Does Sclerotherapy Work on Tiny Facial Capillaries?

In general, facial capillaries are best treated with a laser. I try to stay away from sclerotherapy on the facial areas due to the risk of complications. While one can theorectically treat veins around the eyes with Sclerotherapy, I would not recommend it. The risk for serious complications including blindness and skin necrosis far outweighs the benefits, especially when there are much better alternatives. Telangiectases on the face are relatively uniform in size and depth and... more

Facial capillaries are best treated with a laser. They always go away when the right laser with the right power is used. I have over 30 different lasers in my office and each one is specially used for certain indications. There is no ONE laser that can treat everything. So, if your doctor’s laser does not work, you need to see a dermatologic surgeon who has a variety of lasers so that s/he can use the BEST laser for your specific indication.

First ,a vessel must be large enough in which to insert a needle. The largest practical needle is 32 guage which is too large to fit in most facial vessles. There are many different lasers for facial vessles and most physicians use the one they own. In my experience the most useful is the Iridex, a 532 wavelength diode laser as it doesn't bruise or scar and is usually, but not always, successful.

While very careful sclerotherapy can work, I feel I have more control with the laser. I can watch the vessel "disappear" (go into spasm) as I am treating it. A few treatments are generally  necessary for complete clearance and the vessels along the side of the nose often recur in time.

 As Dr. Oppenheim has siad, I have also had success with stubborn facial capillaries using a Colorado needle point on a cautery set extremely low and just zapping them under 3.5X magnification.

Sclerotherapy can help stubborn facial capillaries, especially the blue ones that require higher energies with laser and the risk of indented scars. The doctor must be a good aim, as you do not want the sclerosant in your skin. Good luck.

I realize this is a very old time, old tech solution to this problem but I have seen very good results with electrocautery. It is far less expensive besides. One advantage of electrocautery is that it does not cause the matting of laser of sclerotherapy. That is the production of smaller blood vessels after the other ones have been destroyed. Most physicians, including myself are reluctant to use chemical sclerotherapy on the face for fear of extravasation and subsequent scarring.... more