The Veins & Redness Guide
Telangiectasia Explained: Broken Capillaries, Facial Veins, Spider Naevi, Cherry Angiomas and Rosacea Vessels
Telangiectasia is the clinical word for fine dilated vessels sitting visibly near the surface of the skin. The everyday red marks people notice are not all the same thing: broken capillaries, facial veins, spider naevi, cherry angiomas, venous lakes and the vessels of rosacea each look and behave differently. Naming yours is the first step.
Most red marks arrive without a name. A thread on the cheek, a tiny ruby dot, a star-shaped mark with a centre, a soft blue spot on the lip: they all look like "something red", and it is hard to know whether one matters more than another.
Telangiectasia is the umbrella term for fine vessels that have widened and stayed visible at the surface. But the marks people group under it are genuinely different entities, with different tells and different answers. This guide names the six Pink sees most, shows you how to tell them apart, and points to where each one leads.
What does telangiectasia actually mean?
Telangiectasia describes fine dilated capillaries, roughly 0.1 to 1 mm across, that lie close enough to the surface to be seen as red threads. They turn up on the face, the chest and the legs. The usual causes are sun, genetics, ageing, rosacea and skin trauma, and some medications and connective-tissue conditions are associated with them too. On the face, most people call them broken capillaries; the word telangiectasia is the clinical name for the same fine vessels. Where the vessel is discrete and visible, a vascular laser can treat it cosmetically once the area has been assessed.
One early note. If fine vessels appear suddenly and widely, or alongside nosebleeds, gut symptoms or a family history of similar bleeding, that pattern is worth a medical review before any cosmetic treatment, because it can point to an inherited vascular or connective-tissue condition rather than ordinary surface telangiectasia.
Broken capillaries and facial veins
These are the most familiar. Broken capillaries are the fine telangiectasia above: defined red or purple threads, most often around the nose and cheeks. Facial veins, sometimes called spider or thread veins, are a little larger than the finest telangiectasia but the same idea, a surface vessel that has widened and stayed visible. Both are discrete, both hold still, and both can be treated directly with a vascular laser after assessment. There is more on these in broken capillaries on the face.
What is a spider naevus, and how is it different?
A spider naevus, also called a spider angioma, has a shape the others do not. It is a central feeding vessel, a tiny arteriole, with finer vessels radiating outward from it like the legs of a spider. The tell is its behaviour under pressure: press on the central point and the whole mark blanches, then it refills from the centre when you release. That central-arteriole pattern is what separates a spider naevus from a cherry angioma, which is a solid red dome with no radiating legs. The two are not the same thing and are not synonyms, even though they sometimes get grouped together.
Spider naevi are common in healthy people. They are associated with oestrogen, which is why they appear in pregnancy, in around 60 percent of pregnant women, and can be linked to the oral contraceptive pill. The ones that arrive in pregnancy often fade on their own within 2 to 6 months after birth. A vascular laser can treat a spider naevus after assessment, though one can return if the trigger that produced it persists.
There is an important exception worth holding. More than three to five spider naevi, especially if they appear suddenly or come with fatigue or a yellowing of the skin, are a reason to see a GP before any cosmetic treatment, because a number of them together can be a sign of a liver or thyroid condition. Cosmetic laser is not the right first step until those medical causes have been considered.
Cherry angiomas: the bright red dots
A cherry angioma, sometimes called a Campbell de Morgan spot, is a small bright red or ruby dome, usually 1 to 5 mm, that is raised on the skin. It can look darker, almost blue or black, when the blood inside it has clotted. These become more common from around the age of 40 and are benign. Unlike a spider naevus, there is no central feeding vessel and no radiating legs, only a solid little dome of vessels.
Because they are discrete and benign, cherry angiomas can be cleared after assessment, though for these very small surface lesions results and the number of sessions vary, and a clinician confirms suitability first. There is a full explainer on what they are, who gets them and when a red spot warrants a check in cherry angiomas explained. One point belongs here too: a nodular melanoma can appear as a raised pink or red dome that resembles a cherry angioma, so any new, growing, changing, irregular or bleeding spot should be assessed by a GP or dermatologist before any cosmetic laser.
What is a venous lake?
A venous lake is a soft, compressible, blue-purple papule that turns up on the lower lip, the ears or other sun-exposed skin, usually in older adults. It is a widened venule, a dilation rather than a growth of new vessels, and the tell is that firm pressure empties it and makes it blanch. It can be treated after assessment.
The lip is where care matters most. Any blue, dark or uncertain lesion on the lip should be clinically assessed before treatment, because a venous lake needs to be distinguished from a labial melanotic macule and, rarely, from an oral malignant melanoma. Pink assesses all lip lesions before treating them, and this is one assessment that is not optional.
The vessels of rosacea
The last entry behaves differently from all the others. Rosacea carries persistent central redness together with visible telangiectasia, the fine vessels that thread across the cheeks and nose. The difference is that rosacea is a chronic condition, not a one-off discrete vessel you can point to and clear. Laser and light can reduce the appearance of the redness and the vascular component, but rosacea is managed, not cured. The aim is calmer, less visible redness over a course of sessions, not removal.
There is a related boundary. Eye symptoms such as grittiness, dryness or light sensitivity can be ocular rosacea, which is a matter for a GP or optometrist, not cosmetic facial laser. If your concern is the diffuse redness rather than a single thread, the rosacea, redness and flushing page is the place to look next.
A quick way to tell them apart
A look in the mirror against the table below is a useful starting point, not a diagnosis.
| What you see | The tell | Usually |
|---|---|---|
| A fine red or purple thread or web | Holds still, no centre | Broken capillaries or facial veins |
| A star with a centre and radiating legs | Central point blanches, refills from the middle | Spider naevus |
| A small bright red or ruby dome | Solid, raised, no radiating legs | Cherry angioma |
| A soft blue-purple lump | Compressible, empties with firm pressure | Venous lake |
| A wash of redness with fine vessels | Diffuse, flares and settles | Rosacea telangiectasia |
Many faces carry more than one at a time, which is part of why naming the mark is a starting point rather than the whole answer.
Which of these does Pink treat?
The common thread is the technology. Pink's vascular treatments use a long-pulse Nd:YAG laser at 1064 nm, a wavelength absorbed by blood rather than pigment, which is why it can be more suitable for a broad range of skin tones than shorter vascular wavelengths. Individual suitability is always assessed and a test patch is performed first; lower pigment risk is not the same as no risk. For discrete vessels such as broken capillaries, facial veins, spider naevi and venous lakes, the laser closes the vessel and the body clears it over the following weeks. Cherry angiomas can also be addressed with this laser, though for these very small surface lesions results and the number of sessions vary, and shorter vascular wavelengths are often the better-evidenced option, so a clinician confirms suitability at assessment. For the diffuse redness of rosacea, the same laser family is used to calm and reduce the background colour over a course, sometimes alongside LED light therapy as a gentle companion between visits.
The shape of pricing is the useful thing to hold. Vein treatment is priced by the time a session takes; rosacea and redness are priced by area, in short courses, with a few sessions a sensible place to start. Exact prices are shown on the treatment pages, where they stay current. A consultation maps which of these applies to your skin. See how Pink brings the lanes together on the veins, rosacea and redness page.
The few marks worth a check before any laser
Most of these marks are a cosmetic concern rather than a medical one, but a few situations come before any laser. More than three to five spider naevi, especially sudden ones, deserve a GP visit to consider a liver or thyroid cause. Any blue or dark lip lesion needs assessment first. Any spot that is new, growing, changing, irregular or bleeding should be seen by a GP or dermatologist before treatment. And if you are unsure whether a mark suits cosmetic laser at all, Pink advises on that at consultation; for anything that looks concerning, see a GP or dermatologist first. None of this is a reason to put off the cosmetic side. It means the right help sometimes starts in more than one place.
Frequently Asked Questions
What is telangiectasia?
Telangiectasia is the clinical word for fine dilated capillaries, roughly 0.1 to 1 mm across, that lie close to the surface of the skin and show as red threads. They appear on the face, chest and legs, and the usual causes are sun, genetics, ageing, rosacea and skin trauma. On the face, most people call them broken capillaries. Discrete vessels can be treated with a vascular laser after assessment.
What is the difference between a spider naevus and a cherry angioma?
They are different entities, not synonyms. A spider naevus has a central feeding vessel with finer vessels radiating out like spider legs, and the central point blanches under pressure then refills from the middle. A cherry angioma is a solid bright red or ruby dome, usually 1 to 5 mm, with no central vessel and no radiating legs. Both can be treated after assessment, but they are not the same mark.
When should spider naevi be checked by a doctor?
A single spider naevus is common and usually harmless. More than three to five of them, especially if they appear suddenly or come with fatigue or a yellowing of the skin, are a reason to see a GP before any cosmetic treatment, because a number of them together can indicate a liver or thyroid condition. Cosmetic laser is not the right first step until those medical causes have been considered.
What is a venous lake, and is it serious?
A venous lake is a soft, compressible, blue-purple lump that appears on the lower lip, the ears or sun-exposed skin, usually in older adults, and it empties when you press it firmly. It can be treated after assessment. Because it is on the lip, any blue, dark or uncertain lip lesion must be clinically assessed first to distinguish it from a melanotic macule or, rarely, an oral melanoma. Pink assesses all lip lesions before treating them.
Can the vessels of rosacea be removed with laser?
The vascular component of rosacea can be reduced. Laser and light can calm and reduce the appearance of the redness and the visible vessels over a course of sessions. Rosacea itself is a chronic condition, so it is managed rather than cured or removed; the underlying tendency remains, and the aim is calmer, less visible redness rather than a one-off clearance.
Is laser suitable for deeper or darker skin tones?
The long-pulse Nd:YAG laser at 1064 nm targets blood rather than pigment, which can make it more suitable for a broad range of skin tones than shorter vascular wavelengths. Suitability is always assessed individually and a test patch is performed beforehand, because lower pigment risk is not the same as no risk. Your clinician calibrates for your skin type.
Once you can name the mark you are looking at, the next step is seeing how each kind is treated. See Pink's approach to veins, rosacea and redness.
