They do not fade on their own, and they are not your fault.
They do not fade on their own, and they are not your fault.
Two things people believe about broken capillaries are wrong, and both of them cost time.
The first is that they will eventually go away. They will not. A vessel that has lost the ability to constrict does not regain it, and waiting simply allows more of them to form around it.
The second is that they say something about how you have lived. The association with heavy drinking is persistent, unfair, and largely inaccurate. Most of the people we treat for this have fair skin, an Australian childhood, and a genetic predisposition. That is the whole story.
The good news is that this is one of the more satisfying things we treat, because the target is specific and the technology is well matched to it.
The umbrella term is telangiectasia, meaning small blood vessels sitting close enough to the skin surface to be visible, permanently dilated, and generally between a tenth of a millimetre and a millimetre across.
Beyond that, what you have matters, because they do not all behave the same way.
The classic presentation. Usually arterioles or capillaries, red rather than blue, most often across the nostrils, nasal alae, cheeks and chin. These respond best to light-based treatment.
Venules rather than arterioles, sitting slightly deeper. More common around the temples, under the eyes, and along the jaw. Deeper and larger vessels are harder to treat with light and sometimes need a different approach.
A central feeding vessel with fine branches radiating outward, like a spider. Press the centre and the whole thing blanches, then refills from the middle out. Individually these are common and benign, particularly in children, in pregnancy, and after sun exposure. Multiple ones appearing across the upper body are a different matter, and we cover that below.
Small, bright red, slightly raised domes, also called Campbell de Morgan spots. These are benign proliferations of blood vessels rather than dilated existing ones. They become more common with age, they are entirely harmless, and they are very treatable.
Dark blue or purple, soft, compressible, usually on the lip or ear, and strongly associated with sun exposure.
Mottled redness and brown pigment across the sides of the neck and upper chest, characteristically sparing the shaded area under the chin. That sparing tells you exactly what caused it. This is combined vascular and pigmentary sun damage and it responds well to treatment.
Not discrete vessels at all, but a general flush across the central face. This behaves differently and often sits alongside rosacea.
Most facial vessels are cosmetic. A few are not, and we would rather say so plainly on a page like this than treat around it.
Please see a GP or have a skin check if:
A vessel sits over a raised, pearly or translucent bump. Basal cell carcinoma classically presents with fine branching vessels running across a slightly raised, shiny lesion that may bleed, crust, or fail to heal. This is the single most important thing on this page. If you have what looks like broken capillaries over a small lump that has appeared and not gone away, that needs a doctor, not a light treatment.
Any vascular lesion that bleeds, grows, changes, or does not heal.
Multiple spider naevi appearing across the upper body, chest, arms or hands. One is nothing. A number of them appearing together can be associated with liver disease or with hormonal change, and that warrants investigation.
Vessels appearing alongside other symptoms. Nosebleeds with a family history of the same, changes in the fingers or hands, joint symptoms, fatigue, or difficulty swallowing. There are rarer conditions that present with telangiectasia, and they need a diagnosis rather than a device.
Vessels that appeared after long-term topical steroid use. Prolonged steroid application thins the skin and produces telangiectasia. This is treatable but the steroid situation needs addressing first, with the doctor who prescribed it.
We are a medical-dermal clinic and we do not diagnose or treat skin cancer. If we see something at consultation that we are not completely comfortable with, we will tell you and send you for a skin check before we treat anything. We refer to Avatar Imaging in Toorak, or to your own GP.
If you have not had a full skin check, please have one. Australia has among the highest rates of skin cancer in the world, and the sun-damaged skin that develops visible vessels is the same skin that develops other things.
A healthy small vessel dilates when it needs to and constricts back afterwards. That is its job.
Broken capillaries are the result of that process failing. Repeated or sustained dilation gradually damages the elastic and muscular components of the vessel wall, and eventually it loses the ability to return to its original diameter. It stays open. Because it is now permanently wider, it carries more blood and becomes visible.
Two things drive it.
The vessel wall itself is stressed. Through repeated flushing, temperature extremes, pressure, or trauma.
The support structure around it degrades. This is the part most people have never heard. Small vessels sit within a scaffold of dermal collagen and elastin. Ultraviolet exposure degrades that scaffold. As the surrounding support weakens, vessels dilate more easily and are less well held in place.
That second mechanism is why sun damage and visible vessels travel together so reliably, and why the neck and chest are so commonly affected.
Sun exposure. The dominant factor in Australia by a considerable margin, both through direct vessel damage and through degradation of the surrounding dermis.
Genetics. Fair skin, thin skin, and a family history all increase susceptibility. This is often the largest single factor and it is entirely outside your control.
Rosacea. Telangiectasia is a core feature. If you have visible vessels alongside persistent central facial redness, easy flushing, or inflammatory bumps, that is worth assessing properly.
Repeated flushing. Heat, alcohol, spicy food, hot drinks, saunas, exercise in heat, and rapid temperature change. Note that this is about repeated dilation over years rather than any single episode.
Ageing. Dermal support thins and vessels become more visible.
Pregnancy and hormonal change. Oestrogen influences vascular behaviour, and vessels that appear in pregnancy sometimes resolve afterwards and sometimes do not.
Trauma and pressure. Including, occasionally, aggressive extractions and over-vigorous skincare.
Long-term topical steroid use. Well documented and worth identifying.
Alcohol. Chronic heavy intake does contribute, which is where the association comes from. It is one factor among many and it is not the explanation for most people.
This matters because the answer changes the plan.
Isolated thread veins on an otherwise calm face, particularly around the nose and cheeks in someone with fair, sun-exposed skin, are usually just that. We treat the vessels and you are done, with maintenance.
Vessels sitting on a background of persistent redness across the central face, in someone who flushes easily, burns or stings, and perhaps gets inflammatory bumps, is a rosacea picture. The vessels still respond to treatment, but treating them alone without addressing the underlying condition means new ones will keep appearing.
The distinction is not always obvious and it is a genuine assessment question. We have a dedicated rosacea page if that sounds like you.
We see more of this than clinics in most parts of the world, and the reason is not complicated.
Australian ambient UV is among the highest globally. Most Australians of a certain generation had a childhood involving a great deal of unprotected sun. The dermal damage accumulated then is what is surfacing now, and it surfaces on the nose, cheeks, ears, neck and chest because those are the exposed areas.
Melbourne adds its own contribution through repeated temperature swing. Heated indoors, cold outside, several times a day for months. That cycling drives flushing, and flushing drives vessel fatigue.
This is also why sun protection is not merely an aftercare instruction here. Untreated UV exposure continues degrading the dermal scaffold that holds your vessels in place, which means new ones will keep arriving regardless of how well we treat the current ones.
We are a medical-dermal clinic. Caitlin is a Registered Nurse with ten years in cosmetic medicine, Belinda is our Senior Dermal Clinician with around ten years of industry experience, and the whole team works to a shared philosophy: assess first, treat conservatively, sequence with intent, and never do more to the skin than it can handle.
For this particular concern the assessment matters more than usual, because the treatment itself is relatively straightforward and the errors are almost all diagnostic ones.
We use the Lumenis M22 Stella with XPL, one of the first of these systems in Australia.
How it works. Light at selected wavelengths is absorbed preferentially by oxyhaemoglobin, the oxygen-carrying pigment inside red blood cells. Haemoglobin has absorption peaks at several points across the visible spectrum, and the one at around 577 nanometres is the most relevant for these vessels.
The absorbed light converts to heat inside the vessel. The vessel wall is damaged, the vessel collapses, and the body clears it over the following weeks. The overlying skin is left intact throughout, which is what separates this from older approaches.
There is a secondary benefit worth knowing. Light-based treatment also stimulates collagen deposition in the surrounding dermis, which improves the structural support around remaining vessels. Treating the vessels also, modestly, treats the reason they formed.
What it does well. Fine red thread veins. Diffuse background redness. Poikiloderma on the neck and chest, where it addresses the red and brown components together. Cherry angiomas. Multiple small vessels spread across an area, which is where IPL's broad coverage genuinely outperforms a targeted device.
What to expect. Most people describe a brief snap of heat with each pulse. Treated vessels often appear to darken, grey or disappear immediately, which is satisfying to watch. Expect redness and warmth for a few hours to a day. Occasionally a small raised weal appears over a treated vessel and settles within hours. Bruising is uncommon with IPL, which is one of its advantages.
Typically three to four sessions spaced three to four weeks apart, then maintenance.
What the evidence actually shows, honestly.
Light-based treatment for facial telangiectasia is well studied and it works. Where it gets more interesting is the comparison with pulsed dye laser, which is often described as the gold standard for isolated vessels.
A 2024 meta-analysis pooling four studies covering 141 participants found no statistically significant difference between IPL and pulsed dye laser in achieving greater than fifty percent clearance. Some individual trials, however, have favoured pulsed dye laser for larger isolated vessels, with one split-face randomised study reporting median vessel clearance of ninety percent with laser against fifty percent with the IPL system tested.
Settings and device generation matter enormously in these comparisons, and several of the studies used lower-energy systems than current platforms.
On durability, a randomised controlled trial in patients with late-stage rosacea followed participants for two years after a course of IPL. Recurrence occurred in around eight percent of the treated group against roughly forty-eight percent of untreated controls.
A systematic review of IPL in rosacea concluded it is a safe and effective intervention while noting honestly that many of the included trials had methodological limitations.
Our reading of all of that: IPL is genuinely effective, it is particularly well suited to diffuse and multiple vessels, and for a small number of large, isolated, resistant vessels a dedicated vascular laser may achieve more.
Which brings us to the part most clinics leave out. We do not have a pulsed dye laser. If we assess you and think a vascular laser would serve you better than what we own, we will tell you and refer you. That happens occasionally and we would rather lose the treatment than take your money for the second-best option.
Suitability. A patch test and full consultation are required. IPL is not suitable for every skin type, recent sun exposure or a tan rules it out entirely, and certain medications increase photosensitivity. It is not performed during pregnancy. We assess all of this before proceeding.
Red and near-infrared light to reduce inflammation and support repair, with no downtime.
It does not treat vessels directly. Where it earns its place is alongside IPL in someone whose vessels sit on an inflammatory or rosacea background, and as a settling treatment between sessions.
We will be straightforward. No cream removes a broken capillary. Anyone selling you one is selling you something else.
What home care genuinely does here is prevent the next ones.
Sunscreen, daily. This is the entire game. UV degrades the dermal scaffold that supports your vessels, so untreated sun exposure guarantees new vessels regardless of how well the current ones are cleared. Mineral filters if your skin is reactive.
Barrier support. A compromised barrier is more reactive and flushes more readily. iS Clinical Reparative Moisture Emulsion and Dermaceutic K Ceutic, which repairs and protects at SPF 50 in one step, both do useful work here.
Anti-inflammatory actives. Niacinamide and azelaic acid help with background redness and with the inflammatory component where one exists.
Vitamin C. Supports collagen synthesis in the dermis, which is the support structure in question. iS Clinical Super Serum Advance+ or Dermaceutic Tri Vita C30 depending on tolerance.
Trigger management, sensibly. If you flush hard and often, reducing the frequency helps. We are not going to tell you to give up exercise, hot showers and red wine permanently. Identify the two or three things that genuinely matter for you and manage those.
What to stop. Very hot water, aggressive scrubs and brushes, and anything that leaves your face reliably red.
A narrower role here than in other conditions, and we would rather be accurate than oversell.
Where it is genuinely relevant is vascular and connective tissue support, and stress, which drives flushing frequency. Alida looks at inflammation, nutritional status and the factors influencing how often and how hard you flush.
Where there is an underlying condition worth investigating, that goes to your GP.
Infrared sauna, cold plunge and private shower in a private, solo-use space.
An honest note. Heat causes vasodilation, and repeated vasodilation is the mechanism that produces these vessels in the first place. Regular sauna use is worth discussing rather than assuming if visible vessels are your primary concern, and rapid temperature change carries the same consideration.
We will talk it through in the context of your plan.
Consultation. Assessment under magnification, identification of vessel type and depth, exclusion of anything that needs a doctor, patch test, and a discussion of whether an underlying condition such as rosacea is driving it.
Weeks 1 to 12. A course of three to four IPL sessions, three to four weeks apart. Sun protection corrected from day one, because treating without addressing UV is treating a leaking tap without turning it off.
Beyond. Reassessment and maintenance, typically one or two sessions a year. Where rosacea is the underlying driver, ongoing management of that alongside.
On recurrence. Treated vessels are cleared permanently. New vessels can form, particularly with continued sun exposure or ongoing rosacea, and that is management rather than failure. Realistic expectation-setting at the start is the difference between someone pleased with an excellent result and someone disappointed by the same one.
We will not quote before we have seen your skin, because a few isolated vessels around one nostril and diffuse poikiloderma across an entire chest are not the same treatment.
At consultation you will get a clear, itemised plan including the course, roughly how long it runs, and what maintenance looks like. No surprises and no pressure to commit on the day.
Cosmetic and dermal treatments do not attract a Medicare rebate.
If any lesion is suspicious or you have not had a recent skin check. If there are multiple spider naevi across the upper body. If there are systemic symptoms alongside. If long-term topical steroid use is involved. And if we think a vascular laser would serve you better than the technology we have.
We do not diagnose or treat skin cancer and we do not remove moles.
For most people, no. The dominant factors are fair skin, genetics and cumulative sun exposure, and the majority of people we treat drink normally or not at all.
Chronic heavy alcohol intake does contribute, which is where the association came from. It is one factor among many and it has done a lot of unfair damage as an assumption.
They will not. A vessel that has lost the capacity to constrict does not regain it. Waiting does not help and generally allows more to develop nearby.
Trauma can contribute, but a single squeeze does not produce a permanent thread vein. Sustained pressure and repeated trauma over time is a different matter.
No topical product removes an established vessel. Good home care prevents new ones and supports the surrounding dermis, which is genuinely worth doing, but it is prevention rather than removal.
Not directly. Repeated swings between cold and warm drive flushing, and flushing over years contributes. The cold itself is not the culprit.
Occasionally a single isolated vessel responds in one treatment. Most people need a course of three to four, and diffuse redness or chest and neck work usually needs more.
Most people describe a brief snap of heat with each pulse, similar to a light flick of an elastic band. It is well tolerated without anaesthetic for the large majority. The nose is the most sensitive area and also, conveniently, usually the quickest.
The vessels we treat are cleared permanently. New ones can form over time, particularly with ongoing sun exposure or untreated rosacea. Most people move to maintenance once or twice a year.
Often immediately. Treated vessels frequently darken, grey or vanish during the session, with further clearing over the following one to two weeks. Diffuse redness improves more gradually across a course.
Yes, and it is one of the most common requests we get. It is also usually one of the shortest and most satisfying treatments we do.
Yes. Poikiloderma on the chest responds well, though the skin there is thinner and less forgiving than the face, so we use more conservative settings and it typically takes more sessions.
IPL requires careful assessment in deeper skin tones because melanin competes with haemoglobin for the light energy, which raises the risk of pigmentary change. It is not automatically ruled out, but the assessment is more careful, settings are more conservative, and some presentations are better served elsewhere. We will be honest with you at consultation.
We do not perform IPL during pregnancy. Vessels that appear in pregnancy sometimes resolve afterwards, so it is often worth waiting and reassessing.
Every plan at Plump begins with a full consultation. We examine the vessels under magnification, identify what type and depth they are, rule out anything that needs a doctor, check whether something underlying is driving them, and give you a realistic picture of what treatment will achieve.
There is no cost and no obligation.
Book online, or call or text us on 0478 844 048
Plump Aesthetic Clinic
525 Chapel Street, South Yarra
We see patients from South Yarra, Prahran, Windsor, Toorak, Armadale, Richmond, Malvern, St Kilda, and across inner Melbourne.
Reviewed by the clinical team at Plump Aesthetic Clinic. Caitlin King, Registered Nurse, Founder and Clinical Director, ten years in cosmetic medicine. Belinda, Senior Dermal Clinician, approximately ten years of industry experience.
We treat skin, not trends. Where we make a claim about what a treatment does, we want it to be traceable to something better than marketing.
This page is a good example of why that matters. The honest position is that IPL is effective for facial vessels, that for a small number of large isolated vessels a dedicated vascular laser may do better, and that much of the comparative literature has methodological limitations. We would rather tell you that than claim our device is superior to everything else on the market.
Important information: All treatments described on this page require an individual consultation with a qualified practitioner to determine suitability. Results vary between individuals and depend on vessel type, size, depth, skin type and ongoing sun exposure. No result is guaranteed. All treatments carry risks and potential side effects, including redness, swelling and, less commonly, pigmentary change or blistering, which will be explained to you in full before you proceed. This information is general in nature and is not a substitute for individual medical advice. We do not diagnose or treat skin cancer. If you have a lesion that is new, changing, bleeding or not healing, please see your GP.
