Does Sclerotherapy Work on Tiny Facial Capillaries?

Hello, I have very fair skin and lately have noticed that my capillaries are becoming increasingly noticeable. I have tried several types lasers to treat my facial veins (underlying my acne scars, surrounding the nose) to no avail.

In fact, lasers often leave additional scars and capillary matting. The bottom line is that lasers do not work as my capillaries seem to require an intensity that my skin cannot tolerate. Are there other options? Can sclerotherapy target tiny facial capillaries?

Doctor Answers 10

How do you treat capillaries on the face ? Buffalo Niagara, NY

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We evaluate the face with special instruments such as a dermatoscope and it can be said that generally most of the smaller capillaries (telangiectasias) on the face can be treated nicely with IPL. 

Varicose veins on the forehead or temples can be injected with sclerotherapy. 

Other Options Available.

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There are many options to treat facial veins and capillaries including sclerotherapy, microneedle radiofrequency, VeinWave ,VeinGogh and IPL.  All of these modalities work and can be an alternative to laser.  You should see a vein specialist who has familiarity with these treatments and who can advise you as to the optimum treatment for you.

John Landi, MD
Naples General Surgeon

Facial capillaries

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Facial capillaries are best treated with a laser, such as IPL.  I do not recommend sclerotherapy on the face due to risk of serious complications.

Lasers work best for facial capillaries

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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 lasers can effectively eliminate these.  In our office, we have many different laser systems for vein treatment including a Pulsed Dye Laser (595nm), KTP (532 nm, better for smaller vessels), the Diode (940nm, best for larger vessels), Gemini, Nd:Yag, etc.  Just as important as using the right laser is finding the right doctor who knows the correct settings for your skin.  I would recommend seeing an experienced dermatologic surgeon.


Dr. Mann

Margaret Mann, MD
Cleveland Dermatologic Surgeon

Facial capillaries are best treated with a laser

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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.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 25 reviews

Lasers or sclero for facial vessles

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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.

Stephen Mandy, MD
Miami Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

Using a cautery for facial capillaries

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 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.


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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.


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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.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Love my 532nm KTP laser for face veins!

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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.

Ann Lott, MD (retired)
Lincoln Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.