A common complaint we see, especially in women and children, is a cluster of blood vessels on the face called a Spider Angioma. This can be quite unsightly as it can resemble a permanent large red pimple.
What is a Spider Angioma
A Spider Angioma is a cluster of small red capillary sized blood vessels, usually on the face. They are also called Spider Naevi and typically start off as flat red marks that over time become raised and then resemble a large pimple. The term comes from the word angioma being a medical term for blood vessels, and spider referring to the fine network of interconnecting blood vessels which under magnification resembles a spider web pattern
Why do Spider Angiomas occur?
The vast majority of patients who develop a Spider Angioma have no associated medical problems and the Spider Angioma develops from local trauma such as squeezing a pimple or due to hormonal triggers such as being on the pill or pregnancy.
There are some medical conditions associated with the development of multiple spider angiomas (such as liver disease) but these conditions are quite rare. Assessment in a medical laser clinic will identify if patients with Spider Angiomas require further investigations.
Where do Spider Angiomas occur?
Spider Angiomas can potentially occur on any area of the skin but most commonly occur on the face and especially on the cheekbones, under the eye and on the nose. They typically begin as small, flat red marks that then progressively over several months gradually become larger and raised and often start to resemble a permanent large pimple.
How are Spider Angiomas treated?
Spider Angiomas can be very effectively removed by medical grade vascular lasers. When Spider Angiomas are relatively flat and have only recently appeared they can resolve spontaneously, so as a rule of thumb we don’t treat a flat Spider Angioma until it has been present for at least 6 months. If Spider Angiomas appear during pregnancy we recommend waiting until after delivery to see if it disappears when hormones return to normal.
When a Spider Angioma becomes raised or has been present for over 6 months it is very unlikely to resolve without treatment. The treatment of choice in removing a Spider Angioma is with a medical grade vascular laser such as the EXCEL V. The VEINGOGH radiofrequency device can also be effective in removing Spider Angiomas.
Can children be treated?
Young children quite commonly develop Spider Angiomas. Again our rule of thumb is to wait until they have been present for at least 6 months before treating. The main consideration in treating the younger age group is aftercare. Following laser treatment the area of skin will swell slightly and may develop a small crust (like a cat scratch) that can last a week, and if this area is picked and squeezed then a small scar or blemish can result (healing skin is more vulnerable to trauma). Hence in deciding at what age to treat a child, it requires a consideration of how responsible a child would be in not traumatising the area after laser treatment. We also suggest waiting until the child is concerned about the appearance as they are more likely to be careful and look after the area following treatment.
Is treatment painful?
The laser treatment of a Spider Angioma feels like a pin on the surface of the skin and most people do not rate the procedure as painful.
When treating children and patients with very sensitive skin we do recommend applying EMLA cream to the area at least 60 minutes before laser treatment.
How many treatments are needed?
An isolated Spider Angioma can usually be effectively removed in a single treatment, especially if it is flat. Raised and large Spider Angiomas can take 2-3 treatments to completely disappear.
In a small percentage of patients a Spider Angioma appears to disappear after laser treatment but then recurs in the weeks after treatment. This is due to pressure from an underlying blood vessel pushing blood back into the overlying Spider Angioma. These recurrent Spider Angiomas can take several treatments to completely shut down the feeder blood vessel.
Follow up treatments need to be spaced at least 4-6 weeks apart to allow the skin to recover fully.
What are the likely costs?
A typical EXCEL V laser treatment or VEINGOGH radiofrequency treatment of Spider Angiomas is $350. The Government will charge GST of 10%.
For recurrent Spider Angiomas the cost for a follow up treatment is usually $100-$150.