I have had this broken capillary on my upper lip line for years. What is the best treatment? (Photos)

angiomas can be treated with vascular laser (v beam or excel V >> IPL) versus needle desiccation.
For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)
Best, Dr. Emer.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian

Thank you for your question. I believe Vbeam would give you a very good result. This vascular laser targets the blood inside the vessel to coagulate the visible vein and eliminate it. The laser energy does not touch surrounding skin and tissue. I would expect you to achieve a full result in a single treatment session. Make sure you work with a board-certified dermatologist with expertise in using this laser to ensure an optimal outcome. 

Thank you for your question and photo. I would likely recommend the Vbeam laser for this purpose. It is a vascular laser device designed to target the blood inside visible vessels and lesions to eliminate them without damaging surrounding skin and tissue. The procedure is relatively quick and comfortable and patients often achieve full results in a single session. Choose a board-certified dermatologist and laser expert for your treatment to ensure your procedure is both safe and successful. 

For over three decades, I have personally been employing light electrocautery for treating all sorts of vascular abnormalities on the lips (and elsewhere). From what I can see in the photo provided, following numbing of the region with lidocaine, literally a short one second "buzz" of electrocautery would immediately close off the vascular abnormality leaving a little scab. Lips typically heal quite quickly, so usually the very small treatment area, would heal in about a week or so. Be cautious when evaluating all kinds of heavily marketed bells and whistles light and laser devices that may be recommended to you. Best of luck.