Bruising & swelling are not side effects, they are part of the healing process. Rarely scarring can occur (less than 2% of cases). Blistering can occur in 5% of cases & will take 4-5 days to settle down.

In most cases, patients do not need to see me for laser therapy, as our trained nurses at Cutis Dermatology & DVP Sydney can manage facial veins. Cost for laser vein removal-

• $590 for 1 session (nurse)
• $1560 for 4 sessions (nurse or dermal clinician)
• $690 (dermatologist) 

A Medicare rebate is possible, however there are strict guidelines; namely vessels must be highly visible at a distance of 3 meters or more. 

For rosacea patients, a series treatment of 4 is recommended as it often takes 3 to 4 sessions to reduce redness & spider veins.

It’s a hard call to prevent spider veins, as they are genetically predetermined. A simple but marginally effective skin care routine is-

• Sunscreen twice a day. UV degrades collagen, collagen thickens the skin & keeps the blood vessel walls strong. 
• Gentle washing & tepid showers to reduce vasodilation. 

Avoidance of things that may dilate blood vessels; examples include alcohol & certain medications including ACE inhibitors & various blood pressure medications.

The diameter of spider veins ranges from 0 mm to 1 mm approximately. Small blood vessels that are bright red range in size from those that are larger and blue. Common patterns include single strands, branching tree patterns, and circular star patterns. On the side of the nose, larger spider veins frequently form on the face. 

Spider vein development appears to be influenced by a wide range of factors, though they do run in families and the underlying causes appear to vary depending on the region. On the legs, prolonged standing, hormones, and pregnancies are more significant than environmental factors like the sun, wind, and cold that affect the face. Asthma symptoms like hay fever and sinusitis are linked to spider veins around the nose. In spite of the fact that both sexes are capable of developing spider veins, men are more likely to develop facial spider veins than women are to develop leg veins.

Not everyone with rosacea will experience spider veins, & not everyone with spider veins has rosacea, however there is an overlap. Recurrent skin inflammation can lead to spider veins; namely erythrotelangiectatic rosacea or ETR. For a diagnosis of rosacea, one may have the following symptoms & signs-

• Flushing, blushing, facial redness
• Spider veins
• Pimples, pustules & acne like lesions
• Mid facial swelling
• Nose swelling, rhinophyma
• Ocular or eye signs; gritty eyes, dry eyes
• Skin sensitivity 
• Flares to UV, wind, climatic changes, stress, alcohol, spicy food, exercise

There are a few first-line treatments that can be tested at home if the spider veins in the feet and ankles are mild. Compression stockings, elevating the legs, massaging the area, maintaining a regular exercise routine, eating healthfully, and avoiding restrictive clothing are a few of these. 

There are several safe, non-invasive medical procedures that can be used if these are insufficient or if the veins are more severe. The best treatment is with sclerotherapy by injection performed by a vascular surgeon. In Brisbane, I refer to Dr Andrew Cartmill, in Sydney, Dr Adrian Lim. 

My team & I do not perform lasers on the lower limbs; sclerotherapy is far more effective.

When it comes to treating spider veins, there are basically 4 options, of which laser is best.

Surface Injections: This procedure, known as microsclerotherapy, involves injecting a solution into leg veins to cause them to close off and eventually disappear. This is the primary treatment for leg spider veins. Has the benefit of treating larger varicose veins at the same time. 

BBL or IPL: Largely outdated with newer long pulse dedicated vascular lasers. I did use IPL nearly two decades ago.

Needle-hyfrecation & or RF energy: Radiofrequency energy, is used in this procedure to heat up and close the veins. Short radiofrequency heat pulses are applied to the skin using a tiny probe. Anywhere on the body, it can be used to treat spider veins, but it works best on smaller ones. The same applies to needle tip hyfrecation. 

Laser: Vascular lasers may be used, and this procedure is known as photocoagulation because unwanted spider veins are sealed off (coagulated) using light. When treating blue or red spider veins, a different laser wavelength may be required. It’s crucial to keep the skin cool. This is the main treatment for broken capillaries and facial spider veins. Lasers have the benefit that no needles are used, making it a good option for patients who are needle-phobic.

Nope, however sunscreen can reduce redness, especially if you have rosacea. You may want to try the following creams prior to seeing a dermatologist as they can help alleviate skin inflammation, especially if you are prone to rosacea. 

• Azelaic acid: 10-15%. Apply nightly. This acid is great for sensitive skin, including rosacea patients. 
• Niacinamide: or vitamin B3 can help with skin barrier function. It is also anti-inflammatory.
• Brimonidine gel: Mirvaso can be marginally effective, however rebound is common.  
• Tranexamic acid: A popular over hyped skin care cream, found in many online stores.
• Ivermectin cream: Especially useful in a subpopulation of rosacea patients. 
• Creams can be sourced online or via an overseas pharmacy; be resourceful.