OVERVIEW

What is telangiectasia?

Telangiectasia is a skin condition caused by persistent dilation of capillaries, small veins, and tiny arterioles on the skin or mucous membrane surface. Clinically, it is characterized by red or purplish-red pinpoint, patchy, thread-like, or star-shaped lesions.

The lesions can occur anywhere on the body, appearing in localized, widespread, segmental, or unilateral distributions. They blanch under pressure, may develop slowly or persist long-term, and some may resolve spontaneously. Most cases are asymptomatic.

Is telangiectasia common?

Telangiectasia occurs more frequently in high-altitude environments. It is less common in children than adults and more prevalent in women than men.

What are the types of telangiectasia?

Telangiectasia can be classified into four types: generalized essential telangiectasia, unilateral nevoid telangiectasia, angioma serpiginosum, and spider angioma (spider telangiectasia).

SYMPTOMS

What are the manifestations of telangiectasia?

• Generalized essential telangiectasia: Presents as extensive telangiectasia that may later spread upward to the thighs, abdomen, and upper limbs, usually unaccompanied by systemic diseases or bleeding tendencies. Characteristics include: widespread skin lesions; progressive or persistent lesions; worsening of lesions in dependent positions; and absence of epidermal or dermal changes.

• Unilateral nevoid telangiectasia: Manifests as fine punctate, linear, or stellate telangiectasia.

• Angioma serpiginosum: Presents as multiple tiny copper-red or purple angiomatous macules that tend to develop into papules, blanch under pressure, and show no hemosiderin deposition or inflammation. Lesions cluster or distribute in small patches, with slight scaling on the surface. New lesions continuously appear at the periphery while the central areas regress, forming small rings or serpiginous patterns. Histopathology reveals non-inflammatory telangiectasia in the dermal papillae.

• Spider angioma-like telangiectasia: Features a central red papular spider body with radially dilated capillaries around it, and the central nevus exhibits arterial pulsation.

What are the consequences of telangiectasia?

It severely impairs the skin's ability to absorb nutrients. Over time, this leads to insufficient nutrient supply to the skin, resulting in roughness, dryness, and premature aging symptoms.

CAUSES

What are the common causes of telangiectasia?

• Physical factors: Such as stimulation from temperature changes, which exceed the normal tolerance range of capillaries, leading to their dilation and rupture. Excessive sun exposure can also cause chronic actinic dermatitis and dry skin.

• Environmental factors: Long-term exposure to harsh living conditions, such as high-altitude areas with thin air and skin hypoxia, increases red blood cell count and compensatory blood vessel dilation. Over time, this impairs vascular contraction function, causing permanent telangiectasia. People frequently exposed to wind, cold, or heat—like sailors, chefs, farmers, and athletes—are also prone to capillary dilation.

• Hormonal dilation: A sequela of improper treatments, such as the misuse of topical medications on the face.

Who is commonly affected by telangiectasia?

• Generalized essential telangiectasia predominantly occurs in women aged 40–50 but can also appear in children.

• Unilateral nevoid telangiectasia is more common in women.

• Angioma serpiginosum mostly affects women under 20, with occasional familial cases reported.

• Spider angioma-like telangiectasia frequently occurs in children, pregnant women, and individuals with liver disease, oral contraceptive users, or aluminum plant workers.

Under what circumstances is telangiectasia more likely to occur?

For individuals prone to telangiectasia, triggers may include genetic factors, high-altitude environments, cosmetics, and hormonal influences.

DIAGNOSIS

What tests are needed to diagnose telangiectasia?

If telangiectasia is suspected, an experienced dermatologist can confirm the diagnosis through a physical examination. Characteristic skin lesions of telangiectasia can be observed during visual inspection.

Which diseases is telangiectasia easily confused with?

Generalized essential telangiectasia needs to be differentiated from atypical hereditary hemorrhagic telangiectasia and telangiectasia associated with systemic diseases.

• Hereditary hemorrhagic telangiectasia presents with widespread skin lesions, predominantly on the upper body, and has symmetrical bleeding characteristics.

• Telangiectasia associated with systemic diseases shows active alkaline phosphatase in the endothelial cells of peripheral arterioles and arterial segments of capillary loops.

TREATMENT

Which department should I visit for telangiectasia?

Dermatology.

How is telangiectasia treated?

Telangiectasia is a chronic condition, and the main principle of treatment is addressing both symptoms and root causes to alleviate discomfort. Currently, there are two primary treatment methods for telangiectasia.

• Laser therapy: Options include long-pulse YAG lasers, intense pulsed light (IPL), and pulsed dye lasers (PDL). For example, 585 nm laser treatment works by selectively targeting oxyhemoglobin in blood vessels, leading to their destruction while restoring skin elasticity and reducing redness or visible blood vessels. Laser therapy is safe, fast, and effective but requires multiple sessions and does not provide a permanent solution, with a risk of recurrence.

• Topical anti-redness products: These primarily focus on soothing, anti-irritation, hydration, and moisturizing. Some products specifically target capillary and stratum corneum repair.

What types of medications are used for telangiectasia?

Topical skincare products often contain soothing, anti-irritation, hydrating, and sun-protective ingredients, such as witch hazel, horse chestnut, or chamomile. These help reduce external irritation to capillaries, alleviating symptoms and minimizing their dilation.

Should medication be continued after telangiectasia improves?

Yes.

• Continued use of skincare and sunscreen products is necessary. While not life-threatening, maintaining skin health and appearance requires ongoing care to protect facial capillaries.

• For severe or widespread telangiectasia, laser therapy is recommended. However, since it doesn’t address the root cause, topical products must still be used post-treatment.

What should be noted during hospitalization for telangiectasia?

• Cooperate with doctors for laser therapy;
• Avoid prolonged sun exposure;
• Maintain a light diet, drink plenty of water, and stay emotionally stable.

Is follow-up required after discharge? How?

Yes.

A follow-up examination should be conducted one month after laser therapy to assess its effectiveness and check for improvements. If no issues arise, continue using topical products. If symptoms reappear, further medical evaluation is needed.

Can telangiectasia be completely cured?

Yes.

• Mild cases can often be fully resolved with 1–2 laser treatments.

• Severe cases require laser therapy alongside diligent sun protection, moisturizing, and anti-irritation care. A positive attitude toward treatment also improves quality of life.

Can telangiectasia recur?

Possibly.

Recurrence may happen if underlying causes worsen or if lifestyle habits (e.g., sun exposure, skincare neglect) are not properly managed.

DIET & LIFESTYLE

What should patients with telangiectasia pay attention to in daily life?

• Strictly follow medical guidance when using sunscreen and skincare products;

• Attend regular check-ups, monitor the condition closely, and seek immediate medical attention if sudden changes occur;

• Patients should educate themselves about telangiectasia to recognize worsening symptoms promptly and seek timely treatment;

• Maintain a light diet, prioritizing easily digestible foods like vegetable porridge or noodle soup. Increase intake of fresh fruits and vegetables to ensure adequate vitamin consumption.

PREVENTION

How to Care for Facial Telangiectasia Daily?

• Sun Protection: A primer with SPF and foundation coverage not only evens out skin tone but also effectively blocks pollution, dust, makeup, and UV rays. Suitable for all skin types, it can also serve as a makeup base to reduce irritation from cosmetics, making it ideal for those concerned about visible redness. Additionally, apply sunscreen with SPF 30 or higher when going outdoors to prevent direct UV damage.

• Avoid Exfoliation: One of the main causes of telangiectasia is a thin stratum corneum. Treatments like photorejuvenation, chemical peels, or deep facial cleansing in salons can thin the skin and weaken its immunity. Similarly, cosmetics with overly acidic or alkaline properties have the same effect, while harmful ingredients and hormones in such products further damage the skin.

• Use Cold Water to Wash Your Face and Strengthen Capillaries: Cold water helps constrict dilated capillaries and provides physical cooling, alleviating facial redness and burning sensations. It also trains the skin, improving its resilience.