Capillaries and skin redness

Capillaries are the smallest blood vessels in the body, normally invisible. When they dilate or increase in number near the skin surface, the area looks red, flushed or blotchy, and individual vessels can become visible as fine red lines.

This is extremely common, particularly on the cheeks, around the nose and across the chest, and it is not harmful. People treat it because of appearance.

Diffuse redness versus individual vessels

These are different problems and respond to different devices:

Diffuse redness - a general flush across an area, with no single vessel standing out. Treated with broad light-based treatments across the whole area, in a course.
Discrete vessels (telangiectasia) - individual visible red or purple lines. Treated vessel by vessel with a targeted laser.

Most people have some of each, which is why plans often combine the two. See also facial veins and spider veins.

What causes it

Sun damage - cumulative UV weakens vessel walls and the supporting collagen around them
Genetics and fair skin
Rosacea - redness is its central feature
Repeated flushing - heat, alcohol, spicy food, exercise, extremes of temperature
Hormonal factors, including pregnancy and hormone therapy
Ageing and thinning of the skin, which makes vessels more visible
Trauma to the area
Long-term use of topical steroids on the face, which thins skin and worsens redness

Assessment first

Consultation establishes whether the redness is simple vascular change, rosacea, a photosensitivity reaction (some medications cause this), or something else. That matters because the treatments differ, and because treating rosacea as if it were plain capillary damage misses the inflammatory part of the problem.

Skin type also matters: light-based treatment in darker skin carries a higher risk of pigment change, so device and settings are chosen accordingly.

Treatments

Nd:YAG laser - absorbed by haemoglobin; the usual choice for individual visible vessels, which can often be closed in one or two passes
Laser Genesis - gently heats the upper dermis, reducing diffuse redness and stimulating collagen; typically a course
IPL - broad-spectrum light for diffuse redness and associated pigment
Cosmeceutical skincare - barrier support and antioxidants; niacinamide and similar ingredients help calm reactive skin
Daily broad-spectrum sun protection - the single most useful long-term measure
Mineral make-up - green-toned products neutralise red, and provide physical sun protection

See laser treatments for more on the devices.

What to expect at a session

Sessions typically take 20 to 45 minutes depending on the area. Most people describe the sensation as a flick or a hot pinprick. Expect redness and mild swelling afterwards for a few hours to a couple of days. Treated vessels may darken before clearing over one to two weeks.

Avoid sun before and after treatment, avoid hot showers, saunas and vigorous exercise for a day or two, and use sun protection throughout.

What results are realistic

Individual visible vessels usually clear well, often after one or two sessions. Diffuse redness generally reduces over a course of three to six treatments.

New vessels form over time. This is the honest limitation: treatment addresses the vessels that are there, not the tendency to develop them. Maintenance sessions, commonly annually, are normal. Sun protection and managing flushing triggers slow the rate at which new vessels appear.

Individual results vary with skin type, the cause and the extent of the redness.

Risks

Redness and swelling after treatment
Bruising or purpura, which can last a week or more with some settings
Blistering and crusting
Changes in pigmentation - lighter or darker - which can persist, and are more likely in darker skin
Scarring, uncommon but possible
Infection
Flare of underlying rosacea
Incomplete clearance; recurrence and new vessels over time
Increased sun sensitivity after treatment

See risks and complications.

Cost

As at September 2024 and including GST, a skin assessment is $50 and a Cosmetic Doctor consultation is $150. Dermal skin treatments start from $130. Cost depends on the area and the number of sessions, and is quoted after assessment. Not covered by Medicare.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.