Telangiectasia is a condition in which broken or widened small blood vessels that sit near the surface of the skin or mucous membranes create visible patterns of lines.
For most people, these patterns, or telangiectases, neither cause any damage to overall health and nor require treatment. The widened vessels becomes weaker, causing bleeding and the eventual appearance of telangiectases.
However, they can sometimes signify a more severe medical condition and may warrant closer inspection.
In this article, we look at the causes, symptoms, diagnosis, and treatment of this condition, as well as the outlook.
Unless a more serious medical condition is causing telangiectases to occur, they should not usually be cause for concern.
Telangiectases often occur in fair-skinned individuals with long-term sun damage. They can occur anywhere on the body but are most noticeable on the skin, some visible mucous membranes, and the whites of the eyes.
In most cases, telangiectases do not cause any symptoms. However, they can sometimes bleed. If this bleeding occurs in or near the brain, it can have severe effects.
The exact cause of telangiectases is often unclear, but several factors may contribute to their development.
- sun and wind exposure
- medications that widen blood vessels
- excessive alcohol consumption
- trauma to the skin
- surgical incisions
- prolonged use of oral or topical corticosteroids
The risk of a woman getting telangiectasia increases during pregnancy.
As her body grows to accommodate the developing fetus, it places significant pressure on the blood vessels.
Older individuals are more likely to have telangiectasia too, as the blood vessels start to weaken with age.
Telangiectasia is sometimes a symptom of a more severe medical condition, such as:
- ataxia telangiectasia (AT), an inherited childhood disease that attacks the brain and other parts of the body
- Bloom syndrome, a rare genetic disorder that causes various symptoms, including telangiectases
- Osler-Weber-Rendu syndrome, or hereditary hemorrhagic telangiectasia (HHT), a genetic condition that leads to the formation of abnormal blood vessels in the skin
- port-wine stain, which is a large patch of discolored skin that is present at birth
- Klippel-Trenaunay-Weber (KTW) syndrome, a combination of port-wine stain, varicose veins, and enlarged soft-tissue cells
- rosacea, which is a chronic skin condition that causes redness and swelling in the face
- spider angioma, an abnormal collection of blood vessels near the surface of the skin
- Sturge-Weber syndrome (SWS), a rare disorder that can cause problems with the nervous system
- xeroderma pigmentosum (XP), a rare medical condition in which the skin and eyes become very sensitive to ultraviolet (UV) light
- liver disease
Connective tissue diseases
Connective tissue diseases can cause telangiectasia to develop on the face and the part of the hands and feet where the skin meets the nail.
Examples of connective tissue diseases include:
- Scleroderma: Limited scleroderma primarily blemishes the skin on the face, hands, and feet, while diffuse scleroderma also reaches the internal organs. Telangiectasia occurs more frequently in patients with limited scleroderma.
- Dermatomyositis: Telangiectasia can occur in areas of skin that get exposure to the sun, often including the neck, chest, shoulders, arms, and upper back.
- Lupus: People with lupus may get telangiectases in the nail folds and at the edges of discoid lupus lesions.
When to see a doctor
Visit a doctor when a telangiectasia points to a more serious condition.
If many small lesions appear on the face, it could be a sign of HHT, which is potentially a serious condition.
Limited patches over the breasts and buttocks can indicate poikilodermatous mycoses fungoides, a cancerous condition of T-cells in the immune system.
Telangiectases are fine, threadlike lines that are typically pink or red but whiten under pressure. Once telangiectasia appears on the skin, these tiny lines can range in color from red to blue or purple.
The distorted blood vessels generally measure between 1 and 3 millimeters (mm) in width. They are usually harmless but can cause itching and pain.
They commonly occur on the face, nose, chin, and cheeks, where they may cause facial redness.
Telangiectases are also often present on the legs, chest, back, arms, and legs. People often refer to those that appear on the legs as spider veins. A spider telangiectasia is a telangiectasia that has a red, central feeding vessel with outward branches.
Telangiectasia is common in people with no health problems and is generally a result of sun damage or aging.
Anyone experiencing severe cases of telangiectasia throughout the body with significant blood vessel enlargement should consult a doctor.
People should also seek treatment as soon as possible if they become aware of a family history of telangiectasia or have any bleeding or lesions in the mouth or eye area.
These symptoms could indicate a more serious condition.
To determine if there is an underlying medical condition, an individual may need some of the following tests:
There is no cure for telangiectasia, but the condition is treatable. Doctors will often devise a treatment plan based on the results of diagnostic tests.
For example, if acne or rosacea is the underlying cause, the doctor may prescribe an oral or topical antibiotic.
Many people choose to remove telangiectases, both for cosmetic reasons and because the condition can cause discomfort.
Doctors can use laser therapy, sclerotherapy, or excision surgery to remove telangiectases.
Laser therapy is minimally invasive and generally the most straightforward treatment for facial telangiectasia and broken capillaries. Laser ablation can seal the widened blood vessels. This procedure does not cause much pain and the recovery time is short.
Sclerotherapy is a more effective procedure for larger veins, so it is the standard treatment for telangiectases on the legs. It is a minimally invasive procedure in which a dermatologist injects salt water or a chemical solution into the affected veins. The veins will harden and disappear.
The treatment is effective but can take a long time. Insurance companies rarely cover the procedure, as they consider spider veins to be cosmetic in nature. The treatment can therefore also turn out expensive.
One injection can treat an inch of a vein. People may need between five and 50 injections, depending on the size of the area that the condition affects.
This low-cost treatment does not require a stay in the hospital, as there is no recovery time or anesthesia. It may also be a good option for facial spider veins that are larger than regular broken capillaries.
Excision surgery can remove widened blood vessels, but this procedure has a more extended recovery period and causes considerable pain.
Some causes of telangiectasia will not resolve. However, treatment can remove any new telangiectases that occur.
There are several treatment options for telangiectasia.
Individuals can resume normal activity after treatment, but they should protect the treated areas from sunlight until the skin color returns to normal.
If blistering, crusting, or scabbing occurs, it is best to clean the skin gently and apply an antiseptic ointment. A doctor may prescribe an antibiotic, but non-prescription antibacterial options can also be beneficial.
People who have telangiectasia due to underlying conditions may gradually develop new blood vessels.
Telangiectases are small, broken, or widened blood vessels near the surface of the skin.
Although they are generally harmless, they can cause pain and itching, and some people want to remove them for cosmetic reasons.
Occasionally, telangiectasia may be a symptom of a more severe medical condition that requires treatment.