I have a few clients that have broken capillaries in there chin, nose and cheek areas.  Does anyone have some ideas for treatment in those areas to help make the veins not to noticeable? Is the red light therapy good?

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Hi Nicola - I have been told, and also have read about it - the capillaries aren't actually broken. In some (or most?) cases, it is more about that the skin has thinned (a loss of collagen) and the capillaries are visible.

I suppose the age factor is to be considered as far as how much you can help your clients.  However, one approach is to use products that will help the collagen to reform in those areas.  I suppose it could be helpful for them, if they are, to stop putting products on their skin that are breaking it down in the first place - something that is causing inflammation, for instance.

The last place I came upon this opinion is from Osmosis skincare.  Dr Ben Johnson has written a book and covers this topic ("Transform Your Skin Naturally"). 

Hope that is helpful!

Nicola, you really cant help your client other than to sooth and hydrate the skin.  I would make a referral to a dermatologist for laser treatment.  The results are great. 

There are certainly differences in capillary damage to the cheeks, nose and chin area.  If they are big enough they are Telangectasias or sometimes if it is diffuse redness it can be diagnosed as Rosacea.  The term "broken" gets used incorrectly.  They really are not broken otherwise it would look like a bruise or hematoma under the skin.  I don't necessarily agree that thinned skin is why these capillaries are more visible.  Think of capillaries as if they were a balloon.  What happens when you blow up a balloon too many times?  It never shrinks back down to its original size.  That is what happens when the skin flushes frequently whether it be from spicy food, alcohol, medications, Rosacea or severe sun damage.  There are many products and treatments available for capillary damage. When we are talking Telangectasias, usually they need to be treated in a derm office - they will sometimes inject them or use a hyfrecator to destroy the capillary.  For general capillary damage - pink cheeks, chin, etc. I like to use a Rosacea serum with natural ingredients to target the flushing aspects.  I also like to use a topical Vitamin A.  It helps to repair and strengthen the capillaries.  As far as treatments, I have had great success with microdermabrasion followed by Vitamin A peels or IPL treatments.  Certainly, you want to evaluate the current products they are using along with whether they are using sunscreen which is an absolute must, but make sure it is free of synthetic chemicals.  Also evaluate their habits.  Are they wine drinkers, enjoy spicy foods, etc.  Just educate them that those things can be triggers and make the pink/red appearance worse and damage the capillaries further.  Do as much research as you can and know your stuff.  I do not know anything about red light therapy so I cannot comment on that.  Hope this helps!

Erin,  which rosacea serums have you found give the best results? I am still on the hunt.  I had amazing success myself with Dr. Weil's skin care from Origins.  So now I am looking to find a professional serum that performs as well.  His line uses extracts of mushrooms to target inflammation.

I carry strictly Rhonda Allison for my skin care line.  I am clinically based so I needed something that would appeal to the many "organic" clients (I live in Oregon) and be able to give them the results they seek.  I have used many different lines that have had a "Rosacea" serum, but none were very effective.  I also truly believe that you must do treatments to enhance and speed up the the results of your topical treatments rather than just using them alone. 

What are your favorite treatments and products?

This is a widely debated topic that I have always read very different answers. In my teachings, "broken capillaries" are enlarged (dialated) capillaries that can only be truly treated by derms, docs, and RNs because of their ability to cauterize them via laser treatments. Topical products with Vitamin K can help, but to what extent, I haven't been convinced. I also think some treatments that acknowledge inflammation would help calm and soothe redness. Genetics play a large role in this condition too.

Sometimes even when they are treated by IPL or other laser treatments they can come back, even just by sneezing (if they are around the nose). So no solution is permanent, I would tell your clients this upfront.

These vascular conditions are contraindications for many treatments including but not limited to: microdermabrasion, intense scrubbing, deep chemical peels, waxing, etc. because they will make it worse if not harm the client.

Also influence your clients to wear sunscreen ALL THE TIME, as the sun can make it worse, as well as alcohol.

Yes, it is a very widely debated topic.  Topical products are certainly key to help maintain, but they probably will not fix the problem on their own (I am referring to the diffuse redness - not telangectasia's).  I have worked with Vitamin K, but it is not easily available and I have not experienced results from this product alone.  I agree that genetics play an important role and if inflammation is the cause of the redness, that must be addressed first and foremost.  Just like any treatment, whether it be chemical peels, IPL or laser it all must be maintained and you have to be up front and honest about this prior to beginning any treatments.

I have to disagree that these vascular conditions are contraindications for microdermabrasion and chemical peels.  You must know what your doing first and foremost.  Get the education necessary so that you do not harm a client.  But, chemical peels with AHA's, BHA's, Retinoids and AFA's (acidified amino acids) are very effective especially when combined with microdermabrasion.    There is a wonderful book called Maximizing Medical Microdermabrasion written by Gail M. Jones RN, BA, LE and Richard H. Jones DMD.  It is very informative and has before and after pictures.  Bottom line - it is important to formulate an opinion on what you are comfortable doing and using to treat skin.  But, be open to other opinions and options, they may lead you to an amazing treatment you are not familiar with and end up making a lifelong client because your were able to help their skin.


That is an interesting point of view Erin. In my experience and research, broken capillaries can be caused by clients squeezing the skin (popping pustules) around the nose and they ultimately travel across the face. I have had this happen to me and I can attest to this theory as well. Think of it like a windshield and one rock hits it, and the crack travels through the path of least resistance, the same as blood travels in our bodies. If our capillary lining (endothelium) traumatized, it is not strong and intact, causing atrophy, and will cause them to become dilated and to pool and/or leak/burst. Thus, the appearance of these tiny red squiggly lines in the skin. This is why cauterizing is so successful.

The suction from a microdermabrasion machine will cause more broken capillaries because of the action it is doing. Microdermabrasion treatments increase circulation and can make the already present inflammation worse. In Milady's Aesthetician Series Comprehensive Guide To Equipment the contraindications of microdermabrasion state, "Vascular conditions: such as rosacea and telangiectasia: In some cases, microdermabrasion can make the appearance of telangiectasia worse by removing layers of stratum corneum. It is not making the condition worse: it is only exposing what is already there." Which, I would say, does your client care if it makes it worse or just makes it look worse? It is the same to them! It also says it makes inflammation worse and sensitive skin more sensitive. This is NOT something an aesthetician should be doing. It would be a disservice to your client.

While the book you have referred to may say this is a great treatment, it is a written by a nurse (also an aesthetician, yes) and a dentist. These are both using medical grade microdermabrasion techniques, as stated in the title. This is unfair advice for an aesthetician unless that is inside your scope of practice to do such treatments.

I would agree that chemical peels (AHA, BHA and enzymes) are effective in conjunction with microdermabrasion for anti-aging when you are trained appropriately and the skin is pre-conditioned and fit for such desquamation, but it is not an appropriate treatment when treating skin with rosacea and/or couperose (telangiectasia) skin, ever.

I think if you do this and you have been successful, good for you. But for other aestheticians reading this, I hope you reconsider and err on the side of caution because you cannot reverse this condition once the damage is done. If you are working under a doctor, you are under his insurance and they say that is fine, that's one thing. But lawsuits aren't fun!

My suggestion: Just Google "contraindications and microdermabrasion" if you are still questioning this.

Certainly, we could go back and forth in regards to opinions.  Mine, yours and the author's of all the books we use as our reference.  There is a multitude of material out there we can use to educate ourselves with and thus make an educated decision as to whether it is a service we are comfortable performing.  There have been many articles along with peel protocols written by product manufacturers to support why I do these treatments on my clients. They have been written, performed and studied specifically for those skin conditions.  Not all red skin means inflammation or that the barrier function has been compromised.  At least in my area, it is usually sun damage or Rosacea that is the cause for their red skin - not pimple popping but, I can appreciate how that could occur.   You don't have to be a medical Esthetician to perform such peels as long as you are educated and know what you are doing. And, of course, practicing within the scope of your license as your state so determines.  I do not think it is unfair advice as some Estheticians are not motivated by just doing spa facials all day.  Some really like the treatment aspect and would like to know what others are doing and what works. This forum is here so that everyone's opinion or experiences are heard.  I do appreciate your view but, I have to gracefully agree to disagree with your opinions.  Thank you for your input.

I like that, gracefully agree to disagree :) But you're right, this is what this forum is for! Thank you for your input as well Erin!



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