Common Causes of So-Called “Broken Capillaries” and How to Treat Them

Common Causes of So-Called “Broken Capillaries” and How to Treat Them
Common Causes of So-Called “Broken Capillaries” and How to Treat Them

By Allison Schmidt

I’ve had allergies for as long as I can remember. Like clockwork, every time a plant blooms (or the wind blows, or I haven’t dusted in a while,) I get a sneezing attack. Likewise, I’ve always got Kleenex at the ready. My seemingly incessant sneezing, chronically excessive nose blowing, and rubbing/itching has put too much pressure on the skin around my nose and after several years, has resulted in a few broken capillaries.

I will admit that I’ve gotten pretty good at covering them up with makeup. The annoying thing about having a series of small broken capillaries around my nose is that without makeup I constantly look like I have a cold.

The older I get, the more I worry about how little things like this will prematurely age me. How exactly do I deal with these little veins on my nose? Is there anything I can do about them, other than pile on concealer? To uncover what is really going on with broken capillaries and spider veins, I spoke with board-certified plastic surgeon, Tracy M. Pfeifer, MD, MS

Dr. Pfeifer started by clearing up a huge myth: broken capillaries aren’t actually broken at all! Broken capillaries are actually dilated capillaries, also known as spider veins or telangiectasias. Who knew?!?


So what causes telangiectasias? According to Dr. Pfeifer, there are many. Everything from sun exposure, genetics, obesity, hormonal changes associated with pregnancy, hormone replacement therapy, birth control pills, conditions such as rosacea or other inflammatory conditions and even alcohol consumption.

Dr. Pfeifer said that the pressure from prolonged standing can contribute to the development of spider veins in the legs. For those who are on their legs all the time, (teachers, nurses, etc.), whose job requires extended periods of standing, this tends to be more pronounced.


If you know that you are susceptible to any of the possible triggers listed above, but haven’t yet noticed any pesky little red spots or veins, it’s a good idea to take preventative action now.

For those who have rosacea, Dr. Pfeifer suggests a lifestyle and skincare program to ensure it is under control. “Avoiding the rosacea triggers can help reduce the inflammation and therefore the redness. Sulfur-containing masks are very good for treating inflammation.”

For non-rosacea related spider veins, Dr. Pfeifer says that taking oral vitamin C can help along with a thoughtful and consistent skincare routine. “The idea is to make the skin as healthy as possible, prevent additional spider veins and minimize the appearance of existing spider veins.”

Dr. Pfeifer also says that using sunscreen daily is a must for people who are prone to spider veins/transgielactasias. She also suggests using skincare products that contain antioxidants like vitamin C, and anti-inflammatories like witch hazel and sulfur. Dr. Pfeifer notes, “In our office we also use Auriderm, which has vitamin C and E as well as vitamin K oxide. There is no scientific data to support the claim that vitamin K helps. Building the thickness of the skin by using retinol and retinoids can also help.”

In-Office Treatment Options

If you do have spider veins/telangiectasias that bother you, there are definitely ways you can treat them with the help of a doctor. Essentially, all treatments achieve the same result using different methodologies: Collapse the capillary which prevents it from filling with blood, which effectively removes it.

For dilated blood vessels on the face, Dr. Pfeifer says they are typically treated with a laser, either with IPL, V-Beam laser (pulsed dye) or electrocautery. In the legs, where spider veins are typically larger, she explains that all of the above therapies will work as well as sclerotherapy, which involves injecting hypertonic saline into the capillary. This will make the vessel react leading to scarring of the vessel and causing the vessel to collapse. For this she explains that two solutions are used in the United States: Hypertonic saline (off-label use of FDA-approved product) and sodium tetradecyl sulfate, which is FDA approved.

“In general, I think that sclerotherapy is the most effective treatment for leg spider veins. In my practice, we inject leg spider veins with hypertonic saline. For the face, we use electrocautery to treat a few, isolated spider veins. In situations where a larger area of the face needs treatment, for example the nose and cheeks, we recommend a V beam or IPL. Many plastic surgeons have these lasers in their office,” explains Dr. Pfeifer.

After chatting with Dr. Pfeifer, it’s clear to me that my best bet for treating the annoying dilated capillaries around my nose is through skincare. Because of their small size and ease of concealing with makeup, I’m more concerned with preventing more of these suckers from appearing in the future.