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Also known as benign vascular lesions, visible facial veins stem from different
sources. Telangiectasias, which often appear on the cheeks and nose are groups of
dilated capillaries. Spider angiomas are dilated capillaries fed directly by an
arteriole. They can be solitary or multiple and can occur anywhere on the body.
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Telangiectasias are most commonly found in people with excessive sun exposure,
rosacea, and with topical steroid use. Spider angiomas can occur spontaneously
or in pregnancy, with oral contraceptive use, or in liver disease. Spider angiomas
are sometimes seen in childhood.
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Usually, facial veins have no visible symptoms however, in the context of rosacea,
telangiectasias can be associated with a burning sensation. As mentioned above,
spider angiomas can be seen in people with liver disease, such as cirrhosis of the
liver from alcohol. Some autoimmune diseases, including lupus, may be associated
with facial telangiectasias. Furthermore, there are a few very rare genetics
diseases that are associated with visible veins. Your physician can help
distinguish between the different causes of facial veins.
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Telangiectasias look like thin red lines in the skin. In some cases, however, the
vessels might be so tiny that the only sign is generalized redness of the skin.
Spider angiomas have a spider-like appearance because the arteriole appears as a
central red dot (body) with telangiectasias radiating out from the center (legs).
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Physicians can usually diagnose facial veins based on their appearance but in some
cases, a detailed interview and exam is needed to evaluate for the more rare causes
(see above).
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Electrosurgery
- What is it?
Electrosurgery is a classic treatment, especially for small facial
telangiectasias and spider angiomas. In this treatment, an electric current from
a hand held probe is used to destroy the superficial piece of the skin covering
the lesion. Because these vessels lie on the surface of the skin, they are usually
easily destroyed. The procedure is quick, relatively inexpensive and requires
little recovery time.
- What are the risks?
For a tiny, solitary vessel, no anesthesia is needed. However, for larger areas,
local anesthetic is required. Rarely, bleeding, scarring and discoloration can occur
at the treated site.
Laser Therapy
- What is it?
Most of the vascular lasers used today are called "pulsed dye lasers" and
specifically target the blood cells in dilated vessels. The blood cells in the
vessel absorb the energy from the laser which selectively destroys the blood vessel.
Lasers are quite effective, especially for conditions such as rosacea. Usually one
to three treatments is required, 4-8 weeks apart.
- What are the risks?
Some of the lasers cause moderate pain during the procedure although minimal
recovery is needed after treatment. The most common side effect-darkening of the
treated area- occurs in less than 10% of patients and fades gradually. Cost ranges
from $200 to $500 per treatment depending on the size of the area treated. As with
any surgical procedure, the risks and benefits of laser therapy need to be discussed
in detail with your physician.
Intense Pulsed Light Therapy (IPL)
- What is it?
IPL is one of the newer forms of facial rejuvenation. Unlike lasers, which use
intense, focused light, IPL is intense broadband light. Although IPL delivers
energy to both the superficial and deep layers of the skin, the epidermis is spared
from damage requiring virtually no recovery time. In the studies performed so far,
IPL can smooth the skin and fade age spots, freckles, melasma, and even broken blood
vessels and with proper sun protection, improvements usually last for about a year.
- What are the risks?
Because IPL does not damage the epidermis, it is safer than laser therapy.
There may be some pain during the procedure but no recovery time is required.
Unlike laser therapy, however, you may need multiple treatments (average is 4-6, at
three weeks intervals) to achieve the full benefit. The cost is variable but is
usually more expensive than peels and less expensive than lasers ($300-$600 per
treatment). The risks and benefits of IPL therapy need to be discussed in detail
with your physician.
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