Facial red vein and vascular birthmark treatments

Author: Dr Mark Gray, Dr Amanda Oakley, 1997.

Broken veins (telangiectasia) of the face and vascular birthmarks can be unsightly and difficult to conceal.

What treatment is available?

Traditional treatment using diathermy or thermolysis systems (electrosurgery) have been superceded by less painful, safer and more effective light therapies. These are more expensive however.

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

What lesions are suitable for treatment?

The lasers and intense pulsed light machines target red skin, which arise 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.

Blue vessels are generally unsuitable for 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 venous lake on the lip, 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 down-time is generally worth it since the results are mostly excellent.

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