What to do first, rosacea treatment or microdermabrasion?

The VBeam and Excel V can treat both problems simultaneously. I would try these. Microderm won't do much to acne scars and is a waste of money. If the scars remain, Infini or Fraxel are good choices. For the deeper scars, try using Bellafill.

The main thing to consider before you start your treatments
is to have a consult with a reputable dermatologist/facial/plastic surgeon. My
practice has been considered by Lumenis lasers to be a Lumenis laser center of
excellence and I have been a "Luminary" (Lumenis physician teacher)
for the last 10 years. Not many physicians have these recognitions. I also help
develop and teach my own Rosacea and Melasma protocols for the Lumenis IPL
systems to other physicians and technicians.I will treat the acne scars first with fractional CO2 resurfacing. This treatment may encourage more rosacea at the beginning as it will create an inflammatory process of the skin. Then treat the rosacea after the skin has healed.In my humble opinion I believe that a multi-treatment combination is needed in order to effectively control rosacea. Oral & topical medications, and IPL laser are the main tools to combat rosacea in my opinion. you will need to add the avoidance of the triggers like alcohol, sun exposure, sudden temperature swings, mood changes, stress.Hope this helps,Dr. Gus Diaz