This common cosmetic concern, often described as “broken blood vessels” on the nose and face, is medically known as telangiectasia. These tiny, visible blood vessels are not truly broken but are permanently dilated capillaries situated close to the skin’s surface. They frequently occur, especially as people age and on areas regularly exposed to the environment. These fine, thread-like lines can range in color from bright red to purple or blue, sometimes forming a branching, spider-web pattern across the nasal tissue.
What Are These Vessels?
The visible vessels are capillaries that have become enlarged and remain chronically dilated. Capillaries are the body’s smallest blood vessels, acting as a bridge between arteries and veins to facilitate the exchange of oxygen and nutrients. When the delicate walls of these capillaries lose elasticity and structural support, they widen or distend, making them visible through the thin outer layer of skin on the nose and cheeks.
The vessel wall remains intact, but the capillary is permanently stretched beyond its normal size. This permanent dilation causes blood to pool, giving the telangiectasia its characteristic reddish or bluish color. The color difference depends on the type of blood vessel involved; red indicates an arteriole, and blue indicates a venule.
The Root Causes of Formation
The primary factor driving the formation of these vessels on the nose is chronic exposure to ultraviolet (UV) radiation from the sun. UV rays damage the collagen and elastin fibers that normally support the capillary walls, leading to a loss of structural integrity and eventual permanent dilation. This photo-damage is cumulative, explaining why telangiectasias become more prevalent with age and often appear first on the most sun-exposed areas of the face, like the bridge and sides of the nose.
A significant underlying condition often associated with nasal telangiectasias is rosacea, a chronic inflammatory skin disorder. Vascular rosacea is characterized by frequent flushing and persistent redness, which repeatedly causes the facial blood vessels to swell and contract. This repeated stress eventually overstretches the capillaries, leading to fixed, visible lines on the nose and cheeks.
Genetics plays a substantial role, as some individuals are predisposed to having more fragile blood vessel walls. If there is a family history of telangiectasias, development is more likely, even without significant environmental triggers. Advancing age naturally contributes because the skin thins and loses elasticity over time, making existing vessels closer to the surface and more fragile.
Physical and hormonal factors can also contribute to their development on the nose. Trauma, such as aggressive scrubbing, squeezing blemishes, or forceful nose-blowing, can place excessive pressure on delicate capillaries. Hormonal fluctuations, such as those experienced during pregnancy or menopause, can influence vessel fragility and dilation. Furthermore, prolonged use of topical or systemic corticosteroid medications can cause the skin to thin, making underlying vessels more apparent and vulnerable to damage.
Minimizing Risk and Preventing New Damage
The most effective strategy for preventing the formation of new telangiectasias centers on rigorous sun protection. Daily application of a broad-spectrum sunscreen with an SPF of 30 or higher shields against UVA and UVB radiation that weakens vessel walls. Wearing a wide-brimmed hat when outdoors provides a physical barrier, which is beneficial during peak sun hours.
For individuals with underlying rosacea, managing flare-ups is an important preventative measure. Identifying and avoiding personal triggers can reduce the frequency of flushing episodes:
- Spicy foods
- Hot beverages
- Alcohol
- Emotional stress
Avoiding extreme temperature shifts, such as moving rapidly from a warm indoor environment to cold, windy weather, also helps. These rapid changes cause capillaries to dilate and constrict suddenly, stressing the vessel walls.
Gentle skincare practices are also recommended to reduce mechanical stress on the nose. This involves avoiding harsh astringents or toners that can irritate the skin and refraining from excessive rubbing or aggressive exfoliation. For those who use topical corticosteroid creams near the nose, consulting a physician about long-term use is advisable due to their skin-thinning side effects.
Methods for Removal
Once telangiectasias have formed, they do not disappear on their own and require professional intervention for cosmetic removal. The gold standard treatment for facial vessels is vascular laser therapy, which uses concentrated light energy to target hemoglobin inside the vessel. The hemoglobin absorbs the light, which instantly converts to heat, causing the vessel wall to collapse and coagulate without harming the surrounding skin.
Specialized lasers, such as the Pulsed Dye Laser (PDL) or KTP laser, are highly effective because their wavelengths are optimized for absorption by blood. The body’s immune system then gradually reabsorbs the destroyed vessel over the following weeks. While many small vessels can be reduced in one or two sessions, larger areas may require a series of treatments to achieve a satisfactory result.
Electrocautery
Electrocautery, also known as electrodessication, offers an alternative method, particularly for treating smaller, superficial vessels. This procedure uses a fine needle to deliver a low-level electrical current directly into the vessel, which seals it shut through heat. While effective and precise, this method can sometimes lead to temporary scabbing or mild discoloration at the treatment site.
Sclerotherapy
Sclerotherapy involves injecting a chemical solution into the vessel to close it. While common for leg veins, it is generally less favored for the very fine, superficial vessels on the face due to the small size of the capillaries.