Can you give me some direction as I am non responsive to Vbeam prima and IPL? (Photos)

I would likely do more treatments with pulsed dye laser (Vbeam, Cynergy, etc) using purpuric settings so that you see some visible bruising after treatment. See a laser expert, preferably a dermatologist, not just a medispa. Also, consider other treatments such as oral beta blocker (carvedilol) and perhaps microdose Botox, etc.  Regards,Dr. Ort

Lasers like the v beam are very powerful and effective for vessels that are dilated and large. You appear to have a more subtle redness. For this, I generally recommend  good gentle skin care with adequate moisturizer and serums (skin better science alto, alastin skin nectar, ce ferrulic) and avoidance of toners or exfoliants as baseline treatment. Adding to this a gentle laser like laser genesis and a few hydrafacials is a beneficial way to go. Sometimes more power isn’t the best way to go.