What is Telangiectasia?
Telangiectasia refers to a condition in which the small blood vessels that are present on the skin surface and mucous membranes either break or become wide. This result in lines appearing on the skin that often is unsightly. Telangiectasia in itself is a benign condition and poses no threat to the health of the individual and does not necessarily require any treatment. The blood vessels that become wide tend to become weak resulting in bleeding and appearance of the lines on the skin surface. In rare instances, they may signify an underlying medical condition and require further investigation of the patterns seen with Telangiectasia.[3]
The pathophysiology related to Telangiectasia is not yet known but there have been reports of it having a familial connection with an autosomal dominant pattern of inheritance. What that is known is that substances occurring in the body like estrogen or adrenal corticosteroids are not known to have any influence on development of Telangiectasia.[1]
Conditions like varicose veins or other conditions caused by deep venous insufficiency are not known to be associated with Telangiectasia. The most common areas where Telangiectasias are observed are the face, chin, cheeks, and nose. The chest, legs, back, and arms are also some of the areas where Telangiectasia can be observed.
Telangiectasia present in the legs is also referred to as Spider Veins.[1]
What Causes Telangiectasia?
The etiology for Telangiectasia is still not known but being a relatively benign disease is not a cause for worry. However, as stated in rare instances it may signal a more serious underlying medical condition which should be of concern. It has been observed that Telangiectasia in most cases occur in fair skinned people who have been exposed to excessively to direct sunlight for a prolonged period of time.[1,3]
Telangiectasias are normally asymptomatic but at times they tend to cause bleeding. In cases where bleeding occurs around the brain it may cause severe problems. While the exact cause of this condition is not known, there are some risk factors which predispose an individual to get Telangiectasia. These include genetic makeup of an individual.[3]
Prolonged exposure to skin, especially in people who are fair also is a common risk factor for Telangiectasia. Certain medications that make the blood vessels wide also may lead to Telangiectasias. People who are chronic alcohol drinkers also run the risk for developing this condition. People who are on chronic steroid therapy also are predisposed to Telangiectasia.[3]
Pregnant females are also at risk to develop Telangiectasia. This is because as the fetus grows within the body there is excessive pressure put on the veins and blood vessels which make them wide. Postmenopausal females also are at risk for developing Telangiectasia. This is because of the hormonal changes that occur with menopause.[3]
There are some medical conditions that cause Telangiectasia including liver dysfunction and ataxia telangiectasia where the brain gets affected. Bloom Syndrome which is a rare genetic condition along with port wine stain, and Osler-Weber-Rendu Syndrome. Dermatological conditions like rosacea and spider angioma also cause Telangiectasia.
There are also certain connective tissue disorders that cause Telangiectasia. These include limited scleroderma. A person is said to have limited scleroderma where the disease only affects limited areas of the body like the face, hands, and feet.[3]
Telangiectasia also occurs in people with dermatomyositis and lupus. In case if the Telangiectasia is suggestive of a serious condition such as associated with Telangiectasia there are lesions that form on the face it is best to consult with a physician for diagnosis and treatment. Additionally, if there are patches that appear on the breasts and hips then again consultation is required and diagnosis and treatment done as it suggests a potentially malignant condition.[3]
What Are The Risk Factors For Telangiectasia?
Telangiectasia is seen more in females than males. People above the age of 40 are also vulnerable to Telangiectasia. People who have a family history of this condition run the risk of getting this condition in an autosomal dominant pattern.[4]
What Are The Symptoms Of Telangiectasia?
Coming to the symptoms of Telangiectasia, as stated they are very minute thread like lines that appear on the skin surface. These lines are normally red or pink in color but tend to become white when pressed or when pressure is exerted. Over time, these lines change in color from red to blue. The blood vessels that become wide in people with Telangiectasia usually are 3 mm in width.[2,3]
Telangiectasias are usually asymptomatic but at times can cause itching and pain. Facial redness is also a symptom that is associated with Telangiectasia. Although Telangiectasia can appear in any area of the body, they are more common in the face, chest, arms, and legs.[2,3]
How Is Telangiectasia Diagnosed?
In most cases, Telangiectasia is a result of chronic sun exposure and the natural process of aging. However, if they become severe and are associated with other symptoms then a consultation with a physician is recommended.[3]
People with a family history of Telangiectasia with a history of bleeding from the mouth and eyes should also consult a physician to identify any potential risks of a more serious condition. The physician may order blood tests, CT and MRI scans, liver function tests to confirm a diagnosis and formulate a treatment plan once a cause for the Telangiectasia is identified.[3]
How is Telangiectasia Treated?
Telangiectasia does not have a cure but can definitely be treated. A treatment plan is formulated depending on the investigations ordered by the physician. As an example, if the patient is believed to have acne or other infection as a cause for Telangiectasias then prescription antibiotics will be prescribed by the physician. Many people with Telangiectasia opt for complete removal for cosmetic reasons as well as it at times cause discomfort.[2,3]
Laser therapy, sclerotherapy and surgical excision are the primary modes of removal of Telangiectasias. Among these options, laser therapy is most preferred as it is minimally invasive and extremely easy to do without any specific complications with a faster recovery rate. This therapy works by sealing the widened blood vessels. Sclerotherapy is yet another option to treat Telangiectasia. This form of treatment is especially effective for areas where the veins are large like the lower extremities. Thus, it is recommended to treat Telangiectasia in the legs.[2,3]
This is also a minimally invasive procedure but usually takes much longer to take effect and is quite expensive with no insurance coverage for it due to it being more of cosmetic in nature. The patient will require multiple injections in this form of treatment ranging from 5-50. Surgical excision involves complete removal of the blood vessels that have become wide. This is quite a painful procedure and also has an extended recovery period along with inherent complications seen with any surgery. In majority of the cases, people go for treatment of Telangiectasia purely for cosmetic reason as the appearance of it is quite unsightly.[2,3]
What Is Prognosis Of Telangiectasia?
As stated, Telangiectasia does not have a cure. In fact some of the causes of this condition are irreversible but with proper treatment new Telangiectasias may be prevented. Once treated, the patient can resume normal activity but caution need to be maintained so as not to expose the affected area, especially to direct sunlight. This is to be practiced till the time the skin color gets back to normal.[1,3]
In case there is crusting or blistering around the affected area, then cleaning the skin gently and applying an antiseptic cream or lotion is recommended. Prescription antibiotics may be required for severe cases. The overall prognosis from Telangiectasia is pretty good if proper treatment is given and the underlying cause is taken care of adequately.[1,3]
The primary aim of treatment is not only to reduce or completely remove the thread like lines from the skin surface but also to prevent recurrence. Once treatment is successfully completed in most cases new blood vessels are formed replacing the widened vessels. In case if occurs as a result of a malignant condition causes Telangiectasia, then the prognosis depends on the extent and severity of the underlying cause and can range from good to fair and how successful the treatment is.[1,3]
