As a teenager, I was more concerned about battling breakouts than anything else. Fast forward many years, and while I seem to be doing okay swerving lines and wrinkles, my skin is hormonally charged, environmentally stressed and unpredictably reactive.
 
Instead of pubescent acne, my main focuses nowadays include stress-induced redness, dilated pores and tiny broken capillaries, also referred to as spider veins or thread veins. I have no idea where these enlarged blood vessels came from – or even when – but I can bet they were likely caused by sun and wind exposure, possibly alcohol consumption, an over zealous facial or just bad genetic luck.

“Broken capillaries are dilated or enlarged blood vessels just beneath the surface of the skin,” says Dermatologist Dr Elif Benar. “On the surface, that translates to little red splotches that don't seem to go away — especially around your nose, cheeks, and chin. But if you (or your aesthetician) zoom in super close, you'll notice that the splotch looks like it almost has vein-y little legs. Some might even look like winding red veins.”

Dr Benar says that almost anyone can suffer from this problem at one point or another, however, those with fair skin are more likely to notice it. It is also very common in people with sensitive skin, rosacea, and acne.

“Broken capillaries are actually caused by an external disturbance in your skin — windburn, extreme temperature changes, excessive drinking or smoking, but especially UV damage and trauma to the skin, such as popping a pimple too forcefully,” she continues. “Even a sneeze that’s too strong can cause broken capillaries. Broken capillaries are pretty difficult to avoid, especially if you have a predisposition. But for the things that you can avoid, it's all about prevention.”

I am unsure that you can effectively treat and/or minimise broken capillaries at home (and please don't splash your face with hot water or take overly hot showers which won't help at all), so that leaves aesthetic procedures.  

Depending on your skin tone (some treatments should not be used on darker skin tones), the most effective treatments for facial veins involve precisely targeting and introducing energy into the blood vessel – this is then converted into heat, causing the vein to seal itself off, so the blood no longer flows through it.

You’re likely to need more than one treatment, however the results are permanent, although it should be noted that new ones can form in other areas on the face if you’re pre disposed to them, or you don’t step up effective prevention measures such as wearing a high factor broad spectrum sunscreen.

We round up three options tried and tested by some of our favourite Experts:

Cutera Excel V+ 

If your facial veins go hand in hand with rosacea, you have an ally in EV Expert Dr Anna Hemming from Thames Skin Clinic, who is a rosacea sufferer herself. She favours the Cutera Excel V+ laser which removes redness and thread veins in a targeted and precise manner. Medical grade lasers work by treating the skin with a particular wavelength of light; wavelengths are chosen according to the type of issue the treatment is focused on. It can be used to treat redness, rosacea, deeper facial veins, and port wine stains and there is no downtime. Hemming also uses Thermavein for thin thread veins on more sensitive areas.

Elos Plus

This treatment simultaneously delivers radio frequency and IPL (intense pulsed light) to treat the superficial layers of the skin. Leading dermatologist Dr Haus uses this in his Harley Street clinic to treat rosacea and facial veins; the clinic protocol is to combine it with Nd:YAG which goes deeper into the tissue and is the best option for darker skin tones. I personally tried this combination of treatment and can report that with the help of good numbing cream, it was considerably more comfortable than IPL alone, and (after just one treatment) a week later my skin looked clear and even toned.

Lumecca

Lumecca is used to treat skin conditions such as vascular lesions, spider veins and poikiloderma, a condition caused by sun exposure, in addition to redness and rosacea. The powerful intense pulsed light (IPL) machine operates using selective photothermolysis which provides a photofacial through the delivery of a comfortable light treatment. “With Lumecca, you need only 1-2 sessions compared to 6-8 sessions with other IPL devices to the area of concern,” says Dr Munir Somji of Dr Medispa. “Moreover, the Lumecca machine has a higher pulse repetition rate and a larger area that it can cover at any one time, meaning a reduction in treatment time per session."