Simply put "telangiectasia" is spider veins, otherwise known as “broken capillaries.” These spider veins afflict many people. In fact, two our of three woman over the age of 30 have the appearance of blood vessels just below the skin. They can develop anywhere on the body but are most commonly seen on the face around the nose, cheeks, and chin. They can also develop on the legs, specifically on the upper thigh, below the knee joint, and around the ankles.
(So how do you pronounce "telangiectasia" anyway? Listen here.)
Telangiectasia or broken capillaries are the abnormal dilation of red, blue, and purple capillaries (tiny blood vessels) localized just below the skins’ surface. Simply put your vein walls enlarge, either from pressure or weakness, and become noticeable. Sometimes blood leaks from these vessels and pools, creating a bruising effect. I’ve become a little obsessed with this condition since developing it within the last year or so (due to menopause). My nose constantly looks red and I have what looks like a small bruise on the left side of my nose.
I wanted to know more, and I needed to find out…did I cause this? Will it go away? How do I treat it?
I went to skin care expert Carmen Murillo, R.N., L.E. of Simple Skin Solutions in Naperville, IL, for some answers. Carmen is a registered nurse and a licensed aesthetician. As well, Carmen trains doctors all across the United States & Canada on Cutera Lasers. This expertise contributes to her unique level of knowledge and skill in laser treatment, your best option when dealing with Telangiectasia.
As we know, genetics pre-dispose us to lots of stuff, including Telangiectasia. But, broken capillaries also occur and recur due to other internal and external sources. Internal sources include:
Then, we insult these internal sources with external or life style choices. These are things like:
These contribute to the damage of the vessel walls, thereby the vessels to lose their ability to shrink back down to normal size. Thus, laser treatments, coupled with home maintenance and life style changes, are necessary for maximum long term results. (Sorry, there's no miracle cure here!).
When it comes to telangiectasias, topical products can only do so much and are best used in conjunction with laser treatment. Thus far there is little scientific support for topical treatments, though some well-researched ingredients have been shown to improve skin elasticity and resilience — like coenzyme Q10, copper peptides, and niacinimide — and thus may help diminish the appearance of broken capillaries.
Holistic R.N. and licensed esthetician Geraldine Macenski from the Dana Hotel Spa loves alpha lipoic acid (ALA), not only for prevention but maintenance of Telangiectasia. “ALA is an antioxidant that works synergistically with other antioxidants in the skin to reduce the inflammatory effects of UV exposure by neutralizing free radicals” says Geraldine. What makes alpha-lipoic acid unique is that it functions in water and fatty tissues, meaning it can work throughout the body, unlike antioxidant vitamins C and E, and it has the ability to recycle or repotentiate antioxidants such as vitamin C after they have been used up. ALA’s capacity to regulate production of nitric oxide, which controls blood flow to the skin when applied topically, helps to transform the complexion from dull and pasty to vibrant and glowing.
Geraldine also recommends products containing DMAE, like those found in the Dr. Perricone product line. DMAE or dimethylaminoethenol, is an anti-inflammatory nutrient occurring naturally in the human brain that protects us from free radicals, improves muscle tone, and stabilizes cell membranes. The most significant science I found on DMAE said the primary benefit of topical application is skin firming, which could potentially help diminish the appearance of broken capillaries over time. DMAE has also been clinically shown to significantly improve other visible signs of aging – bonus!
What’s more, products containing anti-inflammatory ingredients like green tea and red and brown algaes could potentially reduce excessive blood flow to the affected areas, making facial spider veins less obvious. However, this would only work for very small veins. Once veins are dark red or purple or have been there for several months or longer, they usually require laser treatment to make them less obvious.
The upside of laser treatments includes better, faster and more long-term results and clinical studies on efficacy and safety. There are many different types of lasers (i.e., YAG, IPL, Diode, VBeam) used to treat broken capillaries and a laser certified specialist will know which one is right for you based on your skin type.
For example, IPL (Intense Pulsed Light) is frequently used to diffuse redness and facial telangiectasia. Recent studies have shown that IPL also helps reduce heightened levels of VEGF (vascular endothelial growth factor) in rosacea patients, thus hindering new vascular growth. But IPL scatters its light energy and can create unwanted reactions like transient hypopigmentation.
No, you cannot “cure” Telangiectasia because although you can treat it by shutting down the blood vessel(s) in question, the body likes to “repair” itself by forming what is known as collaterals or new blood vessels to compensate for those you shut down. Thus, treating broken capillaries requires maintenance on your part. Every patient Carmen treats receives “homework” in the way of:
And, laser treatment typically requires multiple visits, with healing time of 4-8 weeks between treatments. Carmen says, “Don’t let anyone tell you they can fix it with one treatment and you’re done.” A quick fix is virtually impossible (i.e., find another practitioner!).
After researching for this article I decided to proceed with laser treatment(s) at Simple Skin Solutions. I arrived at Carmen’s office at 3:00 p.m. on a Tuesday. She had me lay down on her table for a thorough cleanse (no exfoliation). She then had me sit up so she could assess my Telangiectasia (she wore these funny magnifier-like glasses).
Carmen used the Cutera 1064ND; YAG laser (Excel Laser) on my Telangeactasia. This laser allows her to service all skin types and skin colors (as well as all vessel colors). The entire laser session took about 15 minutes and 111 pulses (which is a lot for one session according to Carmen). I looked pretty bad immediately following the procedure but my skin started to calm down rather quickly. Did the procedure hurt? Honestly, yes, it did. It was one of the most unpleasant procedures I have experienced. Every pulse felt like a bad bee sting!
Afterward, Carmen iced my face. I did experience an immediate histamine reaction (raised bumps on my skin), which is very common. After all, we created a trauma to the skin. We treated this reaction with old-fashioned hydrocortisone cream followed by LOTS of sunblock. On my drive home my skin felt warm (but not hot or uncomfortable at all). It was red but did not hurt or itch in any way. I was instructed not to exercise, not to take hot showers, not to wash my face with hot water, not to do anything that would bring heat to my face (vessels hold on to heat). I was also told not to use glycolic acids or retinols on my face for at least 48 hours.
For some folks, bruising and blistering can occur (I did develop one small blister on the bridge of my nose). I also experienced a brown spot called a “hop” on the side of my nose. Quite complicated to explain but basically a “mode hop” is when the laser changes frequency. I was told that both my blister and my hop would go away in a week or so. I was also told to prepare for minimal (meaning the rest of the day) to some (a few days) downtime in case of bruising or blistering. The only downtime I took was the rest of that day. I stayed in that evening but my morning I was headed back to work!
Full healing or re-absorption of the vessels takes about seven to eight weeks so you won’t see the full, positive effect of the treatment until then. In the meantime, today is Thursday (I was treated on Tuesday) and I look much better. In fact, I look great except that you can still see the blister on the side of my nose and the “hop” on the bridge of my nose. Most of my broken capillaries are gone, but other very small ones are still visible (expected; too early yet). But, my “rudolph nose” already looks much much better and although the treatment did hurt…I’ll be back!
See Your Doctor if You Plan to Treat Telangiectasias
Every state has their own guidelines for who can and cannot perform laser treatments so your best bet is to see a plastic surgeon or dermatologist who has been laser certified. I also suggest asking for references; two to three patients that you can speak to privately about their experience, results, etc. Costs vary as some professionals charge per pulse (that is laser pulse) while others charge based on time spent. Expect to spend about 30 minutes per treatment session and a minimum of $175 per treatment depending on where you live (major metropolitan areas may see significantly higher costs per treatment).
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