What are visible facial veins?
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.
What causes visible facial veins?
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.
Are there any symptoms of visible facial veins?
Usually, facial veins are asymptomatic. 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.
What do visible facial veins look like?
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).
How is the diagnosis of visible facial veins made?
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).
What treatment options are available?
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 aspect of the skin overlying the lesion. Because these vessels are very superficial, 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 but 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. 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. Thus, there is virtually no recovery time. In the studies that have been performed so far, IPL can smooth the skin and fade age spots, freckles, melasma, and even broken blood vessels. Improvements usually last for about a year with good sun protection.
• What are the risks?
IPL is safer than laser therapy because IPL does not damage the epidermis. There may be some pain during the procedure but no recovery time. Unlike laser therapy, however, you may need multiple treatments (average is 4-6, at three weeks intervals) to get the full benefit. The cost is variable, but is usually more expensive than peels and less expensive than lasers (300-600 dollars per treatment). The risks and benefits of IPL therapy need to be discussed in detail with your physician.
Other Resources:
Please visit www.VeinDirectory.org for more detailed information on varicose veins and spider veins.
