Broken blood vessels from broken nose. What should I do?

Question

I have a patch of broken capillaries on the bridge of my nose from when it was badly broken 15 years ago. Sun made it much worse over the years. IPL & ndyag only exacerbated the situation. I’m scared to continue down the road with lasers. My plastic surgeon recommended electro desiccation but I’m concerned about scarring or pitted scars given it’s my it’s on the nose. What should I do? What’s the safest? Will other lasers work safely & with results? Please help.

Richard Burgmeier, MD · Answer

The larger spider veins on the nose are usually easily treated with a long pulsed 1064 Nd:yag laser.  Tiny nose veins can be very difficult to treat. They usually require multiple treatments with a 532 KTP laser. I have not had much success treating the tiny nose veins or redness with an IPl so I  use a laser.

Raffy Karamanoukian, MD, FACS · Answer

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.

Dr. Karamanoukian
Realself100 Surgeon

Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

The best treatments for capillary issues are vascular lasers such as pulsed dye laser, Excel V, Aerolase, Venus Versa IPL, Laser Genesis or Yellow laser. The settings are determined on a per case basis, so it is best to consult with an expert to determine what will work best for you. We often combine vascular lasers with non-ablative fractional lasers such as Clear + Brilliant or Venus Viva for better results. I would suggest seeing a cosmetic dermatologist for a formal evaluation. Best, Dr. Emer.

Dennis Gross, MD · Answer

When it comes to broken capillaries I always recommend the Vbeam laser. The most advanced Pulsed Dye Laser Technology, VBeam® treats red skin, broken blood vessels, rosacea, and birthmarks. This laser targets the selected area with an intense yet gentle burst of light. This laser is so safe that it’s used for the treatment of port wine stains on infants and young children. It also treats photoaging and sun damage with no downtime.

John Landi, MD · Answer

A picture would help to give a better opinion.  I use microneedle RF with the Ellman surgitron for smaller veins and sclerotherapy for larger veins. Scarring should not be a problem with these modalities.

Brian Heeringa, MD, FACS · Answer

I find ohmic thermolysis/ VeinGogh works great for small spider veins on the nose.  If the veins are larger sclerotherapy can also work as well.  The nose is very well vascularized so it tends to heal very well. Dermaka cream for a few days before and after the procedure can help limit bruising and speed healing as well

Broken blood vessels from broken nose. What should I do?

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