Facial Spider VeinsWhat it is, and what we can do about it.

What a broken capillary is

The name is slightly misleading. A visible facial vessel is not usually broken in the sense of leaking. It has become permanently dilated.

Small blood vessels near the surface of the skin normally constrict and dilate as needed, and at their resting diameter they are invisible. Repeated or sustained dilation, along with damage to the vessel wall and the surrounding collagen that supports it, means the vessel eventually loses the ability to constrict back down. It stays open, and once its diameter exceeds a certain point, it becomes visible through the skin as a fine red or purple line.

The medical term is telangiectasia. Most people call them broken capillaries, thread veins or spider veins, and the effect is the same: a mark on the face that no amount of skincare will fade.

Where they appear and why

The nose and the area immediately around the nostrils are the most common site, followed by the cheeks and the chin. These areas share three characteristics: they get more sun exposure than the rest of the face, they have relatively thin skin, and they contain a dense superficial vascular network.

The contributing factors are cumulative rather than singular.

Sun exposure damages the collagen that supports vessel walls, leaving them less able to hold their shape. This is the largest factor for most people.

Temperature extremes cause repeated rapid dilation and constriction. Ontario winters, where you move between sub-zero outdoor air and heated indoor air several times a day, are genuinely relevant here.

Rosacea involves vascular hyper-reactivity as a core feature, and visible vessels are a common part of the picture.

Alcohol causes vasodilation, and regular consumption is associated with more visible facial vessels over time.

Trauma and pressure, including surgery, injury and even forceful straining, can produce individual vessels.

Why they do not fade

This is worth stating clearly, because a lot of money is spent on products aimed at broken capillaries.

The change is mechanical and structural. The vessel wall has lost tone and the vessel has stayed open. No topical ingredient reaches into a vessel and restores its ability to constrict. Products marketed for redness may reduce inflammation or temporarily constrict vessels, which softens general redness, but a discrete visible vessel remains a discrete visible vessel.

Closing it requires the vessel to be treated directly.

How BBL treats them

BBL broadband light works on a principle called selective photothermolysis. The device delivers filtered light at wavelengths that are absorbed far more strongly by haemoglobin, the pigment in blood, than by the surrounding skin. Within the vessel, that absorbed light becomes heat, which damages the vessel wall enough that the vessel closes. Over the following days the body clears the closed vessel and the line disappears from view.

Because the energy is targeted at haemoglobin, surrounding tissue is largely unaffected, which is what makes the treatment precise.

The same technology addresses the diffuse background redness that often accompanies discrete vessels, which is why BBL is our primary tool for both this and rosacea.

Where our scope ends

We want to be explicit, because it saves people a wasted appointment.

We treat facial spider veins. We do not treat leg veins.

Leg spider veins and varicose veins are a different clinical problem. They are frequently associated with underlying venous insufficiency, which needs proper vascular assessment, and the established treatments are sclerotherapy and specific vascular laser systems. We do not offer either, and treating surface leg veins without assessing what is happening underneath is poor practice regardless of who does it.

If leg veins are your concern, see your family physician or a dedicated vein clinic. That is the right answer, even though it is not the one that gets us a booking.