What is the medical term telangiectasia?

What is telangiectasia?

Telangiectasia is a condition in which there are visible small linear red blood vessels (broken capillaries). These are also called telangiectases. Visible small blood vessels that are blue in colour (spider veins) are called venulectasia because venules are involved.

Telangiectasia

What is the differential diagnosis of telangiectasia?

Telangiectases need to be distinguished from other vascular conditions, including blood vessel tumours such as infantile haemangioma and angiomas that arise in adults; and capillary or venous vascular malformations.

Large red blood vessels are arteries and large blue blood vessels are veins. Arteries may be enlarged due to aneurysm formation. Veins enlarged due to the destruction of their valvular system are known as varicose veins.

Classification of telangiectasia

Inherited conditions

  • Hereditary haemorrhagic telangiectasia
  • Benign hereditary telangiectasia
  • Generalised essential telangiectasia
  • Unilateral naevoid telangiectasia
  • Angioma serpiginosum
  • Rothmund Thompson syndrome
  • Ataxia-telangiectasia
  • Bloom syndrome (congenital telangiectatic erythema)
  • Cockayne syndrome
  • Cutis marmorata telangiectatica congenita
  • Focal dermal hypoplasia (Goltz syndrome)
  • Kindler syndrome

Note that telangiectasia may be noted as a normal feature of facial skin in some families.

Hereditary telangiectasia

Acquired telangiectasia

  • Rosacea
  • Sun damaged and aged skin especially in those who smoke
  • Spider telangiectasis (also called spider naevus)
  • Poikiloderma of Civatte (sun damage affecting the sides of the neck)
  • Pregnancy
  • Liver disease particularly when associated with alcohol or viral infection
  • Cushing syndrome
  • Systemic sclerosis especially CRST syndrome (which forms telangiectatic mats)
  • Cutaneous lupus erythematosus
  • Mixed connective tissue disease
  • Dermatomyositis
  • Mastocytosis, specifically the variant, telangiectasia macularis eruptiva perstans
  • Carcinoid syndrome
  • Necrobiosis lipoidica
  • Male genital dysaesthesia
Telangiectasia due to disease

Telangiectasia may follow a cutaneous injury. For example:

  • Scarring, including hypertrophic and keloid scars
  • Livedoid vasculopathy and atrophie blanche
  • Radiation damage
  • Erythema ab igne.
Telangiectasia following injury

Some tumours are characterised by telangiectasia, such as:

  • Sebaceous hyperplasia
  • Basal cell carcinoma
  • Merkel cell carcinoma
  • Kaposi sarcoma
  • Cutaneous T-cell lymphoma (CTCL), particularly poikiloderma vasculare variant
  • Intravascular B-cell lymphoma.
Telangiectasia in skin tumours

Certain medications may give rise to telangiectasia.

  • Vasodilators especially calcium channel blockers; sun-exposed sites are mainly affected
  • Long-term systemic corticosteroids
  • Long-term topical corticosteroids, including steroid rosacea
  • Intralesional triamcinolone injections
Telangiectasia related to topical steroid use

What is the treatment of telangiectasia?

Telangiectases are generally harmless. Treatment may be sought because of bleeding or unsightly appearance. Facial red vein treatment methods include:

  • Electrosurgery
  • Intense pulsed light (IPL)
  • Vascular laser treatment
  • Sclerotherapy.

Telangiectasias are small blood vessels that sit near the skin’s surface that widen and create visible patterns of lines. People often refer to them as spider veins.

For most people, telangiectasias neither cause any damage to overall health nor require treatment.

However, they can sometimes indicate a more severe medical condition and may warrant closer inspection.

This article looks at the causes, symptoms, diagnosis, and treatment of telangiectasia, as well as the outlook.

Telangiectasias can occur anywhere on the body but are most noticeable on the skin, the mucous membranes, and the whites of the eyes.

The exact cause of telangiectasias is often unclear, but several factors may contribute to their development, such as:

  • genetics
  • sun and wind exposure
  • medications that widen blood vessels
  • pregnancy
  • excessive alcohol consumption
  • trauma to the skin
  • surgical incisions
  • acne
  • rosacea
  • prolonged use of oral or topical corticosteroids

In most cases, telangiectasias do not cause any symptoms. However, they can sometimes bleed. If this bleeding occurs in or near the brain, it can have severe effects.

Unless a more serious medical condition is causing telangiectasias to occur, they are not a reason for concern.

People have a greater risk of getting telangiectasias during pregnancy.

The growth of the body to accommodate a developing fetus places significant pressure on the blood vessels.

Hormonal therapy and hormone changes resulting from menopause or from taking birth control pills can also lead to the formation of facial telangiectasias.

Telangiectasia is sometimes a symptom of a more severe medical condition, such as:

  • Ataxia-telangiectasia: This inherited childhood disease affects the brain and other body parts.
  • Bloom syndrome: This is a rare genetic disorder that causes various symptoms, including telangiectasias.
  • Osler-Weber-Rendu syndrome: Also known as hereditary hemorrhagic telangiectasia, this is a genetic condition that can affect blood vessels in the skin and throughout the body and lead to bleeding.
  • Port-wine stain: This is a vascular birthmark that presents as a large patch of discolored skin.
  • Klippel-Trenaunay-Weber syndrome: This is a combination of port-wine stain, varicose veins, and soft tissue enlargement.
  • Rosacea: Rosacea is a chronic skin condition that causes skin discoloration and inflammation in the face.
  • Spider angioma: This is an abnormal collection of blood vessels near the skin’s surface.
  • Sturge-Weber syndrome: This is a rare disorder that can affect the nervous system.
  • Xeroderma pigmentosum: In people with this rare medical condition, the skin and eyes become very sensitive to ultraviolet (UV) light.

Connective tissue diseases

Telangiectasias may also develop on the face and on the hands and feet where the skin meets the nail. Sometimes, this may be the result of a connective tissue disease.

Examples of connective tissue diseases include:

  • Systemic scleroderma: Systemic scleroderma is the rapid growth of connective tissue in the skin and other organs. People with systemic scleroderma may experience telangiectasias on and around their faces.
  • Dermatomyositis: This condition can cause rashes across a person’s shoulders, back, knuckles, and palms. These rashes may include telangiectasias.
  • Lupus: People with lupus may get telangiectasias in the nail folds and on the edges of discoid lupus lesions.

Telangiectasias are fine, threadlike lines that may appear blue, red, or purple. The color of these lines will depend on whether they are veins or arteries.

The distorted blood vessels generally measure between 1 and 3 millimeters wide. They are usually asymptomatic but may occur with itching and pain.

They commonly occur on the face, nose, chin, and cheeks, where they may cause facial redness.

Telangiectasias also often appear on the legs, chest, back, and arms. People often refer to those that appear on the legs as spider veins. Spider telangiectasia is telangiectasia that has a red central feeding vessel with outward branches.

Telangiectasias are typically not a cause for concern. However, a doctor can assess the markings and determine whether they indicate a more serious condition.

For example, small lesions on the lips, nose, and face could be a sign of hereditary hemorrhagic telangiectasia, a potentially serious condition.

Furthermore, limited patches over the breasts, buttocks, and joint folds can indicate poikilodermatous mycoses fungoides, a cancerous condition of T cells in the immune system.

Doctors typically diagnose telangiectasia through a visual assessment of symptoms and by taking a person’s medical history.

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 their mouth or eye area.

These symptoms could indicate a more serious condition. To determine whether they have an underlying medical condition, an individual may need some of the following tests:

  • blood tests
  • CT scans
  • liver function studies
  • MRI scans
  • X-rays

There is no cure for telangiectasia, but it is treatable. Doctors will often devise a treatment plan based on the results of diagnostic tests.

Antibiotics

If acne or rosacea is the underlying cause, a doctor may prescribe an oral or topical antibiotic.

Many people choose to remove telangiectasias for cosmetic reasons and because the condition can cause discomfort.

Laser therapy

Laser therapy is minimally invasive and is typically 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

Sclerotherapy is a more effective procedure for larger veins, so it is the standard treatment for telangiectasias on the legs.

It is a minimally invasive procedure in which a dermatologist injects a solution, called a sclerosant, into the affected veins. The solution irritates vessel tissue, causing inflammation. This inflammation eventually cuts off blood supply and causes the vein to shrink.

This treatment does not usually require a stay in the hospital, as there is no recovery time or anesthesia. It may also be a good option for facial telangiectasias. People often require repeat treatments.

Some causes of telangiectasia will not resolve. However, treatment can help remove any new telangiectasias that occur.

There are several treatment options for telangiectasias.

Individuals can usually resume their regular activities after treatment, but they should protect the treated areas from sunlight until they are fully healed.

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 nonprescription antibacterial options can also be beneficial.

A doctor will need to monitor a person who has telangiectasias as a result of an underlying health condition.

Telangiectasias are small blood vessels that widen and become visible near the skin’s surface.

Although they are generally harmless and asymptomatic, they can occasionally lead to pain and itching, and some people may want to remove them for cosmetic reasons.

Occasionally, telangiectasia may be a symptom of a more severe medical condition that requires treatment.

What is the main cause of telangiectasia?

Telangiectasias are very common in healthy people and are usually caused by sun damage or aging. When seen on the legs, they do not necessarily indicate a vein disorder, such as varicose veins or underlying deep vein problems.

What is another name for telangiectasia?

Telangiectasias (commonly known as "spider veins") are dilated or broken blood vessels located near the surface of the skin or mucous membranes.

What is the best treatment for telangiectasia?

Laser therapy is minimally invasive and is typically 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.

How do you get rid of telangiectasia?

Treatments for telangiectasias and reticular veins include sclerotherapy, laser therapy, intense pulsed light treatment, microphlebectomy and thermocoagulation.