Visible facial veins (spider veins, telangiectasias, spider angiomas, benign vascular lesions)

Visible facial veins, which have many different names (see above), are actually dilated blood vessels. They are usually found on the forehead, nose, cheeks, eyelids, neck, and upper chest.  Blood vessel dilation is due to weakening of the elastic fibers in the walls of the blood vessel. Although the exact mechanisms leading to blood vessel dilation are not understood, visible veins are associated with excessive sun exposure, normal aging, genetics, and trauma to the skin. On the face, visible veins can range in size from the tip of a pencil to bigger than a pencil eraser. Visible veins may be even larger on sites other than the face.

Visible veins are often considered to be a cosmetic issue. However, they can be found in people with rosacea (see rosacea section on this site),  Hormonal changes can be associated with visible veins as well.

Facial Vein Prevention

Visible veins are often secondary to sun damage; thus, sunscreen use and sun avoidance are recommended.

Facial Vein Treatment

There are many different treatments options available for visible veins:

2. Lasers are sources of high energy focused light. Certain lasers, called vascular lasers, are designed to target a component of blood called hemoglobin. Vascular lasers destroy the blood vessel and leaving the surrounding tissue unharmed. The side effects of laser therapy can include pain (similar to a rubber band snap) and temporary purpura or purple pigmentation of the skin similar to bruising. The purpura usually resolves in a day or two. The risk of scarring is very low.

3. Intense pulsed light therapy is similar to laser therapy except broadband light is used instead of focused light. The procedure itself is similar to lasers, but there is usually less purpura.

Laser treatments and intense pulsed light are typically done at four to eight week intervals. 1-3 treatments may be required. When new vessels appear, patients may return for maintenance treatments.

Tattoo Removal

Tattoo removal allows for the removal of tattoos of various sizes, colors and shapes.  Every tattoo is unique and results will vary from case to case, however tattoo removal offers cutting edge skin care technology that lightens and/or removes unwanted tattoos.

Microdermabrasion

Microdermabrasion, also referred to as the “lunch time” procedure, is a popular procedure which is classified as light, or very superficial dermabrasion. This method employs aluminum oxide crystals that are propelled at the skin and immediately sucked up. Although not scientifically proven to improve the appearance of skin, many patients report that their skin feels smoother. It is used to treat acne, dyschromias, and general “rejuvenation”. It is also popular because it is painless and there is no recovery time after the procedure. Newer devices now are crystal-less.

Manual dermasanding abrades the skin with silicone carbide sandpaper. This method is usually considered to be a medium depth procedure and is sometimes used in combination with other methods, such as chemical peels, carbon dioxide lasers, and motorized dermabrasion.

Motorized dermabrasion is a medium-deep or deep procedure and employs the use of a motorized brush or diamond cylinder. These tools are used to remove the outer layers of the skin in a controlled setting. Local anesthesia is used for pain control during the procedure. Dressings usually need to be worn after the procedure and temporary facial swelling and pain are normal. Within 7-10 days, the skin has healed but is often very red. Complete healing may take up to one month and collagen remodeling may continue for months after the procedure. Dermabrasion has been proven to improve the cosmetic appearance of the skin, especially in the treatment of scarring.

Not everyone is a good candidate for dermabrasion. Those with active acne, infections, and other scarring skin conditions may need treatment before undergoing dermabrasion. You and your physician need to decide if dermabrasion is the right procedure for you.

Complications are rare but include infection, prolonged healing, hyperpigmentation, and scarring.

Chemical Peel

Chemical peels, also known as chemical resurfacing, are cosmetic treatments to produce an improved appearance of the face. Chemical peels are used for the treatment of photoaging (from sun damage), wrinkles, scarring, acne, precancerous lesions, and discoloration (or dyschromia). Chemical peels produce controlled injury to the skin that promotes the growth of new skin with an improved appearance.

Many different chemicals are used including glycolic acid, trichloroacetic acid (TCA), salicylic acid, “Jessners” solution, and phenol. The different chemical solutions produce different degrees of injury to the skin. There are two layers of the skin; the outer layer is called the epidermis and the inner layer, the dermis. Superficial peels (e.g. glycolic acid) produce very superficial injury confined to the epidermis. Superficial peels can help improve conditions such as acne and dyschromia. Deeper peels (e.g. phenol peels) produce injury within the dermis and can reverse moderate-to-severe photoaging and wrinkles. In general, the deeper peels offer the most dramatic results but require longer recovery periods and carry a higher risk of complications.

Chemical peels have actually been used for hundreds of years and have a proven safety record in the proper hands. However, chemical peels are not for everyone. For example, people who are in poor general health should not get peels. Also, active infections and certain medications (i.e. isotretinoin (Accutane)) may preclude the use of certain types of chemical peels, especially medium and deep. Sometimes, people with abnormal scarring, certain skin diseases, or recent surgeries should not have a chemical peel. You and your physician should decide if chemical peels are safe for you.

Chemical Peel Procedure:

Chemical peels usually begin with vigorous cleansing of the skin. The depth of the peel depends on the chemical used. Very light peels (e.g. low potency glycolic acid, 10-20% TCA) only penetrate the dead skin cells that sit atop the epidermis and produce almost no injury. Sometimes, this level of peel is called “exfoliation”. Light peels (70% glycolic acid, 25-35% TCA) injure the entire epidermis and stimulate the regeneration of a new epidermis. This level of chemical peel may produce a burning sensation during the procedure. Recovery from light peels is quick- hence the name “lunchtime peel”. Improvement in the appearance of photoaged skin and scarring is usually subtle at best. Medium depth peels involve injury to the upper level of the dermis. Injury to the dermis stimulates the formation of collagen and “plumps” up the skin. Usually 35% TCA, in combination with another chemical such as glycolic acid, is used safely with minimal discomfort. Burning is the most common complaint during the procedure and this is usually well controlled with cool compresses or topical anesthetics. Deep peels involve injury to the mid dermis and are usually performed using a phenol solution. A deep chemical peel may offer dramatic results such as elimination of deep furrows and scars. However, complications such as scarring, permanent textural changes, darkening and redness of the skin can occur. Furthermore, during a deep peel, anesthesia must be used and vital signs must be monitored throughout the procedure. Recovery from a deep peel requires occlusive bandages and can take up to a month under normal circumstances. The phenol peel should only be performed by qualified physicians with proper monitoring equipment.