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Facial red vein and vascular birthmark treatments

Author: Dr Mark Gray; Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997.

Table of contents

What treatment is available for facial vascular lesions?

Broken veins (telangiectasia) of the face and vascular birthmarks can be unsightly and difficult to conceal. Traditional treatment using diathermy or thermolysis systems (electrosurgery) have been superceded by less painful, safer and more effective light therapies. These can be more expensive than electrosurgery.

Several lasers are available to treat red skin including pulsed dye lasers (PDL), alexandrite laser, Nd:YAG, copper bromide, diode, Krypton and KTP lasers and intense pulsed light (IPL) systems.

Pulsed dye laser treatment of facial telangiectasia

What lesions are suitable for treatment?

The lasers and intense pulsed light machines target red skin, which arises either because of the presence of dilated surface blood vessels or because of an overall increase in blood supply resulting in a flushed appearance. Suitable lesions include:

Small red spots such as cherry angiomas usually disappear with one treatment. More extensive veins on the face usually require additional treatments spaced a month or so apart. Photocoagulation with high-intensity diode laser is an effective treatment for venous lake on the lip.  

Blue vessels are more challenging to treat with light or laser treatment, because of their colour, because they have a larger diameter and because they tend to be deeper in the skin. These include large diameter vessels at the side of the nose, and most thread veins on the legs. They may be better dealt with by sclerotherapy.

What can I expect during treatment?

Generally, no anaesthesia is required but there is some discomfort. Some bruising and swelling may occur after IPL or PDL treatment, and small scabs and swelling may arise after copper bromide laser treatment.

Some people take a couple of days off work but most people don't think the unsightliness is too bad. It is quite safe to apply makeup to disguise the bruising or scabbing if any occurs. Any downtime is generally worth it since the results are mostly excellent.



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