Electrodessication for Facial Capillaries

Question

I consulted with a prominent plastic surgeon about using electrodessication for my facial capillaries.  I have tried many of the usually recommended treatments without positive results.  Anyhow, this doctor said that although electrodessication is effective, it can leave enlarged pores.  Is this correct?

Scott Trimas, MD · Answer

Small capillaries or telangectasias of the face can be treated with a variety of different measures. For small ones that are not diffuse spot treatment with a needle tip electorcautery on low power can be effective. However, I have seen over the years patients treated this way that end up with white spots or enlarged pores or depressions in the skin. The safest way in my opinion is still laser treatments with a KTP 532 laser, ND:YAG 1064 or IPL treatments. Another very effective option includes the use of a pulsed dye laser but more bruising may result. I would personally exhaust those options first before treating with an electrocautery. I hope this information helps.

Raffy Karamanoukian, MD, FACS · Answer

I would recommend the pulse dye laser for treatment of these vessels.  If additional therapy is needed, the Yag laser would be equally effective.

Otto Joseph Placik, MD · Answer

In some instances, I have seen enlarged pores with electrodessication and with more extensive use I have seen some dermal fibrosis.However, for isolated telangiectasias I stiill occasionally prefer this modality.

Hratch Karamanoukian, MD, FACS · Answer

I recommend ohmic thermolysis where there is no puncture of the skin or topical laser with long pulse devices. These will not cause ice pick types scars following treatment.

Grant Stevens, MD · Answer

Greetings~

	Electrodessication/electrocautery is an effective treatment for telangiectasias and many years ago was one of  the only treatments available but now there are treatments available that we have found to be more effective with less downtime, discomfort and risk.  In order to cauterize the vessels with electrocautery or dessication the skin is broken with the fine needle tip (the needle must go through the skin to get to the vessel).  With laser or light treatments (PDL, Nd:YAG, KTP, and IPL) the skin is spared while the vessel is treated.  What your doctor described as enlarging pores is actually more like pitting caused by the damage to the skin.  Find a practice that has a great deal of experience with the use of lasers for the treatment of these fine telangiectasias on the face and give it another try.

	Good luck~

	Dr. Grant Stevens

Margaret Mann, MD · Answer

While you are correct that electrodessication is very effective in treating facial capilliaries, the best treatment with the least risk of complications is still vascular laser treatment.  Without seeing a photo or knowing what you treatment you have done in the past, it is difficult to say which laser may work best.

	In general, the pulsed dye laser, the 1064 Nd:YAG, and the 532 KTP, and the IPL are all great vascular lasers-- each with their pros and cons.  I use all these modalities in our office to treat various types of blood vessels.  I would shy away from electrodessication as vascular lasers are more effective with less risks.

	Best,

	Dr. Margaret Mann

Khaled El-Hoshy, MD · Answer

Electrodesiccation was the only approach available prior to the 80s. Nowadays, the pulsed dye laser, KTP laser & Intense pulse light treatment, give excellent results with no adverse events, except for some bruising that may occur at the treated areas for a few days after the procedure. All are done with no anesthesia, or just topical anaesthetic creams. usually 1-3 sessions are needed, one month apart.

Pamela Carr, MD · Answer

Prior to the advent of various laser technologies electrodessication of facial capillaries was the treatment of choice.  It is an uncomfortable treatment and leaves the face "scratched" looking for several days.  
I find IPL to be more effective and more comfortable as a treatment for facial vessels.  Pulse dye laser would also be an option.  With any treatment scarring can occur which I believe is what is meant by "enlarged pores".  Electrodessication would be unlikely to cause scarring when appropriately low settings are used.

Bryan K. Chen, MD · Answer

For isolated spider angiomas (that is a central round/oval blood vessel that sends out small blood vessel "tentacles), electrodessication seems to work well.  For telangiectasias/small capillaries in general, I prefer use of a vascular laser (e.g. 1064 Nd:YAG, pulsed-dye).  Electrodessication does not, per se, increase pore size, but can produce small holes in the skin/punctate depressions if the energy settings are too high.
Good luck.

Richard P. Rand, MD, FACS (retired) · Answer

Usually, in my practice, IPL laser will eliminate these but in rare insatnces, I have resorted to the more old fashioned electrocautery st at a very low level and using a needle point tip. This works well has hasn't cused any problems to my knowledge.

Electrodessication for Facial Capillaries

Answers (10)

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