TELANGIECTASIA, SPIDER VEINS AND CAPILLARIES

Telangiectasia is a condition where tiny veins cause red patterns on the skin, commonly occurring on the nose, cheeks and chest, though can appear anywhere on the body. It is the result of damaged fibers that can no longer support underlying vessels, causing vessel dilation. The dilated vessel coils toward the surface of the skin, thereby becoming visible. These tiny blood vessels result in red clusters on the skin, and are often referred to as spider veins because of their fine and web like appearance.

Other abnormalities in blood vessels also include cherry angiomas (tiny red dots on the skin). The majority of cases of telangiectasia are benign however a full doctors consultation is essential as they can also be a sign of underlying illness.

Telangiectasia can often be uncomfortable and many find them unattractive and unsightly. In the case of spider veins, these may be due to underlying venous incompetence (such as varicose veins) and can be painful and associated with other symptoms.

SYMPTOMS

Spider veins, telangiectasia and dilated capillaries often develop gradually with age but may be exacerbated by underlying health issues such as obesity, hormones and sun damage.

Symptoms include

  • Pain (related to pressure on the blood vessels)
  • Itch
  • Red thread like patterns on the skin
  • Blotchy red areas on the skin
  • Isolated red dots on the skin (cherry angiomas)

CAUSES

The exact cause of telangiectasias is unknown however there are several known causative factors. These causes may be genetic or environmental.

The most common cause of dilated and damaged capillaries is chronic sun exposure and photoageing.

Other causative factors include:

  • Extreme cold
  • Pregnancy
  • Weight gain
  • Ageing
  • Rosacea
  • Injury
  • High blood pressure
  • Genetics
  • Excess alcohol consumption
  • Medications eg corticosteroids
  • Autoimmune diseases eg scleroderma, SLE, dermatomyositis

Spider veins on the legs are discussed in more detail here.

Those at risk of developing spider veins and dilated capillaries are those who do not use daily SPF, work outdoors, sit or stand for long periods of time, are pregnant or use hormonal medication, misuse alcohol, have a history of Rosacea, use corticosteroids or are of advancing age (as telangiectasia is more likely to develop as the skin ages).

TREATMENTS

The treatments available are aimed at improving the appearance of the skin and treating the underlying cause. Removal of damaged blood vessels is done by causing damage to the vessel and forcing the blood vessel to collapse. As a result of this collapse, there is no further blood flow and subsequently a reduction in the appearance of red marks or patterns on the skin.

Treatment for Telangiectasia

  1. BBL - broadband light directs pulse light energy which is converted to heat and absorbed by haemoglobin (colour red) which is part of the fine broken blood vessels which appear as telangiectasia, cherry angiomas, redness and flushing. The light then damages the target and eliminates it from the skin. BBL is an excellent treatment for redness, flushing and vascular lesions such as spider veins and visible blood vessels (fine). 

  2. Laser - vascular lasers (1064nm wavelengths) work on the same theory as BBL but are more targeted to haemoglobin. They are effective for larger and deeper vessels.

  3. Sclerotherapy - this technique is fantastic for spider veins (rather than diffuse redness) and works to damage the vessel by injecting it with a detergent solution which results in collapse of the vessel. 

  4. Diathermy and electrosurgery - this is excellent for small cherry angiomas and small superficial capillaries of the face.

  5. Radiofrequency, surgery and vessel embolisation for severe cases.