Facial veins and spider veins

Facial veins - properly called telangiectasia - are small blood vessels that have become permanently dilated and visible near the skin surface. They appear as fine red, blue or purple lines, most often on the nose, cheeks and chin.

They are harmless. They are also extremely common: most people develop some by middle age, particularly on skin that has had a lot of sun.

Why they form

Sun damage - cumulative UV breaks down the collagen that supports small vessels, so they dilate and stay dilated. The single biggest factor.
Genetics - a strong family tendency, and more common in fair skin
Rosacea - visible vessels are one of its defining features
Hormonal factors - pregnancy, the oral contraceptive pill, hormone therapy
Repeated flushing - heat, alcohol, spicy food, temperature extremes
Ageing - thinner skin makes vessels more visible
Trauma or pressure to the area, including from glasses
Long-term topical steroid use on the face
Some medical conditions, including liver disease - which is one reason a sudden crop of new vessels is worth mentioning to your GP

Spider veins on the legs are a different problem with a different cause and treatment - see varicose veins.

Assessment

Consultation establishes whether this is simple telangiectasia or part of rosacea, checks skin type (which changes the safe device and settings), and takes a medication history - some medications make skin photosensitive and change what can be used.

Treatment

Nd:YAG laser

The usual choice for individual visible facial vessels. The wavelength is absorbed by haemoglobin in the vessel, heating and closing it; the body then clears the closed vessel over one to two weeks. Individual vessels often clear in one or two sessions.

IPL

Broad-spectrum light suited to diffuse redness with many fine vessels rather than a few discrete ones, and useful where pigmentation coexists.

Laser Genesis

Gentle heating of the upper dermis, used across an area to reduce general redness and stimulate collagen; a course rather than a single session.

See laser treatments. Treatment is provided at our Malvern East clinic.

What to expect

A session usually takes 15 to 45 minutes depending on how many vessels are treated. Most people describe a brief flick or hot pinprick per pulse; no anaesthetic is generally needed.

Afterwards: redness and mild swelling for a few hours to a couple of days. Treated vessels commonly darken, then fade over one to two weeks. Some settings cause bruising that takes longer to clear.

Aftercare: no sun on the area, no hot showers, saunas or vigorous exercise for a day or two, gentle skincare, and daily sunscreen.

What results are realistic

Individual facial vessels respond well - most clear substantially, often after one or two treatments.

What treatment does not do is stop new vessels forming. The causes - sun damage already in the skin, genetics, rosacea, flushing - continue. Most people who treat facial veins return periodically. Treating the vessels you have is worthwhile; expecting it to be the last time is not realistic.

Individual results vary with vessel size and depth, skin type and the underlying cause.

Risks

Redness and swelling after treatment
Bruising or purpura, sometimes lasting a week or more
Blistering and crusting
Changes in pigmentation - darker or lighter - which can persist, and are more likely in darker skin types
Scarring, uncommon but possible
Infection
Matting - fine new vessels appearing near the treated area
Flare of underlying rosacea
Incomplete clearance and recurrence
Eye injury if protective eyewear is not worn - it is worn by everyone in the room

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 number and extent of vessels 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.