Can I repair the varicose 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 exactly are they? And is it possible to get rid of it?

Those tiny blood vessels that typically pop up around your nose, cheeks or chin are common, dermatologists say. They’re called telangiectasias — or, colloquially, varicose 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 beneath the skin’s surface. They often appear on the face, but can occur anywhere on the body, including the legs.

They are not harmful, said Dr. Mitchel Goldman, a dermatologist in San Diego who specializes in vein treatments, added, “They just look ugly.”

Although the veins are small, only about a millimeter in diameter (about the width of a sharpened pencil point), he said, they can be so unpleasant that you want to remove them.

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

What causes varicose veins?

Sun damage is the leading cause of varicose veins on your face, said Dr. Goldman. 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 the blood vessels to expand and become visible just beneath the skin.

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

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

Genetics can also predispose you to varicose veins, said Dr. Huang. That includes aging, when your skin loses collagen, making spider veins more apparent.

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

Excessive sneezing or a stuffy nose can also cause the blood vessels around the nose to dilate, he said.

Elevated blood levels of the hormone estrogen are another cause of varicose veins, putting those who are pregnant or using birth control or estrogen replacement therapy at greater risk, said Dr. Huang.

Can you get rid of varicose veins?

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

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

One way to do that is with a pulsed dye laserwhich 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, said Dr. Goldman. This laser penetrates deeper into the skin than other types of lasers and is less likely to cause pigment changes.

Intense pulsed light therapy can also remove varicose veins, added Dr. Goldman adds, using light pulses to target blood vessels and stimulate collagen production. The treatment uses a broad spectrum of lightSo it can also be used to treat other skin problems at the same time, such as acne scars, hyperpigmentation and wrinkles.

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

However, scarring or pigmentation changes are possible if the treatment is not performed correctly. That’s why Dr. Goldman recommends seeing a board-certified dermatologist or other doctor experienced in these procedures.

Varicose veins usually disappear permanently after treatment. But they can reappear if you continue to experience sun damage, use estrogen or have facial trauma, said Dr. Goldman. You may therefore need to be treated again once or twice a year.

Can you prevent varicose veins?

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

However, wearing sunscreen daily can help prevent the kind of sun damage it can cause — and can also protect you from skin cancer, said Dr. Huang.

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