Telangiectasia (broken blood vessels or facial capillaries), found on the face and body, are tiny capillaries close to the surface of the skin that break after dilating too often. Dermatologist Dr Lionel Krause provides an overview.

Fair-skinned people are more prone to telangiectasia. This may be caused by years of sun exposure, extreme temperatures, trauma to the skin caused by accidents or surgery, smoking, alcohol, pregnancy and childbirth, to name but a few.
Broken blood vessels on the face are a part of life for men and women as they age. The skin structure (collagen and elasticity) breaks down and is unable to regenerate itself, causing capillaries to become weak.

Broken blood vessels can also be linked to certain medical conditions. By far the most common is Rosacea, where flushing sensitive facial skin and acne-like pimples occur. Although a nuisance, Rosacea is harmless. It’s a condition that can be managed but not cured.
Much less often ‘capillaries’ may be linked to more serious conditions, including some so-called connective tissue disorders and also very rare genetic conditions where the abnormal veins may also be in other organs and cause internal bleeding. Cortisone treatment may be a cause.

Response to vascular lasers and Intense Pulsed Light therapy in skilled operators is good. These lasers target blood (haemoglobin) and cause the vessels to shrink. Some areas are more stubborn such as the grooves around the nose. A course of 3 to 5 treatments is needed with an interval of 4 weeks between each session. Results vary from person to person and adhering to pre- and post-treatment instructions is vital. For instance, it’s recommended that one avoids smoking for a minimum of 2 hours post-treatment as this will cause the vessels to dilate again. Realistically, one can expect an 85% improvement after laser therapy.

Lasermed uses both the Candela V Beam Laser and Ellipse I2PL to treat broken blood vessels.

Sun spots are called Solar lentigos and commonly known as ‘liver spots’. These well-defined brown macules are an over-production of melanin and occur because of excessive sun exposure. Lasermed manager Penny Jenkinson gives the bad and good news about sun spots.

Sadly, enjoying outdoor activities in your youth will see sun spots developing years later. They increase in number with age and tend to stay. Smooth and flat sun spots are harmless, but unsightly. Those that are raised and rough should be assessed by a dermatologist as they may be a precursor to cancer.

These lesions appear on sun-exposed skin of adults, often on the face, chest, legs, arms and dorsal hands. A woman’s true age can be determined by her hands. Although many women look after their faces, most neglect their hands. Our hands are constantly exposed to the sun while driving cars, causing them to age far quicker. Compare your hands; you will notice that your right hand will appear more tanned and older than your left hand.

As common as brown sun spots are, white spots also occur. White spots are hypopigmented lesions which means that the sun has stripped the skin of its pigment. This cannot be reversed.

Sun spots aren’t seen in children. Freckles are often present in children, but aren’t permanent. The amount of freckles decreases with age.

TREATMENT OF LENTIGOS

Sun protection is vital!

Apply sun block twice daily.  Sun block should be applied 30 minutes before going outside. If you’ve been swimming, reapply your sun block immediately. Wear protective clothing (long sleeves) and a wide brimmed hat. Try to avoid the sun during the peak times of 10am to 4pm.

Topical lightening creams

Some are available over the counter. Creams that contain kojic acid, licorice, mulberry extract and vitamin C will be more effective. Stronger creams containing hydroquinone and retinol require a prescription.

Liquid nitrogen

It’s a cost-effective, quick and often effective treatment, especially for rough and raised sun spots. Liquid nitrogen may, however, leave a white mark.

Chemical peels

Gentle fruit acid peels will lighten sun spots and even out the skin colour with time. It should be done in winter.

Laser Therapy

A variety of lasers may be used on smooth, flat sun spots. The laser will shatter the melanin production and initially the Sun spots will appear before fading. This should also be done in winter.

Both Chemical Peels and Lasers are very effective treatments with additional benefits, including collagen production to refine and improve skin texture, as well as being anti-ageing.

Topical Creams to lighten sun spots:

Neostrata: Enlighten Range

Skin Tech: Blending Cream, Atrofillin

Obaji: Pro C Serum, Exoderm, Exoderm Forte, Blend FX

Zone: Day and Night Creams

Avéne: D-Pigment Cream

Sun blocks:

Heliocare, Photoderm, Skin Tech Melablock, Obaji Professional C, Avéne

Vitiligo is an acquired pigmentation disorder of unkown cause that is characterised by the development of white patches related to the selective loss of the cells that make melanin pigment (melanocytes). Dr Jonathan Smith discusses this misunderstood disorder.

About 1% of individuals in the USA and in Europe have vitiligo, but the prevalence ranges from less than 1 in a thousand to 8% worldwide. A recorded predominance of women reflects their greater willingness to express concern about cosmetically relevant issues. Half of all patients develop the disease before 20 years of age, a time when physical appearance is perceived as important so as to be accepted by one’s peers and to attract a life partner.

Generalised vitiligo is the most common clinical presentation and often involves the face and distal parts of the limbs i.e. exposed areas not covered by clothing. Ignorance regarding its cause has resulted in vitiligo being referred to as ‘white liver’ and acquiring the stigma of an association with alcohol abuse. In many societies it’s also perceived as being contagious and put into the same category as leprosy or sexually transmitted disease, resulting in social ostracism.

The attitude and prejudice of the ignorant also affect the psychosocial development of children at school and on the playground, as well as the chances of school and tertiary education graduates when applying for jobs.

The fact that the course of the disease is unpredictable and the response to treatment varies also causes severe psychological stress and an increased risk of developing psychological and even psychiatric disorders requiring professional treatment.

Vitiligo has a major impact on self-esteem and the perception of self, causing embarrassment, shame, insomnia and depression. There is often no correlation between the severity of the disorder and its effect on an individual’s quality of life.

Therefore, all those with vitiligo should do a quality of life assessment when first diagnosed and regularly during treatment.

As with many problems facing society, the solution to the psychosocial implications of vitiligo lies in educating the general population regarding the disorder and decreasing the misguided stigma attached to it.

Those with vitiligo should also receive psychological counselling as studies have shown that one hour of weekly cognitive behavioural therapy and coping skills training improves the quality of life, self-esteem and perceived body image profoundly.

In addition, psychological stress can influence the progression of the condition. Therefore, its treatment improves the long-term prognosis of vitiligo.

Treatment options include topical treatment and the VTRAC Excimer Lamp system at Lasermed. This is a non-invasive UV lamp for phototherapy without any photo-sensitising (reaction of skin to sunlight) of specific disorders, eg Vitiligo on white and ethnic skins of all ages. The light delivers a short wave length of UV radiation (UVB responsible for tanning) that penetrates the epidermis using a lamp on specific areas. Only the affected area gets treated with a time-controlled dose or influence.