What is the best way to permanently, safely treat telangiectasia (red blood vessels) around the creases of the nose area?

The most safe and effective way to treat nasal telangiectasias is with a pulsed-dye laser. Depending on the size of the vessels and the degree of bruising you are OK with having, you may require 1-3 or 4 treatments, each spaced about 2 months apart. Nasal telangiectasias do tend to re-grow, however, so most individuals require a "touch-up" laser treatment every 2-5 years, to maintain the skin telangiectasia-free.

These thin red blood vessels appearing on the alae of the nose in the
photos are dilated capillaries.Normal capillaries are too small to be seen
but become visible when they dilate.There are many factors associated with capillaries remaining permanently
dilated; it is more common in those with fair complexions compared to those who
have darker complexions.The medical
term to describe a small blood vessel that is dilated is telangiectasia. Therefore, dilated
capillaries are also known as capillary
telangiectases.Capillaries are the
smallest blood vessels in the body.The
other types of blood vessels found in the body – that range from small to large
- are veins and arteries.In the skin,
veins may also appear dilated – dilated arteries are rarely observed in the
skin.Small dilated veins are known as venous telangiectases; these appear as blue or purple blood
vessels, usually on the legs and thighs but sometimes on the face.Large
dilated veins are known as venous
varicosities or varicose veins.The terms spider
veins or broken blood vessels are
often used to refer to both capillary
telangiectasesandvenous
telangiectases; as such these terms are not specific.However, it is important to distinguish capillary telangiectases from venous telangiectases because they
respond to different treatments.Capillary telangiectases (as in this
case) respond best to 532nm (Nd:YAG) laser or 585nm (pulsed dye) laser; they
don’t respond as well to 1064nm (Nd:YAG) laser.Laser is the optimal method of treatment because the light should be
absorbed by the red blood vessel without damaging the overlying skin as it
passes through it.Electrodessication
(‘hyfrecation’), electrocoagulation and other non-selective treatments
invariably heat the skin directly overlying the telangiectasia; scarring –
linear or divets – are common.These techniques
were used prior to the advent of lasers.Venous telangiectases respond
much more favorably to a procedure known as Sclerotherapy than to laser.