What's the Best Way to Reduce Scarring from Spider Vein Removal Around Nose?

I still like laser for vein removal on the nose.  I have treated hundreds, maybe thousands, and have not seen 1 scar.  I think the choice of laser or the energy may not have been dialed in properly.  I like the 532nm KTP laser, the VBEAM, and 1064 yag, an even IPL.

Hi Miami.  We would recommend lasers as the best way to treat these veins.  Even though you have had a bad experience, the proper laser in the proper hands is going to give you the best result. 

As Dr. Crippen points out and we concur, the 532 (KTP), 595 (Pulsed dye) or 1064 (Nd:Yg) lasers are the best for your situation.  

We would not use, nor do we recommend IPL for this treatment.  It is an inferior technology and is the reason for many burns for this type of treatment.  IPL is very, very difficult to use on an area such as the nose because the surface area of the light device is too large and the contours too small.

Unlike other tiny facial vessels, those on the side of the nose (the nasal ala) are high-flow (arteriolar) in nature. Most other facial vessels are tiny veins (low-flow) that are easily treated by laser. Other techniques can be used on these as well (such as IPL--intense pulsed light, or PDL--pulsed dye laser), but when treating only a few tiny vessels I prefer the KTP laser.

For the ones you are asking about, even the KTP laser will shrink or scar the overlying skin and may not easily seal the vessels that are "pounding" with your arterial blood pressure. More energy and more than one treatment may be necessary. If a needle can be stuck into the vessel, Sclerotherapy may actually work better than laser. Cat's whisker electrocautery can also effectively cauterize these difficult vessels.

When they are maximally treated, a bit of Dermabrasion in the area of the (mild) scars or textural irregularity can help to improve these areas. Laser resurfacing also works, but is "overkill" for this technique in such a small area where Dermabrasion is as effective for lower cost.