A lot of people suffer from facial thread veins – these are tiny broken veins just under the surface of the skin that usually appear visually as little red lines. The usual places for them to happen are on the sides of the nose or on the upper cheeks.
These types of veins can happen at any age but they accumulate as we get older, so most people will start to notice them in middle age. There are some people who have quite a lot of them so by the time they get to their mid fifties they are really quite prominent.
We aren’t exactly sure why people develop these blemishes, but being exposed to harsh weather and sunshine seems to be one reason and this probably reflects underlying damage to the skin from dryness and exposure to ultraviolet light. For this reason moisturisers and sun creams can protest the skin from this sort of damage and the development of facial thread veins.
As far as treatment is concerned there are several techniques that can work quite well. The usual treatment for thread veins on the legs is injection sclerotherapy with a chemical which makes the veins shrivel up and go away. However the face veins are often too tiny to inject and in any event, the face is a very sensitive area and injections are very painful.
For that reason face veins are best treated with heat based techniques which avoid injections into the face. These devices use either electrical energy, delivered by a tiny wire into the vein (such as the Veinwave device), or a light based device such as a skin laser or Intense Pulsed Light machine. Both techniques aim to deliver a dose of energy into the vein to make it shrivel up and disappear. For tiny facial veins both options can be quite effective.
One problem with both techniques however is the potential to accidentally burn the patient with the delivery of energy – this is a particular risk for laser and pulsed light systems, so it is advisable to be treated by someone with significant training and experience in the use of the equipment. In addition, particular skin types are more suitable than others for these sorts of treatments – patients with fair skin tend to do better than patients with darker skin. Black skin is a particular problem for laser techniques as the melanin pigment in the skin tends to absorb the laser light before the blood in the vein and this can cause burns or depigmentation of the skin, both of which can look unsightly.
After treatment it is important not to be exposed to prolonged or intense sunlight for a couple of weeks, as the skin is sensitised to light and even mild sun exposure can cause a significant burn – use of high protection factor sun creams can limit this risk, but it is not a good idea to have your face veins treated immediately before flying to Spain for a holiday!
Eddie Chaloner, a consultant vascular surgeon at Radiance Health in London, wrote this article. Eddie has been qualified since 1989, and was appointed a consultant vascular surgeon in 2002. He is a pioneer in the minimally invasive procedures to treat thread veins, varicose veins, and DVT.