Treatment for Stubborn Facial Spider Veins?

I have small clusters of spider veins on both sides of my lower nose. When there were only 3 on each side of my nose, the doctor treated them with a BBL laser. They went away. Two years later, I have more: 4 or 5 in roughly the same area on both sides of my nose. Is there a better laser to use on these veins? Should I look for a doctor with a specific model of laser? I've heard sclerotherapy can be done on the face for veins that don't respond to laser treatment. What do you think?

Doctor Answers 5

Face Spider Vein Treatment

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Spider veins of the face can be difficult to treat,.  Agree with topical laser therapy and Intense Pulsed Light therapy IPL as described.  Our practice has experience with combination laser, IPL and micro electtrocautery therapy.   Electrocautery or micro cautery is very helpful to coagulate very small facial veins. [See Veinwave as a brand of micro electrocautery].  The technique involves very small electric currents transmitted to the vessel by fine wire cautery tips--the kind used to complete electrolysis for hair reduction.  The fine wires are pressed to the surface of the skin.  Electric currents are applied.  Sometimes the vessel will coagulate as the electric current will travel down the flow of blood by the path of least resistance.  Other times, the fine wire tip will actually puncture the skin to allow the tip contact with the vessel and blood flowing in the vessel.  Here is where the problems occur with darker skin types.  Collateral damage.  The electrocautery seals the vessel by coagulation, the surrounding skin also sustains coagulation--tissue damage.  Pigmentation changes can occur.  Patients with dark skin colorations can have hypopigmentation [white spots] or hyperpigmentation [dark brown/black spots] at each of the skin electrocautery contact points. Multiple treatment sessions maybe needed for best cosmetic effect..  Eye shields are a MUST during treatment..

Most cosmetic surgeons who deal with facial veins would recommend a few test spots with a 2-3 month time interval to see how your skin would react to micro coagulation.  Formal consultation is needed to determine your specific skin type and for skin testing prior to therapy for spider veins of the face..


Chattanooga General Surgeon

Would Not Recommend Sclero on Face

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Either laser or electrocautery would be preferred over sclero. Sclero can be tricky and if there is extravasation of the solution you can run into problems. If you do go this route, make sure the physician is very experienced.

If you vessels are small the V Star pulsed dye laser would be quite effective. For larger vessels the Cynergy would be my choice.

Though not "high-tech" electrocautery is also excellent and gives nice results at far less cost. IPL has been used but is not a recommended approach.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Lasers are best

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The veins that you describe around the nose are very common, in fact most people have at least one during some point in their life. The other issue is that they may come back over time or you may develop new ones.

Lasers are still the best treatment for these veins. I think the best laser system is a combined laser that uses a pulsed-dye laser followed by a YAG laser. This machine is made by Cynosure and is called the Cynergy. Again, it treats the veins with two consecutive laser pulses, increasing the chance that the vein goes away wtih the first treatment and stays away.

Other options, if you can't find this laser, are a Diolite laser or an old fashioned method of electrocautery to treat the veins. Generally IPL does not work well on these veins around the nose so I would not recommend this treatment.

Good Luck

Edgar Franklin Fincher, MD, PhD
Beverly Hills Dermatologic Surgeon

How do you treat facial spider veins ? Buffalo Niagara NY

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In our Williamsville laser office, we use long pulse lasers are used to treat these 'stubborn' spider veins. It should be remembered that more than one session may be needed and future maintenance treatments will be necessary for recurrence. 

Treatment options for BBL

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BBL works great for Veins around the nose, cheeks, chin etc.  We combine 1064 Laser with BBL for laser veins for the face/legs.  Patients sometimes need 2-3 treatments for optimal results.  Some patients see results with the first treatment.  Patients should expect mild redness and swelling post treatment.  Veins can typically come back, there is nothing to prevent that.  Treatments typically cost $150 for face.

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.