tool for overall improvement of color, tone, and texture, but it could make some of the red areas worse, and is limited in improving spots and scars.
Get a couple opinions from specialists in skin rejuvenation who offer multiple lasers and other modalities (e.g., pulsed light, peels): "If all you have is a hammer, the whole world looks like a nail."
Ask lots of questions and make your expectations and budgetary constraints explicit.
Depending on the modality and the areas to be lasered, the cost will be $500 - $5000 per treatment. To get the least possible cost, choose an experienced physician laser expert who has the ability to offer you different laser options and different modalities depending on how you are responding to treatment and if there are any changes to your lifestyle.
You will need several different lasers and/or medications to deal with some of the problems, and some of these problems will not be cured with one treatment of a laser. Acne is usually chronic and tends to recur over time, involve hormone changes, genetics, and require medical attention by a dermatologist, etc. The blood vessels need a vascular laser, and fine lines another laser entirely. Thus, meeting with a Board Certified Dermatologist and/or Plastic Surgeon will allow you to explore your options for treating all of these issues.*
The good news is that your fair skin puts you at the least risk for a post-treatment negative outcome.
The good news is that regardless of the type of procedure you choose to address your concerns about the skin on your face, your fair skin puts you at the least risk for a post-treatment negative outcome. Complications related to post-treatment hyperpigmentation is uncommon in patients with fair skin.
To address the broken capillaries around your nose, I suggest that you seek a treatment that uses a laser specifically designed for that function. The type of laser that I use to address this problem is a Varilite KTP laser that goes after each specific capillary individually and eliminates it immediately. That treatment is very cost effective since it is area and problem specific. In order to treat the spots on your skin from tanning, enlarged pores, acne, and to a lesser extent fine lines around your eyes, you may consider an alternative to laser treatments altogether that is much more cost effective.
It may be possible for you to treat all of your goals in this category with a single or a series of chemical peels. A stronger version of chemical peel, known as a trichloroacetic acid (TCA) peel, could be used. This stronger chemical peel formulation is done in a single sitting but requires pre-treatment of the skin for best results.
Alternatively, your problems in this area could be addressed using a series of lighter chemical peels, with no significant down time or recovery time and greatest cost effectiveness. The most important message here is that one size definitely does not fit all. The treatment must be individualized specifically to address your unique concerns and issues.
So, your first best step would be to consult with an experienced facial plastic surgeon and/or one of the experienced medical aestheticians or dermatology experts on staff with him/her in order to get a comprehensive assessment and game plan for the best approach to address your unique needs within your individual budget.
Alternatives to laser resurfacing are out there.
Laser resurfacing is an excellent treatment for fine lines, acne scars, brown spots and sun-damage but not broken capillaries or pimples. An alternative and less expensive option is photodynamic therapy (PDT) and Intense Pulse Light (IPL). This light based treatment utilizes a topical medication called Levulan which is activated by the laser like IPL. It is very effective against brown spots, sun-damage, pimples, broken capillaries, pore size, fine lines and texture. A single treatment is less than $1000.
Best laser treatment for spots, blood vessels and acne scars
If your acne scars are shallow, the laser treatment that will be of most benefit to you is something called the South Beach Peel. South Beach Peel combines Broad Band Light (BBL, a form of intense pulsed light) with the Micro Laser Peel.
The BBL adresses both the brown spots and the dilated blood vessels, while the Micro Laser Peel removes part of the epidermis for an overall smoother and silkier appearance. This peel produces results with minimal down time.
However, if your acne scars are deep, such as ice pick scars, superficial resurfacing will only minimally correct them. The problem with deep acne scars lies in the dermis, and the best modality to address those is fractional resurfacing, such as the ProFractional. Because the ProFractional is a deeper laser resurfacing, the down time is longer, sometimes up to a week to 10 days.
Whichever modality you consider, please be aware that a person with recent sun exposure is not a candidate for laser resurfacing, and sun exposure after the resurfacing will quickly bring back the browns and reds that you want to have treated.
Laser treatment for facial problems
You are describing multiple aesthetic facial issues, including acne, red vessels, tan pigment, and fine wrinkles. These may all be amenable to laser treatment, but different lasers are incorporated to manage each of these problems. Personal consultation with a plastic surgeon or dermatologist with several laser platforms is your best first step. Several consultations to compare cost and recommendations is even better.
Fractional CO2 Is Currently the best Option for most Patients
Loose skin, wrinkles, acne scars, brown "sun spots" are all best treated in my opinion with an ablative laser. After years of experience with Erbium and CO2, and more recently with the Fractional CO2 Ultrapulse laser (Active/Deep FX) I believe fractional CO2 gives the best bang for the buck and for the downtime.
The laser vaporizes the outer layer of skin ( removing surface blemishes and irregularities) and then the heat from the laser leads to skin tightening and contraction, with formation of new collagen. This treats the wrinkles and fine lines.
Active FX in my practice runs between $1000 to $2500 depending on your needs, but it is a one time treatment for most patients.
Dont' forget- laser resurfacing is a waste unless you are ready to commit to long term skin care and prevention. Pores will respond over time to Retin A, which we recommend for most patients. Red spots (broken capillaries) may require a photofacial treatment or two (or three), which can be a part of your routine maintenance.
Costs will vary depending on the type , depth, and # of treatments needed. Depending on the severity of your issues a microlaser peel coupled with IPL/BBL treatment may be all you need vs full laser resurfacing. The best way to determine what you need is tobe evaluated and get a treatment plan formulated especially for you
Laser resurfacing can be costly
Laser resurfacing can be a costly option. There are alternatives that are less expensive which might work well for your situation.
Your first recommended step is to visit a good cosmetic dermatologist. You'll want to get your pimples under control and your skin tone evened out. Often proper skin care regimens can make a huge difference in how your skin looks and behaves, so rather than jumping to the big gun first, explore the basics first.
- Salicylic acid peels - great for clearing pores and dislodging blackheads
- IPL for reducing redness and brown spots at the same time
- Skin care products which help control breakouts (benzoyl peroxide, beta hydroxy cleansers, tazarotene, others) Again, a dermatologist recommendation will go a long long way to helping you get the most results for your dollar
- Sunscreen that works for YOUR skin type
- Clarisonic cleansing brush (this little gadget helps keep you skin super clean, stimulated and for those with clogged pores it's a great addition to the bathroom counter and can be used in the shower too).
Laser resurfacing may not even be the solution for your skin problems. See a dermatologist, find out how to care for your skin and address ongoing issues and stay on track with whatever skin care program ends up working for you. It takes time to "undo" the problems we cause.
And consider a different makeup. Many makeups contain ingredients that are terrible for skin that tends to be sluggish with clogged pored.