Telangiectasias: How to eliminate small veins on the face?

The term "telangiectasia" refers to the permanent dilation of small capillary blood vessels, typically located on the skin's surface. These present as small red or blue lines, often in a spider web or branch-like pattern, and can appear on various parts of the body, including the face, legs, and chest. The emergence of telangiectasias is often associated with a skin condition, particularly rosacea. They are indeed characteristic of the vascular rosacea, or couperose, the primary form of rosacea.

Several factors have been identified as the cause of telangiectasias, among which are a primary abnormality in the circulation of the facial vein, exposure to the sun's UV rays, stress, intense physical effort, temperature variations, consumption of spicy foods, and even genetics. Although benign from a medical standpoint, telangiectasias can be a source of discomfort due to their visibility, particularly when they are located on the face, and treatments to make them disappear are often sought.

There are several methods of dermatological surgery to eliminate telangiectasias. It's important to note that before performing a vein operation, a duplex ultrasonography examination is essential. Indeed, there is a great anatomical variability in superficial veins. Their meticulous observation and pre-operative marking are crucial to ensure the success of the treatment. The duplex ultrasonography examination is quite simple and does not require any preparation for the patient: after spreading a conductive gel on the skin, high-frequency sound waves are sent and reflected by the body's organs, allowing them to be visualized. This examination is painless and poses no health risks.

Sclerotherapy.

Sclerotherapy is often the first treatment suggested for telangiectasias. A substance, known as a sclerosing agent, is injected into the dilated vein, which causes the fibrosis of the vein and its gradual disappearance. Among the most commonly used sclerosing agents are polidocanol and sodium tetradecyl sulfate, which are surfactants. Complications such as hyperpigmentation and phlebitis are rare. Several sessions spaced a month apart are generally necessary to completely eliminate the telangiectasias. The results obtained with this method are often very satisfactory, however, it happens that the telangiectasias return.

Laser treatment.

Skin lasers are highly effective in treating facial telangiectasias, although results are often better with sclerotherapy. Lasers with short wavelengths, such as KTP 532 nm or pulsed dye 585-600 nm, are used to eliminate red telangiectasias , and lasers with longer wavelengths, such as alexandrite 755 nm or diode 800 nm, are preferred for treating blue telangiectasias, which are generally deeper in the dermis. Flash lamps (intense pulse light), whose wavelength can vary between 500 and 1200 nm, are sometimes used and have an efficacy comparable to that of lasers. The goal of lasers and flash lamps is to burn the small vein in order to eliminate its coloration.

External Radiofrequency

A less popular technique, external radiofrequency, relies on the use of high-frequency electromagnetic waves to generate heat at the level of dilated blood vessels and make them disappear. The principle is similar to that of laser treatment and the risks of complications are also low.

Surgery.

When telangiectasias are very extensive, surgery may be considered. A tumescent anesthesia is performed, which means a very diluted local anesthetic is injected into the subcutaneous tissue. This solution is very slowly absorbed into the bloodstream, providing effective and very safe anesthesia. The removal of the dilated veins is then carried out while the healthy superficial veins are preserved. After the operation, a prevention of venous thrombosis through subcutaneous injection may be recommended for a few days to reduce the risks of residual pigmentation and recurrences.

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