Written by The Armstrong ClinicLast reviewed 30 July 20267 minute read
In summary
What facial thread veins are
Small blood vessels near the surface of the skin are normally invisible. They widen when you are hot, flushed or exerting yourself, then return to their usual size.
Facial thread veins, known clinically as telangiectasia, form when a vessel loses that elasticity and remains permanently widened. It then becomes visible through the skin as a fine red, purple or blue line, sometimes branching into a web pattern.
The vessel does not repair itself. This is a permanent change to an individual vessel rather than a temporary state, which is why creams and serums do not remove existing thread veins.
The main causes
Genetics
The most common single factor. If your parents had visible facial veins, you are more likely to develop them. This reflects inherited differences in vessel wall structure and skin thickness.
Sun exposure
The most significant modifiable cause. Cumulative UV exposure damages collagen and elastin in the dermis, weakening the support structure around blood vessels, and also damages vessel walls directly.
The effect accumulates over decades, so sun exposure in early adulthood often becomes visible many years later. People living in high-UV climates tend to develop facial thread veins earlier and more extensively.
Rosacea
Visible facial thread veins are a common feature of rosacea. Repeated flushing progressively widens the vessels until they no longer recover.
Where rosacea is contributing, managing the rosacea matters more than treating the individual vessels, because new ones continue to appear otherwise.
Hormonal changes
Pregnancy, the combined contraceptive pill, HRT and menopause all affect blood vessels and skin. Thread veins that appear during pregnancy sometimes fade afterwards, although many do not.
Temperature extremes
Repeated dilation from heat, including saunas, steam rooms, hot baths and work near ovens or furnaces. Cold wind also contributes, by causing vessels to constrict and then rebound.
Alcohol
Alcohol dilates blood vessels, and regular heavy consumption over many years contributes to permanent widening.
Visible facial thread veins are not in themselves an indication that someone drinks heavily. Most cases are explained by genetics and sun exposure.
Topical steroids
Long-term use of topical steroids on facial skin thins the skin and makes vessels more visible and more fragile. Steroid creams should not be used on the face for extended periods without medical supervision.
Injury and pressure
Trauma to the skin, aggressive extractions, harsh scrubs, over-exfoliation and repeated forceful nose-blowing during a cold can all cause individual vessels to break.
Ageing skin
Skin thins and loses collagen with age, so vessels that were always present become more visible. Existing thread veins tend to become more noticeable over time even where no new ones form.
Telling thread veins and rosacea apart
| Thread veins alone | Rosacea | |
|---|---|---|
| Background redness | No | Yes, diffuse |
| Visible individual vessels | Yes | Often, alongside redness |
| Flushing episodes | Vessels more obvious when flushed | Recurrent flushing is a core feature |
| Bumps or pustules | No | Sometimes |
| Stinging, burning or sensitivity | Not typically | Common |
| Eye involvement | No | Sometimes |
| Identifiable triggers | Not usually | Often heat, alcohol, spicy food or stress |
If rosacea is contributing, treating the visible vessels without managing the underlying condition gives a result that tends not to last. Rosacea has its own effective management.
What makes them worse
- Unprotected sun exposure, which is the most significant factor
- Sunbeds
- Very hot showers, baths, saunas and steam rooms
- Harsh exfoliation and abrasive scrubs
- Over-using strong active ingredients to the point of barrier damage
- Untreated rosacea
- Regular heavy alcohol consumption
- Long-term topical steroid use on the face
- Smoking
Can they be prevented?
Not entirely, since genetics is the largest factor. The following reduce how many appear and how quickly:
- 1Daily broad-spectrum SPF 30 to 50 on the face, all year. This is the single most effective measure.
- 2Managing rosacea, where you have it.
- 3Avoiding extremes of heat on the face where possible.
- 4Using a gentler skincare routine. Barrier damage makes vessels more visible.
- 5Avoiding long-term topical steroid use on the face without medical supervision.
- 6Moderating alcohol.
- 7Not smoking.
Do they fade on their own?
Generally not. Once a vessel has permanently widened, it remains so and does not repair itself.
The exception is thread veins that appear during pregnancy or with a temporary hormonal change, some of which fade within months of the change resolving.
No cream, serum or supplement removes an existing thread vein. Products that appear to help are usually reducing background redness, which can make vessels less noticeable without changing them. That is a real cosmetic benefit, but it is a different effect.
What can be done about them
For existing thread veins. Clinical treatment that targets the vessel directly, closing it so that the body clears it. See thread vein treatment.
For reducing background redness. Appropriate skincare, managing rosacea and consistent sun protection. See medical skincare.
For preventing new ones. Sun protection, avoiding extremes of heat and treating any underlying rosacea.
Treatment removes the vessels you have, but does not prevent new ones from forming, because the underlying causes remain. Many patients have a further session every one to two years.
When to see a clinician
Facial thread veins are harmless and treatment is optional. See a clinician if:
- They are troubling you and you would like them treated
- You have diffuse background redness, flushing, stinging or bumps, which may indicate rosacea
- A vessel has appeared suddenly and is growing quickly
- You have a red lesion that bleeds easily or does not heal
- You have any skin lesion you are unsure about
Anything unexplained, changing or persistent should be assessed.
Common questions
Are facial thread veins a sign of drinking too much?
No. Most facial thread veins are caused by genetics and cumulative sun exposure. Heavy alcohol consumption over many years can contribute, but it is not the most common cause.
Can skincare remove thread veins?
No. Skincare cannot remove a vessel that has permanently widened. Good skincare and sun protection reduce background redness and help prevent new vessels forming, which is worthwhile but a different outcome.
Why do I keep getting new ones after treatment?
Treatment removes the vessels you have but does not change the factors that caused them. Genetics, sun exposure and rosacea remain, so further sessions every one to two years are common.
Are thread veins dangerous?
No. They are benign and cause no harm, and treatment is a cosmetic choice.
Why are they worse around my nose?
The skin there is thin, the vessel network is dense, and the nose receives more sun exposure than most of the face. It is also subject to pressure from glasses and from nose-blowing during colds.
Do they get worse with age?
Usually. Skin thins and loses collagen, making existing vessels more visible, and sun exposure continues to accumulate.
Can children get them?
Yes, although it is less common. Persistent visible vessels in a child should be assessed by a clinician, as some vascular marks in children require different management.
