Can I Fix the Spider Veins on My Face?

Q: I’ve noticed some red, squiggly blood vessels just under the skin of my cheeks and around my nose. What are they, exactly? And is it possible to get rid of them?

Those tiny blood vessels that typically crop up around your nose, cheeks or chin are common, dermatologists say. They’re called telangiectasias — or, informally, spider veins, because they “look like spider webs,” said Dr. Amy Huang, a dermatologist in New York City.

Telangiectasias are small dilated blood vessels that have become damaged and are visible just under the skin’s surface. They often appear on the face, but can occur anywhere on the body, including the legs.

They’re not harmful, Dr. Mitchel Goldman, a dermatologist in San Diego who specializes in vein treatments, said, adding, “They just look unsightly.”

Though the veins are tiny, measuring only about one millimeter in diameter (about the width of a sharpened pencil point), he said, they might be so displeasing that you’ll want to remove them.

Fortunately, spider veins can be treated with the help of a dermatologist.

What causes spider veins?

Sun damage is the No. 1 cause of spider veins on your face, Dr. Goldman said. Sun exposure destroys the coating that surrounds all blood vessels, known as the internal elastic lamina, which he compared to plastic wrap. When the coating is destroyed, it causes blood vessels to expand and become visible just under the skin.

Ultraviolet radiation from the sun can also interfere with the skin’s cellular repair process and cause the skin’s tissue to break down, making spider veins more visible, said Dr. Stephen Warren, a plastic and reconstructive surgeon in New York City.

Your face is most susceptible to spider veins simply because it’s usually not covered up and it tends to get more sun exposure than other parts of the body, Dr. Warren said.

Genetics may predispose you to spider veins as well, Dr. Huang said. So can aging, when your skin loses collagen, making spider veins more apparent.

Facial trauma, such as from surgery or an injury, can cause spider veins, too, Dr. Goldman said. “I just saw a patient who was playing pickleball, and the pickleball hit her in the face, and she developed telangiectasias,” he said.

Excessive sneezing or nasal congestion might also cause the blood vessels around the nose to dilate, he said.

Increased blood levels of the hormone estrogen is another cause of spider veins, putting those who are pregnant or taking birth control or estrogen replacement therapy at higher risk, Dr. Huang said.

Can you get rid of spider veins?

There’s no way to remove them on your own, experts say. So if you don’t like how they look, see a dermatologist, Dr. Warren said.

Laser treatment is the best way to get rid of spider veins, Dr. Goldman said. The heat from the laser destroys the blood vessel, causing it to shrink and eventually dissolve and be reabsorbed by the body, Dr. Huang said.

One way to do that is with a pulsed dye laser, which uses intense, concentrated light beams to destroy the blood vessel without damaging the skin around it.

Another option is the Nd:YAG (or neodymium-doped yttrium aluminum garnet) laser, Dr. Goldman said. This laser penetrates deeper into the skin than other types of lasers and is less likely to cause pigmentation changes.

Intense pulsed light therapy can also get rid of spider veins, Dr. Goldman added, by using pulses of light to target blood vessels and boost collagen production. The treatment uses a broad spectrum of light, so it can also be used to treat other skin issues, like acne scars, hyperpigmentation and wrinkles, at the same time.

Laser and intense pulsed light treatments may cause a little pain, Dr. Goldman said. But they are safe and the side effects, such as minor, temporary bruising, are minimal.

However, scarring or pigmentation changes are possible if the treatment isn’t performed correctly — so Dr. Goldman recommends going to a board-certified dermatologist or other physician experienced in these procedures.

Spider veins usually go away for good after treatment. But they can reappear if you continue to experience sun damage, take estrogen or have facial trauma, Dr. Goldman said. So, you might need to be re-treated once or twice a year.

Can you prevent spider veins?

That’s not really possible, Dr. Warren said, especially if you’re at higher risk because of your genetics or the medication you take.

However, wearing sunscreen every day can help prevent the type of sun damage that can cause them — and can protect you from skin cancer, too, Dr. Huang said.

“Wear an SPF 30 and above, and make sure you reapply it every two hours if you’re swimming or sweating,” she said.