Veins are part of the vascular system and carry de-oxygenated blood from the peripheral areas of the body to the heart and lungs. There are four major types of veins in the body, all composed of three major layers of various tissues that give the veins both strength and elasticity.
Broken capillaries, referred to as “facial veins,” appear as vascular lesions that are typically the result of damaged or enlarged superficial blood vessels that lay just beneath the skin’s surface. Most often these lesions are benign. To obtain a better understanding of what causes veins to become visible, it is helpful to have a general understanding of the organisation and function of the veins.
Veins vs. Arteries
Arteries and veins are the two main transportation systems that move blood throughout the body. Veins receive blood from the arteries through the arterioles and capillaries. Whereas arteries pick up oxygenated blood from the heart and lungs and distribute it throughout the body, providing oxygen and nutrients to the cells, the veins are responsible for carrying the de-oxygenated blood, the blood that the cells have absorbed the oxygen from, back to the heart muscle where it is then pumped through the lungs for re-oxygenation.
Veins are composed of three thin layers of tissue, with the outer wall being composed of connective tissue, collagen and elastic fibres. The middle layer is composed of smooth muscle and elastic fibres. The inner layer is composed of an elastic membrane lining and smooth epithelial tissue covered by elastic fibres. Because the venous system works at a much lower pressure then the arterial system, which is powered by the contractions of the heart, the veins require muscle contractions to push the blood back to the heart.
Smaller veins, called venules, are about one millimetre in size with larger veins being up to 1 1/2 centimetres in diameter. The wall of the veins are much more elastic than the walls of the arteries, allowing the veins to stretch and hold more blood.
Veins fall into four major categories:
- Pulmonary veins move blood from the lungs to the heart.
- Systemic veins return de-oxygenated blood to the heart.
- Deep veins are found near a supply artery, usually inside of muscle tissue.
- Superficial veins are located just below the skin’s surface. It is usually these superficial veins that become prominent in the face, forehead and ears.
What are Facial Veins
There is one larger vein in the head, known as the facial vein. This is also called the “anterior vein of the face,” beginning at the angular vein just below the nose and ending at the carotid artery in the neck.
This main facial vein should not be confused with the smaller visible veins that just below the surface of the skin.
Most of the smaller veins in the face drain blood into the facial vein, to be returned to the heart and lungs. Visible facial veins are typically found on all areas of the head, including the cheeks, nasal area, eyelids, brow and ears. However, visible veins are also sometimes found on the neck and chest. Facial veins often do not present with any symptoms other than a noticeable appearance. As related to the size of the effected vein, facial veins can range from a couple of millimetres to a few centimetres in diameter. Visible veins on the neck and chest are usually larger than those on the face.
Types of Facial Veins
1. Spider veins
These facial veins are named for an appearance that resembles a spider, with tiny blood vessels, called telangiectasias, extending out from a small red dot. Also called spider angiomas, these tend to be small groups of dilated capillaries. Spider angiomas are usually less than one millimetre in diameter and are most commonly found on the nose. Sometimes telangiectasias are so small they appear as just a redness on the skin and may be caused by a condition known as rosacea.
2. Reticular veins
Reticular veins are larger than spider veins, typically two to three millimetres in diameter and exhibit with a bluish-green colour. These are most common on and around the cheeks, eye sockets, temples and the brow.
3. Varicose veins
Even though they typically occur on the lower legs, varicose veins can occur anywhere, even on the face. These are usually larger blood vessels presenting with a bluish colour located just under the skin. While there is typically no discomfort, varicose veins can be painful.
Causes of Facial Veins
Facial veins may be related to other conditions. Rosacea, a common type of skin disorder that results in redness and visible blood vessels on the face, is one of the more common conditions and may be accompanied by a burning feeling. Liver disease will often present with spider veins. Facial veins can occur as a result of a genetic vascular defect, a blood clot or damage to the veins. Facial veins are most frequently seen in older adults, over the age of 40, and are more common in people with fair complexions than darker skinned individuals.
Superficial blood vessels become more noticeable as people age due to the breakdown of the elastic fibres in the vessel walls and this results in blood vessel dilatation, or expansion. As the vessel enlarges it moves closer to the surface of the skin, becoming more visible. Facial veins are generally more prevalent on people who:
- Spend a lot of time outdoors and experience excessive sun exposure.
- Take certain drugs.
- Heavy alcohol consumption.
- Have been exposed to environmental or chemical irritants.
- Have undergone radiotherapy.
- Experienced physical trauma.
- Use oral contraceptives.
- Pregnant women.
- Have a violent coughing, sneezing or vomiting episode, as sudden and extreme pressure in the face can result is broken blood vessels.
There are also several genetic disorders, such as Klippel-Trenaunay syndrome that affects blood vessel development, that are related to visible veins. Larger varicose veins are often the result of injury, but can also be caused by hormonal changes or an autoimmune condition. However, most cases of facial veins are completely benign and your healthcare provider will be able to determine the cause.
Natural Treatments for Facial Veins
While they won’t always be effective, it doesn’t hurt to try an all-natural remedy before considering a more invasive medical treatment for facial veins.
1. Apple Cider Vinegar
Apple cider vinegar used as an astringent may help with the appearance of small facial veins. Apply organic, unfiltered and unpasteurized apple cider vinegar to the skin with a cotton ball or gauze for 10 minutes. Note that regular off-the-shelf apple cider vinegar does not contain the essential nutrients and enzymes that are believed to help reduce the appearance of spider veins.
2. Wash with Cold Water
Because it will relax the skin, hot water will increase the appearance of facial veins. Conversely, cold water will tighten the skin and can temporarily help reduce the appearance of facial veins.
3. Herbal Supplements
Like apple cider vinegar, spider veins may respond to witch hazel applied to the skin. Consuming gingko biloba, garlic and cayenne pepper may also help to reduce the appearance of fine facial veins.
Medical Treatments for Facial Veins
1. Retinoids
Topical creams containing retinoids, that peel away the top layers of skin, can sometimes help reduce the appearance of spider angiomas.
2. Angiogram
While typically only done in severe cases, such as for varicose veins, your physician may want to perform an angiogramme. This procedure involves injecting a harmless dye into your bloodstream that will show up on an X-ray. This procedure will help your doctor map your vascular system to determine the problem.
3. Sclerotherapy
A liquid chemical is injected into the vein that causes the vein walls to seal shut, stopping the flow of blood. This results in the vein becoming scar tissue and should no longer be visible as blood will no longer flow through the vein. More than one treatment may be required and treatments are typically performed at four- to six-week intervals. Sclerotherapy is the most common treatment for facial spider and varicose veins and is usually performed as an outpatient procedure in a doctor’s office.
4. Microsclerotherapy
Microsclerotherapy is a procedure that is similar to sclerotherapy, but uses a smaller needle.
5. Light Treatments
Laser treatment is typically used for treating smaller facial veins where a vein is closed off with a high-intensity burst from a laser. Similar to laser therapy, intense pulsed-light treatment is designed to penetrate into the second layer of skin without affecting the top layer.
6. Endovenous Ablation
This procedure is usually used for more severe cases to alleviate pain and swelling by cauterising the offending vein. This procedure is much less invasive than surgical treatment and results in little, if any, scaring.
7. Vein Stripping and Ligation Surgery
This procedure is typically reserved for very severe cases of varicose veins. A small incision is made in the skin and the vein is tied off and then removed. Since this is actual surgery, you will be given general anaesthesia to put you to sleep. This procedure is most often performed on an outpatient basis and recovery time is typically from one to four weeks.
Prevention of Facial Veins
1. Eat a Healthy Diet
Eating foods that promote healthy blood flow and reduce inflammation can help with both the appearance and prevention of spider veins. Foods rich in antioxidants and omega-3 fatty acids support the immune system and improve circulation. Conversely, avoid foods high in saturated fat, cholesterol, sodium and processed sugar as these can all lead to increased blood pressure that can cause visible veins.
2. Avoid Sun Exposure
Excessive sun exposure is a major cause of of damaged skin and can result in enlarged blood vessels, making them more visible. Wear a hat and use plenty of sunscreen when outside, especially during the midday hours.
3. Limit Alcohol Intake
Alcohol will temporarily dilate the blood vessels, making veins in the face more visible, and prolonged alcohol consumption can result in permanent damage to blood vessels.
While unsightly facial veins can be source of anxiety, and possible embarrassment, they typically are not a health concern. Eating a healthy diet, limiting alcohol intake and reducing sun exposure can help prevent facial veins from occurring. For those who have unsightly facial veins, there are a number of treatment options available to you. Talk to your healthcare provider to rule out a more serious condition and learn what options are best suited to your personal situation.
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