Capillary dilation, commonly known as hemosiderosis, is a skin lesion that occurs on the face or trunk area, mostly secondary to an acquired condition, but also congenital in some patients. Capillary dilation is most common in women and manifests clinically as filiform, punctate, stellate or flaky erythema of the skin. In our daily life we can often see a part of the facial skin redness or legs a line of dilated capillaries, like a thread of red, many women who love beauty is often very troubled by this. Red blood not only affects the beauty, but also affects the skin to draw nutrients, which over time leads to insufficient supply of nutrients to the skin, resulting in roughness, dryness and premature aging symptoms. This skin is thin and sensitive, and becomes more red when it is too cold, too hot, or emotionally agitated, and in severe cases, pigmentation can form, making it difficult to cure. Capillary dilation not only affects the external image of the patient, but may also cause psychological shadows and bring great inconvenience to normal life. Capillary dilation can be single or multiple, slowly developing or occurring without significant enlargement, benign; it can be limited to a certain area or be more extensive; it can be primary or secondary to scleroderma and other diseases; it can be a local lesion or a special manifestation of certain diseases, and most capillary dilation cannot subside on its own. The main pathological factors of capillary dilation are 1. Aging and weakness of epidermal basal cells. They cannot produce collagen, elastin, fibronectin, etc., resulting in capillaries in the dermis floating out of the dermis to the epidermis. 2, capillary elastic fiber defect. There are many factors that cause capillary elastic fiber defects, including long-term ultraviolet radiation, long-term use of corticosteroids, infection or genetic capillary structure abnormalities, etc. 3.Destruction of stratum corneum and epidermis. At present, many so-called blemish removal creams are actually chemical peeling agents or have a very strong peeling effect themselves, which can easily cause capillary dilation in the skin. As a result, it leads to the formation of sensitive skin. These patients are not only allergic or intolerant to many things, but also often have capillary dilation, which is very difficult to treat. 4. Long-term use of antihypertensive drugs and lack of vitamins. Classification and etiology of capillary dilation Capillary dilation is generally divided into two categories: primary and secondary. Primary, such as hereditary benign capillary dilation. The causes of secondary capillary dilation are complex, mainly the following: 1. climatic and environmental factors. Long-term life in a more hostile living environment, such as the highland air thin, skin hypoxia leading to an increase in the number of red blood cells, compensatory expansion of blood vessels, over time vascular contraction dysfunction caused by permanent capillary dilation. Capillary dilation can also occur in sailors, chefs, farmers and athletes who are exposed to wind, cold and heat for a long time. 2, hormone-dependent capillary dilation. Often the sequelae of inappropriate treatment, such as the abuse of topical drugs (skin relaxation, dermatitis, etc.). 3, physical factors stimulation. The stimulation of temperature changes, so that the capillary tolerance exceeds the normal range, causing capillary dilation or even rupture. 4, abuse of cosmetics or long-term “skin moon care”, or the sequelae caused by improper peeling. The acidic components of peeling products destroy the protective effect of the skin stratum corneum and the elasticity of capillaries, causing capillary dilation or rupture. 5, capillary dilation in the lower extremities is related to blood reflux caused by venous valve atresia. The chances of capillary dilation are four times higher in ladies than in men. The appearance of capillary dilation may be affected by hormonal secretion, such as pregnancy and oral contraceptives, the chances of capillary dilation are higher in ladies. 6, complications of certain local or systemic diseases, and also some patients with unclear causes. Previous treatments and drawbacks Capillary dilation has long been a difficult treatment problem. Conventional treatments for this skin disorder are usually ineffective, and drugs can hardly do anything. Before the invention of the new laser, cryotherapy, high-frequency electric knife treatment, isotope radiation therapy, etc. were commonly used. Some of these methods can obtain certain efficacy, but they are prone to ulcers, scars, radioactive skin necrosis and other serious complications, and cannot achieve the ideal cosmetic effect, which is unacceptable to beauty lovers. Some beauty salons in the society, due to the lack of medical knowledge, use treatments such as mask package monthly care in the hope of removing capillary dilation. This is undesirable and on the contrary may become more and more serious. Laser treatment for capillary dilation The laser provides the best treatment for capillary dilation to date and is a leap forward in the treatment of capillary dilation. The hemoglobin inside the blood vessels absorbs more laser light at a specific wavelength than the surrounding tissue, called selective photothermal action of the laser. After the hemoglobin absorbs the laser, the dilated blood vessels are thermally destroyed while the surrounding normal skin is not damaged. Laser treatment can produce a mosquito bite sensation or a sensation like a leather band being pulled apart against the skin. The vast majority of patients can be treated without any medication. For larger areas, preoperative sedation or pain medication may be used. Temporary bruising or purpura may occur in the treated area after treatment, and in rare cases blistering and hyperpigmentation may occur, with minimal possibility of scarring. In the past, CO2 laser, argon laser, krypton laser and copper vapor laser were used for the treatment of capillary dilation, but despite their efficacy, these lasers are rarely used because of the large reactions and side effects after treatment and the tendency to leave scarring. At present, the types of laser treatments with established efficacy and high safety are pulsed dye laser, long pulse Nd:YAG laser and IPL. Based on the patient’s clinical presentation, we will review the skin type and sensitivity and adopt the most suitable treatment plan to achieve safe and effective results. Prognosis The vast majority of capillary dilation can be cured. More extensive and severe capillary dilation may require multiple treatments, with immediate results in most cases. Finer vessels can be treated with a shorter pulse width laser, while thicker vessels should be treated with a longer pulse width laser. Thicker dilated capillaries in the lower extremities often require multiple treatments with increased pulse width, laser energy and pulse frequency. Sometimes, bruising or purpura can occur after laser treatment, and the final effect can be seen only after the bruising or purpura has subsided. Patients with darker skin tones have poorer results and may require multiple treatments. Sun protection is required after the procedure and sunscreen should be used after treatment until the skin tone returns to normal. Care should be taken when cleaning the skin and topical antibiotic ointment may be used if there are blisters or crusts. Triggers for recurrence also need to be avoided after surgery. Capillary dilation of the nose is prone to recurrence because of its high vascular pressure. For capillary dilation of the lower extremities, it is recommended to wear elastic stockings after treatment to prevent recurrence. 1.What is dilation of capillaries (Spider veins / Telangiectasias)? Dilated capillaries or spider veins are purple-red blood vessels that appear on the legs or face and resemble tiny spider webs, hence the name. Capillary dilation is different from varicose veins. Varicose veins are thicker and more prominent vessels that mainly affect both lower extremities, while capillary dilation is a problem with more delicate blood vessels that have a tendency to clump together. 2.Why do I have capillary dilation? Capillary dilation is related to blood backflow caused by venous valve atresia. Ladies are four times more likely than men to have capillary dilation; and 70% of adult women will have capillary dilation of varying severity. The appearance of capillary dilation may be influenced by hormonal secretion, for example, women who are pregnant and taking oral contraceptives have a higher chance of developing capillary dilation. 3.Does capillary dilation need to be treated? Capillary dilation does not usually pose a serious health risk, but if the problem is caused by deep varicose veins, it may cause discomfort such as itchy skin or eczema. In rare cases, dilated capillaries may be associated with severe liver disease or other celiac disease. Many women find capillary dilation on their legs to be an eyesore and therefore tend to undergo treatment. 4.What treatments are available to deal with my capillary dilation? Laser or injection treatment. The principle of laser treatment for capillary dilation is to use the selective absorption of oxygenated hemoglobin to certain wavelengths of laser light, which leads to the selective destruction of vascular tissue. Injectable treatment uses a very thin syringe to inject medication into the problematic vein, which causes occlusion of the inner layer of the vessel wall, resulting in blockage and closure of the vessel. In comparison, laser treatment is less invasive.