Can Broken Capillaries on the Face Be Treated with Sclerotherapy Instead on Laser? What Are the Pros/cons?

The 1064nm long-pulsed Nd-YAG can be used safely in the darkest skin types, and a vbeam would also be appropriate if the right cooling settings are used.  As long as the appropriate cooling is used, there is no reason why the laser isn't the safest option for this condition.  I perform sclerotherapy of the legs, but do not prefer it for the face as it can cause visual disturbances if there is retrograde flow through a larger vessel, which is hard to visualize.  If it connects to an artery, an ulcer can form, as one cannot control how far the solution travels.

It is easy to treat the larger venules on the face with sclerotherapy at 3-4 sessions a month apart. Light electrocautery also is a safe and effective method. Sincerely,

David Hansen,MD

So-called 'broken capillaries" (more correctly known as telangiectasia, since they are actually permanently dilated small vessels rather than broken ones) can be treated by both radiowave therapy and sclerotherapy. Radiowave therapy uses a device that sends radiowaves into the vessel causing heating and destruction of the undesirable vessels. Sclerotherapy accomplishes the same thing but by injecting an irritating solution, such as high concentration salt (and other types of materials) collectively referred to as sclerosants, since they effectively causing scarring, shrinkage and elimination of the unwanted vessels.

In general, sclerotherapy is used for treating the tiny "spider veins" so common on the lower extremities. In fact, despite the plethora of laser hype and marketing, sclerotherapy remains the gold standard from treating this problem in that region. On the other hand, radiowave treatment as described above or electrodessication are considered the treatments of choice for facial telangiectasias. That having been said, I have had good success, especially when treating larger telangiectases on the nose, with the use of sclerosing solution.

Naturally, you would do well to seek the services of a board certified aesthetic physician with experience in treating these kinds of problems with all the current modalities.