Telangiectasia: small visible blood vessels on the face

Telangiectasia is the permanent dilation of small skin vessels, which become visible as fine red or purplish lines, sometimes with a branching look. On the face, they are common on the nose, cheeks and malar region. In everyday language, they are "spider veins". They are not a disease in themselves, but a sign that can be associated with several conditions.

What usually causes telangiectasia?

• Chronic sun exposure: damage accumulated from the sun weakens the vessel wall; see photoaging and solar elastosis.
• Rosacea: an inflammatory disease in which dilated vessels and redness persist; see rosacea.
• Genetics and hormones: family tendency, pregnancy and use of certain hormones.
• Local trauma and long-term topical corticosteroids.
• Local factors: intense heat and repeated friction.

The cause influences the management, which is why the diagnosis belongs to the professional, not to the patient based on a photo.

Why does it matter before an injectable procedure?

Skin with telangiectasia tends to be more fragile and reactive. Heat, friction and trauma can worsen redness, and the puncture can produce ecchymosis and hematoma more easily. In regions such as the nose and the side of the face, visible vessels are a reminder that vascular anatomy is rich. This does not mean a contraindication, but it calls for assessment, communication and, sometimes, adapting the plan.

How is it approached?

Telangiectasia can be treated with technologies such as intense pulsed light and some vascular lasers, at the discretion of the qualified professional, after assessment. See intense pulsed light and fractional laser for the general reasoning. Fillers and toxin are not part of this treatment, and promising this to the patient is inappropriate.

What to record at the consultation

• Location and extent of the telangiectasia, with a standardized photo.
• History of rosacea, sun exposure and topical corticosteroid use.
• Tendency to bruise easily and use of anticoagulants.
• The patient's expectations regarding redness.

In Harmy

Harmy does not identify or simulate spider veins: the AI is instructed not to retouch the skin, and the projection changes only the marked areas. The presence of telangiectasia in the photo should not be read by the app as clinical information.

Also called: spider veins, dilated vessels, vascular spider.