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When you look yourself at the mirror, you cannot avoid noticing those small “broken” blood vessels that break your nerves… Facial spider veins are very common and if this does not make you feel better, you will definitely feel better that they can be effectively and permanently treated.

spider veins

Although their number and diameter are usually small and the fact that they are asymptomatic, “broken” blood vessels of the face are really bad for your confidence. Telangiectasias, which is the medical term for spider veins, occur both in males and females, although they are more common among women. They are actually really small dilated vessels that are visible to the naked eye. These superficial vessels have a diameter of 0.1 to 1 mm and they are dilated venules, capillaries or arterioles. They are located just below the skin and they usually have red, blue or purple colour. Depending on the way they occur, they are classified as diffuse, linear (simple), spider (star-shaped or tree-shaped), dotted and papular lesions.

On the face they usually appear on central and lateral areas of the face, i.e. below the eyelids, on the cheeks, in the area around the nose, and on the chin. Unlike leg spider veins, facial spider veins are rarely due to poor venous circulation. The dilation of these veins is believed to be due to the degradation of collagen, which is the main structural material of blood vessels’ walls, resulting in thinning and spread to their thinning and expansion.

What is the cause?

Excessive sun exposure plays a crucial role in the development of facial spider veins, especially in fair complexions. Ultraviolet (UV) radiation causes premature photoaging, which results in impaired vascular support structures.

However, spider veins may be due to hereditary predisposition, collagen diseases, rosacea, regular use of corticosteroids (topical or oral), hormonal changes that occur during puberty, pregnancy, menopause or due to oestrogen treatment, poikilodermia of “Civatte”, and autoimmune diseases such as systemic lupus erythematosus. There is also possibility to be due to mechanical trauma, like for example in cases of ‘violent’ pulling of care during waxing, or when using a tweezers or thread.


Facial spider veins are usually asymptomatic. Rarely they may cause a burning sensation and they do not pose any health risk in most cases. However, they can affect self-esteem to a great extent and if not properly treated they may get worse as time goes by.

How to manage spider veins

If you have already tried to get rid of the spider veins on your face using special creams, most probably you have been disappointed, as these formulations are usually rich in flavonoids, and they only act on the skin’s surface so the actual problem is not managed. At the same time, the method of micro-diathermocoagulation or electrocautery that was used in the previous decade is also outdated; its results were poor and many times it caused permanent scars on the face.

Now facial spider veins are treated only through the use of advanced Laser devices that work based on the principle of selective photothermolysis, such as Long Pulse Pulsed Dye Laser, KTP 532nm and Long Pulse Nd:YAG Laser and ensure the effectiveness of treatment. These Laser devices are actually light sources and can be used to effectively eliminate both thinner spider veins as well as the more resistant, deeper, wider and with thicker walls spider veins.

High efficacy and absolute safety of the treatment is achieved through the selective elimination of dilated vessels without affecting the surrounding healthy tissue (selective photothermolysis), which is possible as the vessels are only exposed to radiation for half a millisecond. This time is enough to eliminate them but short enough so that not to affect normal skin around spider veins.

Main advantages of this method

  • The treatment is non-invasive and therefore leaves no incisions or scars.
  • It is suitable for all skin types.
  • There is no need to administer any foreign substances as the treatment is applied on the skin surface.
  • There is no need to use needles or puncture the skin, so there is no risk on bleeding minimising the risk of infection.
  • No need for topical anaesthesia or administration of other painkillers.
  • Patients can return straight away in their everyday activities.
  • 1-3 sessions are enough to effectively treat the problem.

About the author:

Christofer Tzermias

Specialised in the UK (Oxford & London) and in North America (New York & San Diego) in the field of LASER Dermatology, Dr Tzermias, has been providing dermatological state-of-the-art treatments using cutting-edge LASER and Energy based Devices for over 20 years. He has been Director of Interventional and LASER Dermatology Department at the Athens Medical Center for over 18 years and for the last 9 years is the Scientific Director of IQ - Intensive Quality Dermatology & Cosmetic Surgery Clinics, which at the 2017 Healthcare Awards won the ‘Innovation Award for Innovative Services’ for their pioneering contributions. Since 2018, IQ Dermatology & Cosmetic Surgery Clinics has also been operating in London, UK and in Muscat, Oman. Dr Tzermias is a Fellow of the world-renowned American Society for LASER Medicine and Surgery (ASLMS), a Founder Member of the European Society LASER Dermatology (ESLD), the Vice President of the ‘Open Health Alliance’ and he is also on the Board of Directors of Elitour - Greek Medical Tourism Council.

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