Telangiectasia refers to the superficial cutaneous vessels which are visible to the human eye. They can be associated with underlying conditions such as rosacea or secondary to photodamage. These vessels measure 0.1 to 1.0 mm in diameter and represent a dilated venule, capillary, or arteriole.
Telangiectasia that are arteriolar in origin are small in diameter, bright red in color, and do not protrude above the skin surface. Those that arise from venules are wider, blue in color, and often protrude above the skin surface. Telangiectasia arising at the capillary loop are often initially fine, red lesions but become larger and purple or blue with time because of venous backflow from increasing hydrostatic pressure.
There are four primary classifications of telangiectasia based on clinical appearance: (1) simple or linear, (2) arborizing, (3) spider, and (4) popular. Red linear and arborizing telangiectasia are very common on the face, especially the nose, midcheeks, and chin. These lesions are also seen relatively frequently on the legs. Blue linear and arborizing telangiectasia are most often seen on the legs but also may be present on the face.
Patients often present to our clinic with facial telangiectasia, especially around the nasal alar area. These vessels tend to be red or deep blue and are ropey in appearance. Typically one to four treatments of the Cynergy laser (Pulsed dye laser multiplexed with Nd:YAG) will treat the vessels. The larger the vessel is in diamter, the more treatments are typically needed to erradicate the vessel.
After the treatment, the area will be mildy erythematous (red) with slight swelling at the area treated. Make-up can be worn afterwards. There can be some bruising present, but with the presence of the longer pulse duration Pulsed Dye Laser with Nd:YAG the purpura tends to be minimal.
Patients are seen in follow up in 6 weeks and evaluated for clinical clearance or whether an additional treatment is needed.