Question

I have fine spider veins on my cheeks and around my nose. These are not severe, but I feel compelled to cover my face with make-up as I find them unsightly. In the past I've tried both sclerotherapy and laser treatment. Both caused blistering and scarring which took months to heal, and neither resulted in significant improvement. I'm now considering Veinwave thermocoagulation treatment. The consultant I saw would not test the treatment on my skin, and I've been unable to find any testimonials. Can you offer any advice on the effectiveness of Veinwave, or possible side effects? Would you recommend any alternative treatments or steps to prevent more from occurring? Thanks and regards, Cherie

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The cosmetic doctor
Dr Patrick Bowler

Facial spider veins are common and are caused by genetics, too much alcohol, acne, rosacea and sun over-exposure. They can be successfully treated, but best results are on pale skins with bright spider veins, as the most effective treatments, lasers and intense pulsed light (IPL) therapies, work by focusing on colour. It's hard to know if your bad reaction is due to your skin type or your practitioner. Laser treatments are often carried out by beauticians with little training, so if you think your practitioner was to blame, consult a trained cosmetic doctor (www.cosmeticdoctors.co.uk). There's limited independent evidence for the efficacy and safety of Veinwave, which delivers a high-frequency energy to the skin, heating and coagulating the blood vessels, so I don't offer it. If you decide to try it, ask for a test treatment. If your request is refused, don't risk it. Your spider veins might not get any worse, and wearing make-up is surely better than further scarring.

· Dr Patrick Bowler is a member of the British Association of Cosmetic Doctors

The fellow sufferer

Sheila Bushell

Until recently, I had the distressing condition of thread veins and rosacea all over my face, and was often so upset by my appearance that I didn't want to leave the house without a lot of make-up to disguise the redness. Over 15 years I tried virtually every 'cure', from creams and vitamins to strengthen the capillary walls to at least four different types of laser procedure including IPL and ruby-laser treatment. The procedures didn't work at all, or only improved my condition for a short time. Like you, I was also left with scarring. I then tried Veinwave, and I have to say I feel almost evangelical about it. Not only did it work extremely well, but there was no bruising or scarring. After a course of treatments, my skin looks normal. All the thread veins and redness have gone and I no longer need to hide behind make-up. I cannot recommend it highly enough and believe that Veinwave treatment should be available in NHS hospitals.

· Sheila Bushell, 43, suffered from thread veins and rosacea for 15 years

The dermatologist

Mark Goodfield

Visit your GP to refer you to a consultant dermatologist, as I'm not sure the advice you've been given has been in your best interests. Sclerotherapy does not have a good record on facial spider veins, and if you have blistering and scarring from laser treatments the person operating the laser may not have had enough experience. A dermatologist will diagnose whether your spider veins are a genetic problem (often the case for women) or part of a condition like rosacea, which can be improved with antibiotics. They might advise a different laser treatment, or you may want to give Veinwave a try, though it is quite new and I don't know of any results from longterm clinical trials. You can also take steps to protect your skin, such as regular moisturising, a daily sunscreen in spring and summer, and gentle cosmetics. Whatever you decide, please discuss it with a medical professional first, as his/her advice will be based on science and be impartial.

· Mark Goodfield is a consultant dermatologist and honorary secretary of the British Skin Foundation