What should I do first?

So y'all may want to suggest products to use but that's honestly not really what I'm looking for because I've already spent thousands of dollars in the past 10 years on products and now I'm ready for something that will actually work which is professional help. Does this look like something I should go to a dermatologist for or is this something a beauty spa would help with like a skin resurfacing treatment? I've been looking into both and I've read some amazing things about skin resurfacing and micro blading and all that stuff that can be done at a beauty spa or would it be best to start with a dermatologist? Like I said I've tried everything I've tried different types of pills and different types of cream serums I've done my own at home microblading and some things worked and some things didn't but overall this is what I'm dealing with now and I'm tired of it because no matter what I do it always comes back.. Thank you in advance for the comments! It's very much appreciated