Facial redness and spider veins are a common cosmetic and medical complaint. These are particularly common in rosacea suffers. Common associations are seen with sun damage, a fair complexion, stress, spicy foods and fluctuations in temperature which exacerbate rosacea symptoms. As with many conditions, genetics plays a role too.
Numerous treatments are available but laser and light based treatments are the gold-standard treatment options. Commonly used lasers are ktp and pulse dye lasers for red veins and nd-yag lasers for blue veins. The smaller wavelength lasers work well on superficial spider veins whereas, the longer wavelength lasers are effective for the ablation of slightly deeper and larger veins. Pulse duration must also be matched to vessel size; the larger the vessel diameter, the longer is the pulse duration required to treat the vessel.
Recently intense pulsed light devices have gained popularity. Unlike lasers, IPL devices produce a broadband light and effectively target a number of cosmetic concerns such as brown/ black pigmentation and red and blue vessels simultaneously. IPLs also tend to have larger spot sizes and purpura [bruising] is not a required endpoint as is the case with certain lasers. Patients see gradual but very noticeable improvements with complexion blending and brightening achieving photo rejuvenation of the skin.
Often we see larger blood vessels especially around the nose and these may require treatments with nd-yag lasers. Caution is required with these lasers as high energy or pulse stacking can cause scars. Some doctors use sclerotherapy for facial veins and very precise small volume injections are made. I do not use sclerotherapy on the face as a rule. Area around the mouth and nose is a danger area as veins here communicate directly with venous sinuses inside the skull. Similarly veins around the eyes are another risky area as there is a possibility of flow of scleroscent in the retinal vessels.
Before (above) and After (below) Treatment for Facial Thread Veins
Before and After Treatment with IPL for Spider Angioma
Sclerotherapy is very valuable for treatment of leg veins but laser and IPL treatment is safer and better for facial veins. We will look at leg vein treatments in my next blog.