Spider telangiectasias

You may have been worried when your child was diagnosed with spider telangiectasias — but you don’t need to be. These are quite common marks that can be left untreated or gotten rid of with simple laser therapy treatments.

What are our options for cosmetic treatments?

At Children’s Hospital Boston, our experts use a device called a pulsed dye laser to destroy these abnormal blood vessels that can disfigure your child’s skin. Pulsed dye laser is the gold standard of treatment for spider telangiectasias because it’s highly effective and rarely causes any scarring.

How does it work?

First, the doctor “tunes” the laser to a specific wavelength of light. It produces a bright light that is absorbed by blood vessels. The abnormal blood vessels are destroyed without damaging the surrounding skin.

What’s the treatment like?

Your child’s physician holds a wand against the skin and "pulses" the laser for about a minute. It should only take one or two treatments to destroy the blood vessels and lighten your child’s skin. During the treatment, your child wears eye protection because laser light can potentially harm his eyes.

Is the treatment painful?

Not really. The laser light feels a bit like a rubber band snapping against the skin. Afterwards, your child may feel a bit of pain equivalent to a minor sunburn.

If you’re worried about your child’s reaction to the discomfort, we can give her a topical anesthetic. Tylenol can also help reduce the pain.

Are there any side effects?

There are a few minor side effects:

• Immediately after the treatment, your child’s skin will be purple where the laser was focused. This lasts for seven to ten days.
• As the purple fades, the treated area may still look red, but it will slowly fade to normal skin color over the next few weeks.
• In a few kids, crusting may develop in the first several days and last up to two weeks.
• Some kids may experience a temporary brown discoloration of the skin for several months.

What else do we need to know about the treatment?

• Avoid direct exposure to the sun for three weeks prior to the treatment. Sunburn and suntan may absorb the laser light and make the treatment less effective.
• You should also avoid sun exposure for several months after the treatment. We recommend always applying a sunscreen with SPF 15 or greater.
• Avoid aspirin and aspirin-like products for 14 days prior to treatment.
• You may want to apply antibiotic ointment and a bandage to your child’s skin immediately after treatment.

Your child's physician and other members of your care team will work with you to develop an appropriate follow-up care plan should that be necessary.

What if my child has concerns about his appearance?

Spider telangiectasias don’t pose any health problems, so many parents decide not to treat them at all. However, as your child gets older, he may be uncomfortable with the marks, especially if they’re in a prominent location, such as his face or neck. Our counselors can help your child deal with the psychological and social issues related to having spider telangiectasias.

Coping and support

We understand that you may have a lot of questions when your doctor tells you that your child has spider telangiectasias.

• Will they go away?
• How will they affect my child long term?
• What kinds of treatment are there?
• What do we do next?

We’ve tried to provide some answers to those questions in the following pages, but there are also a number of other resources to help you and your family.

Patient education: From the first office visit, our nurses will be on hand to walk you through your child’s treatment and help answer any questions you may have — Does my child need treatment? What can we expect next? They will also reach out to you by phone, continuing the care and support you received while at Children’s.

Parent to parent: Want to talk with someone whose child has had laser therapy? We can often put you in touch with other families who can share their experience.

On our For Patients and Families site, you can read all you need to know about:

• getting to Children’s
• accommodations
• navigating the hospital experience
• resources that are available for your family