Age, genetics,& sun exposure. You can not modify the first two causes, however with good sun protection you can decrease collagen breakdown secondary to UV radiation.

Capillaries & broken veins increase with age. Genetics plays an important role, as fair skin patients are more prone to rosacea. UV radiation, especially UVA penetrates into the dermal layer of the skin, breaking collagen around blood vessels. This leads to weakening of the vessel walls, with resultant leaky capillaries. 

They can, especially in erythrotelangiectatic rosacea as well as chronic sun damage. Recurrence rate is determined by genetics modulated by lifestyle factors. You can reduce recurrence by-

• Sun protection (this reduces collagen breakdown of the walls of blood vessels)
• Reducing inflammation (this reduces the dilation of vessels)
• Controlling conditions such as flushing – blushing – rosacea

Rare genetic skin conditions including hereditary hemorrhagic telangiectasia, essential telangiectasia / generalised essential telangiectasia, etc will have recurrence.

Under eye veins or periorbital veins can be classified as one of two main groups.

1. Diffuse small calibre veins under the eye. This pattern contributes to dark circles*. Best treated with 595 V Beam laser. Conservative settings, 3 to 6 ms pulse duration. 2-4 sessions.
2. Large calibre periocular veins– ‘big blues’. These are best addressed with long pulse 1064 Nd Yag lasers. 1-2 sessions.

*Dark circle treatments are extraordinarily complex as there are multiple aetiologies including vascular, pigment due to PIH, constitutional, contact dermatitis, anatomical trough, genetic variants & more.

Specific vascular lasers are by far the best treatment for facial veins. I primarily use the 595 & the 1064 NdYag wavelengths however occasionally I use-

• 532 nm vascular lasers
• 755 Alex vascular lasers (bigger veins)
• IPL/BBL
• 810 diode lasers
• Hypertonic saline sclerotherapy (really resistant veins on the nose & face, usually in elderly gentleman)

1. Wear sunscreen. Capillary walls weaken with UV exposure, so wearing a good sunscreen can potentially prevent the development of some broken capillaries. Look for broad spectrum coverage, as it is the longer wavelength UVA that is the primary culprit. Neutrogena, La Roche Anthelios, Invisible Zinc & Melan 130 are a few great brands. Antioxidants including ascorbic, ferulic acids & green tea can reduce UV damage. They should be incorporated into your am routine.
2. Strengthen the blood vessel walls. Vitamin A or retinol/retinoids can increase collagen production in the dermal layer. They can also increase collagen around the arteries & veins, thus providing support for leaky blood vessels. Start with 0.5% retinol. Brands include The Formulated, Obagi, Aspect Dr & Medik8. Note; if you have rosacea, you should modulate your retinoid use as this can flare up your skin.
3. Reduce inflammation. Especially important for patients with rosacea. Ingredients to consider include niacinamide, green teak, rosehip & essential oil. Prescription topicals include Soolantra, Azelaic Acid, & Rozex.
4. Tepid washes. No, you don’t need to swear off hot showers for life, but know that you’re putting your skin at an increased risk the warmer the water is. Hot water on your face increases the blood flow, dilating capillaries. This results in increased redness in the skin. Wash your face with cool or tepid water, instead, & try to keep your face out of the direct blast of the hot shower stream.

Yes, however there are more effective treatments, namely sclerotherapy. Even though the product information from laser companies state that lasers can be highly effective for spider veins on the legs, simple injections known as sclerotherapy provide better results in most cases.

Larger veins are treated with an endovenous laser. This treatment is performed by a vascular surgeon.

No. Facial veins will not respond to creams. On the other hand, redness due to rosacea can respond to cream including metronidazole, ivermectin, & bromotrimidine. Sodium sulfacetamide washes, & niacinamide can be useful in treating inflammatory skin conditions.

For medical / topical treatments, consult your medical dermatologist. 

$690 per session with myself.

$260 per session with my nurses.

95% of the time, my nurses use the very same settings I do. Facial vein treatment is basic dermatology & I recommend the majority of patients to book in with my nursing team. I can certainly take over if you have complex vessels (resistant vessels, facial veins in darker skin type, genetic causes of veins & capillaries).

Yes, however you must fulfill 3 requirements.

1. Valid referral from your GP to a dermatologist.
2. Facial veins seen at a minimum of 3 meters.
3. Procedure conducted by dermatologist.

As of time of writing, you will get back approximately $145 from Medicare. Most patients do not meet the criteria as one must have super high resolution eye sight to pick up individual veins at 3 meters (as opposed to general redness).

Some private overseas medical insurance companies cover this procedure, please check item number 14100.

The bad news is that there are no home remedies available for established veins. They require treatment with laser, IPL or sclerotherapy.

You can however prevent new veins with adequate sun protection & anti-inflammatories such as niacinamide. Blood vessel walls can be strengthened with antioxidants & retinol*. 

* Caution if you have overly sensitive skin/rosacea.