But from tiny red thread veins to more prominent blue ones, they can be a frequent complaint, especially as we age.
Thread veins, broken capillaries, spider veins — what’s the difference?“Facial veins vary in size from visible to non-visible,” explains Dr Anna Hemming, Founder of Thames Skin Clinic and EV Editorial Panel member. “Visible facial veins can be easily seen as thread veins (which may also be called spider veins or broken capillaries), often around the nose, cheeks and chin. Non-visible veins are deeper and thinner and appear as a generalised redness on the skin.
"These can become more intense and are often found surrounding the visible thread veins. Both of these are found in patients with rosacea. The smaller veins creating redness are often connected to the more visible larger thread veins. Finally, blue veins can also be found, and are more often seen as the skin thins around the temple and eye area.”
Are certain people prone to them?While thread veins are often seen in patients with rosacea, you don’t have to have rosacea to have thread veins, as Vascular Surgeon and Cosmetic Doctor and EV Expert Dr Giuseppe Serpieri, explains.
“Veins can be genetic, they can appear for hormonal reasons or may be the result of trauma — as when bruising fades it can leave visible veins," he says. "They can also be related to acne, alcohol consumption, temperature extremes, and even to a sudden increase of blood pressure in the face, for example when sneezing or vomiting.”
And while the colour of your skin doesn’t seem to have an impact on how likely you are to suffer from facial veins, it does affect how likely you are to see them, and be bothered by them.
“They are most visible on caucasian skin where the skin is pale and the blood shows more in contrast to the skin colour,” says Dr Hemming. “While patients with thinner skin (which tends to happen with age) are more prone to seeing blue veins around the eye area.”
So, once you’ve got them, what can you do about them?
Is there a skincare solution?“Treatment for veins depends on the cause and skin type,” says Dr Hemming. While Dr Serpieri is broadly sceptical about topical treatments saying, “I don’t really believe in creams when it comes to treating these sorts of issues, you’d be better off using a concealer,” Hemming insists that in certain patients they can be a valuable mode of treatment.
“There are some effective skincare products — Rozatrol from ZO Skin Health is a specially formulated skin desensitisation product effective for reducing facial redness and minimising facial thread veins,” adds Hemming.
What about in-clinic?The most effective treatments for veins involve directing energy to the problematic blood vessel. This energy is subsequently converted into heat and causes the vein to seal itself off, so the blood that makes it visible on the skin no longer flows through it.
Dr Sepieri uses both radio frequency and laser treatments but believes laser is the most effective.
“The appropriate laser set at the appropriate wavelength can be set to target the blood (as it differentiates between the red of the blood and the surrounding skin, and the light is attracted to the red) so you can be incredibly precise,” he says. “This can also be done with some radio frequency devices but, in my experience, I think that the laser is usually better.”
While Sepieri says many different lasers can be used that work with various wavelengths from 530 nanometers to 1064 nanometers, he’s particularly fond of the 980 nanometer.
And, he warns that patients shouldn’t expect a one-off treatment to solve all their problems.
“Patients vary, but unless they only have a couple of thread veins on their nose or cheeks, I would normally expect to treat a patient at least twice, with a month in between. It’s also worth bearing in mind that we’re treating the symptoms here, not the cause, so even if you get rid of the existing problem, it’s possible that the same conditions can cause it to happen again.”
Dr Hemming is also a fan of using laser treatment. “We use the Cutera Excel V+ laser which selects blood and removes redness and thread veins in a targeted and precise manner. For patients with extensive redness and thread veins, we offer a course of 3 V+ laser treatments and use Thermavein (which sends a current via a probe) for additional large vascular lesions on the skin.
"LED treatment can also be effective in patients with very sensitive skin where laser may not be initially possible – as can the HydraFacial's facial redness protocol,” says Dr Hemming.
And while there’s nothing to stop the problem recurring in the future, Dr Serpieri does advise avoiding extremes of hot and cold, and using a high factor broad spectrum SPF daily.
Anna Hemming, Aesthetic Doctor
Dr Anna Hemming MBChB BSc DFFP MRCGP is a highly respected and skilled aesthetic doctor working in London. Conference speaker and KOL in aesthetic medicine,...Book with Anna Hemming
Giuseppe Serpieri, Doctor
Giuseppe Serpieri attained his Medical Degree at the University of Turin in 1986 and the Specialist Qualification as Cardiac and Vascular Surgeon at the...Book with Giuseppe Serpieri