Visible facial veins (spider veins, telangiectasias, spider angiomas, benign vascular lesions)

Visible facial veins, which have many different names (see above), are actually dilated blood vessels. They are usually found on the forehead, nose, cheeks, eyelids, neck, and upper chest. Visible veins are most commonly seen in fair-skinned women and usually appear in the fourth or fifth decade. Blood vessel dilation is due to weakening of the elastic fibers in the walls of the blood vessel. Although the exact mechanisms leading to blood vessel dilation are not understood, visible veins are associated with excessive sun exposure, normal aging, steroid use, liver disease, genetics, radiation therapy, and trauma. On the face, visible veins can range in size from the tip of a pencil to bigger than a pencil eraser. Visible veins may be even larger on sites other than the face.

Visible veins are often considered to be a cosmetic issue. However, they can be found in people with rosacea, liver disease, and more rarely, autoimmune disease. Hormonal changes can be associated with visible veins as well. Your physician can help to determine the cause of your visible veins.

Facial Vein Prevention

Visible veins are often secondary to sun damage; thus, sunscreen use and sun avoidance are recommended.

Facial Vein Treatment

There are many different treatments options available for visible veins:

1. Electrosurgery uses an electric current from a hand held needle. The electric current, when applied to the blood vessel, destroys it. This method is somewhat painful, but is usually tolerated because it is quick. After the procedure, a tiny scab forms which usually heals quickly and with minimal scarring.

2. Lasers are sources of high energy focused light. Certain lasers, called vascular lasers, are designed to target a component of blood called hemoglobin. Vascular lasers destroy the blood vessel and leaving the surrounding tissue unharmed. The side effects of laser therapy can include pain (similar to a rubber band snap) and temporary purpura or purple pigmentation of the skin similar to bruising. The purpura usually resolves in a day or two. The risk of scarring is low.

3. Intense pulsed light therapy is similar to laser therapy except broadband light is used instead of focused light. The procedure itself is similar to lasers, but there is usually less purpura.

Laser treatments and intense pulsed light are typically done at four to eight week intervals. Several treatments may be required. When new vessels appear, patients return for more treatments.