Fine red or purple lines across the cheeks and around the nose have several names, which is part of why they are confusing to research. Spider veins, thread veins, broken capillaries and facial telangiectasia all describe the same thing.
The visible lines are small blood vessels sitting close to the skin surface that have dilated and stayed that way. The vessels are not broken, despite the common name, and they will not resolve on their own.
What they actually are
Capillaries constrict and dilate constantly as part of normal circulation. When a vessel loses its ability to constrict back down, it stays widened and becomes visible through the skin as a fine line.
The wall is intact, so nothing is leaking. This matters practically: the treatment is not about repairing a break, it is about closing a vessel that is no longer doing anything useful. Surrounding vessels take over its work.
| Name you may have seen | What it refers to |
|---|---|
| Spider veins | The common term, from the branching pattern |
| Thread veins | The same thing, more common in UK usage |
| Broken capillaries | The same thing, though nothing is actually broken |
| Facial telangiectasia | The clinical term used in dermatology |
| Spider naevus | A related but distinct lesion with a central feeding vessel |
A spider naevus is worth separating from the others. It has a central red dot with vessels radiating out, and it blanches then refills from the centre when pressed.
What causes spider veins on the face
Facial skin is thin and richly supplied with blood vessels, so changes show readily. Several factors contribute, and most people have more than one.
- Cumulative sun exposure, which weakens the supporting collagen around vessel walls. In South Australia this is the dominant factor for most people
- Rosacea, where persistent flushing progresses to fixed visible vessels over time
- Genetics, particularly in fair skin that flushes readily
- Age, as the dermal support structure thins
- Alcohol, which dilates vessels repeatedly
- Trauma or pressure, including habitual nose blowing or spectacles resting on the bridge
The nose, cheeks and the area beside the nostrils are the usual sites, which follows the pattern of sun exposure and flushing.
Pregnancy and hormonal change can bring vessels out too, and some settle on their own afterwards. There are several skin changes that can follow pregnancy, and it is worth waiting to see which resolve before pursuing treatment.
Occupation matters more than people expect. Decades of outdoor work in South Australia produces a pattern of vessels across the nose and upper cheeks that is recognisable, and it usually sits alongside other forms of sun damage worth assessing at the same appointment.
Spider veins on cheeks and nose
Cheeks and nose are where facial spider veins turn up most often, and there are straightforward reasons why.
Skin across the cheeks is thin and sits over a dense network of superficial blood vessels. Years of sun exposure, wind and repeated flushing gradually weaken vessel walls in this area until some dilate and do not recover. The nose, particularly the bridge and the creases beside the nostrils, is similarly exposed. Vessels along the nose can be slightly more stubborn to clear because of the concentrated blood supply, but they respond well to vascular laser when the wavelength and pulse settings are matched to the vessel size.
If vessels are concentrated on one cheek or along one side of the nose, that can reflect sleeping position, habitual sun exposure from one direction, or where spectacles rest. It does not usually indicate anything more concerning, but an assessment can confirm what is going on.
Why creams and home remedies do not work
The vessel sits in the dermis, below the layer any topical product can meaningfully reach. Nothing applied to the surface will close a dilated vessel.
Some products reduce redness temporarily by constricting vessels, which makes them look better for a few hours. That is a cosmetic effect on tone, not a change to the vessel itself, and it reverses.
Visible facial vessels do not fade with time. Left alone they generally become more numerous, because whatever caused the first ones is usually still present.
How vascular laser treats them
Vascular laser works by selective photothermolysis. A wavelength is chosen that haemoglobin absorbs far more strongly than the surrounding tissue, so the energy is taken up by the blood inside the vessel.
The absorbed energy heats the vessel wall enough to collapse and seal it. The body then clears the closed vessel over the following weeks, and the line fades as it does. Surrounding skin is largely unaffected because it absorbs much less of that wavelength.
At our Kent Town clinic this is generally done with the Excel V vascular laser in Adelaide, which allows the wavelength and pulse to be matched to the depth and calibre of the vessels being treated.
What treatment involves
Sessions are short, often 15 to 20 minutes for the nose and cheeks. Eye protection is worn and a cooling system protects the skin surface as the pulses are delivered.
- Most people describe each pulse as a brief sting, similar to a rubber band flick
- Fine vessels often disappear during the session as you watch
- Larger vessels may darken first and clear over two to three weeks
- Redness and mild swelling afterwards typically settle within a day or two
- Bruising is possible where vessels are larger
One to three sessions is a common range, spaced around four to six weeks apart. How many you need depends on how many vessels there are and how deep they sit.
Will they come back
A treated vessel that has been closed does not reopen. New vessels can appear, which is a different thing and worth being clear about before you start.
New vessels are more likely to develop when the underlying cause is still present. Someone with rosacea or continuing heavy sun exposure is more likely to see new vessels than someone whose vessels came from a single period of sun damage decades ago.
Where rosacea is driving it, managing that alongside the vessels gives a better long-term result than treating vessels repeatedly in isolation. The clinic can discuss rosacea treatment in Adelaide if flushing is part of your picture.
Reducing the chance of new vessels
Once existing vessels have been cleared, the practical question is whether anything slows new ones from forming. The risk cannot be eliminated entirely, particularly where genetics or rosacea are involved, but a few measures make a noticeable difference.
- Daily broad-spectrum sunscreen on the face, reapplied through the day. Sun damage is the single biggest modifiable cause of facial spider veins in South Australia
- A hat with a brim when outdoors, which shields the nose and cheeks more effectively than sunscreen alone
- Managing rosacea if flushing is part of the picture, rather than treating vessels in isolation each time
- Limiting alcohol and very hot drinks, both of which dilate facial vessels repeatedly
- Avoiding prolonged heat exposure from saunas and steam rooms, which can worsen facial flushing over time
Prevention is about slowing progression rather than stopping it completely. Keeping an eye on treated areas helps catch new vessels early, when a shorter follow-up session can deal with them before they become widespread again.
Risks and who it may not suit
Vascular laser is well established, but every laser treatment carries risk and these should be discussed before you proceed.
- Prolonged redness, swelling or bruising beyond the usual few days
- Blistering or crusting, which requires care to avoid marking
- Pigment change, either lighter or darker, more likely in deeper skin tones
- Scarring, which is uncommon but possible
- Incomplete clearance, where some vessels need further sessions
Recent sun exposure or a tan usually means postponing, which matters through an Adelaide summer. Some medications increase light sensitivity, and certain skin conditions make treatment unsuitable. Outcomes vary between individuals and are not guaranteed.
Assessment by a registered health practitioner is required first, partly to confirm what the vessels actually are. General information on skin conditions is available from healthdirect.
Before your appointment
A few things make the session more effective and reduce the chance of it being rescheduled on the day.
- Avoid deliberate sun exposure and fake tan for at least two weeks beforehand
- Tell the clinic about any medication that increases light sensitivity
- Come with clean skin and no makeup on the area being treated
- Mention any history of cold sores if the treatment area is near the mouth
- Avoid blood thinning supplements in the days before, where your doctor agrees it is appropriate
Plan the timing too. If you have an event coming up, allow a fortnight in case of bruising rather than treating the week before.
Cost
Cost depends on the area treated and how many sessions are needed. Current pricing is listed on our pricing page and is indicative only.
Because vessel counts vary so much between people, your fee is confirmed at consultation once the area has been assessed.
Common questions
How many sessions will I need?
Commonly one to three. Isolated fine vessels sometimes clear in a single session, while widespread vessels across the nose and cheeks usually take more.
Can I wear makeup afterwards?
Generally the following day, once any swelling has settled and provided the skin is intact. If crusting occurs, leave the area alone until it resolves.
Is it the same treatment used for leg veins?
Related but not identical. Leg veins are larger and deeper, and are often treated differently. Facial vessels respond well to vascular laser because they sit close to the surface.
Does it help with general facial redness?
It can. Diffuse redness responds differently to discrete vessels, and settings are adjusted accordingly. If flushing is the main issue, that is assessed as part of the consultation.
What if the vessels are around my nostrils?
That is one of the most common sites and it is treatable. Vessels there can be more stubborn and occasionally need an additional session.
Are spider veins on the face a sign of a medical condition?
Usually not. Most facial spider veins result from a combination of sun exposure, genetics and normal ageing. They can accompany rosacea or, less commonly, a connective tissue condition. An assessment at the clinic clarifies what is causing yours and whether anything else needs attention.
Can pregnancy cause spider veins on the face?
It can. Hormonal changes during pregnancy increase blood volume and may bring out spider veins on the cheeks and nose. Some settle after delivery, so it is generally worth waiting a few months before deciding on treatment.
The short version
Spider veins, thread veins and broken capillaries are the same thing: dilated vessels sitting close to the surface. Creams will not clear them and they do not fade with time.
Vascular laser closes them in one to three sessions. You can read more about facial telangiectasia treatment at our Adelaide clinic.
An assessment confirms what the vessels are and how many sessions yours are likely to need. Book a consultation at our Kent Town clinic in Adelaide, or call the clinic on (08) 8239 0431.
