Cosmetic veins

What are cosmetic veins?

Cosmetic veins show up as fine red, blue or purple lines just beneath the surface of your skin. The everyday names for them are thread veins and spider veins, while doctors use the term telangiectasia. Unlike varicose veins, they don't bulge or twist, and they're usually more of a confidence issue than a medical one.

What are the common causes of cosmetic veins?

A number of things can make these veins appear, and often more than one factor plays a part:

• getting older
• your genes, since they can run in families
• spending time in the sun without protection
• hormonal factors, including the effect of oestrogen on your blood vessel walls
• certain medicines, such as steroid creams
• skin conditions like rosacea
• pregnancy or a past injury to the area

On your legs specifically, they can also follow on from extra pressure building up in the veins that sit deeper beneath your skin, or from nearby varicose veins.

Are there different types of cosmetic veins?

The two main patterns are facial and leg thread veins, and they're generally treated differently.

On your face, they tend to show up on your nose, cheeks and chin, and are usually put down to some combination of genetics, sun exposure, steroid creams, rosacea or simply getting older. Certain areas of your face, including around your eyes and temples, need particular care, since veins here can drain into the eye socket, so some treatments are avoided there.

How are cosmetic veins treated?

Treatment depends on where the veins are:

On your legs, the main option is microsclerotherapy. A very fine needle delivers a solution into the vein, which makes the vein walls stick together; your body then breaks the vein down and reabsorbs it over the following weeks. Laser treatment is also used, particularly for smaller veins. You may need more than one session, and how far apart these are spaced varies: some clinics leave around 10-12 weeks between sessions, while others work on roughly a month.

On your face, smaller broken veins are often treated with short wave diathermy, where heat delivered through a fine needle causes the vein to clot and fade, or with light-based treatments that target and collapse the vein. Sclerotherapy can also be used on facial veins, but this needs particular caution around your eyes and temples, given the drainage risk mentioned above.

Afterwards:

• leg treatment can leave redness that settles anywhere between a few days and a fortnight, a little longer if you have fairer skin; moisturising and daily sunblock are recommended, and strenuous exercise is best left for around a fortnight, though walking is fine
• some sources recommend wearing compression stockings for at least 48 hours (and up to a month) after leg treatment to help results last, while others say there's little evidence that stockings make a difference, so it's worth asking your practitioner directly
• facial treatment recovery is usually immediate, though the area may look red or swollen for around 24 hours, with a small scab sometimes forming; avoiding exercise for 48 hours is generally advised

When should you see a doctor?

If you're considering treatment for leg veins and you also have varicose veins or think pressure in your deeper leg veins could be a factor, it's worth having this looked at before any cosmetic treatment goes ahead. For facial veins, get a proper specialist assessment before agreeing to any injection-based treatment near your eyes or temples, since these particular veins carry an added safety consideration.