Melasma with vascular component: Will PicoSure laser treat very very fine broken capillaries?

The answer to your question is that picosure will not treat fine capillaries. I do not think laser Genesis is the proper solution either. It would be best if you seek a personal consultation to find the best answer for your particular condition which may involve multiple etiologies.

While the PicoSure works very well for the brown pigmentation for melasma, it won't address your vascular concerns. There are other lasers suited to treating vascular issues. I would suggest having a consultation with a physician experienced in lasers and light devices to discuss your concerns and what would be the best treatment protocol. When you have melasma, it is imperative that you seek treatment from a provider that has experience with both melasma and lasers as there are instances in which suboptimal choice of laser or treatment settings can actually make your melasma worse. 

i would recommend that you treat the Melasma with the Picosure laser. This is definitely the best laser for Melasma. You should plan at least 3 sessions, spaced a month apart. You need a good sunblock. you may want to also use 8% HQ.After the Melasma is resolved, it is very easy to treat the spider vein or vascular component with a laser such as the Cynosure Elite laser. you will probably only need 1 session with this laser (however hard to be sure until you examined in person) david berman md