Hemostatic or blood-clotting related disorders are often the underlying cause of a facial vein. Blood-flow among humans is regulated through a minimal degree of clotting that is needed to maintain the vascular balance. However, in genetic disorders like Hereditary Hemorrhagic Telangiectasia, the blood doesn’t clot in the proper manner.

Patients with this rare congenital condition have excessive or impaired blood clotting. However, reduced blood clotting is the norm wherein most patients of HHT tend to bleed profusely from the smallest of tissue cuts. The internal vascular imbalance induces excessive pressure on the veins, leading the development of swollen, facial veins.

Understanding Hereditary Hemorrhagic Telangiectasia

Hereditary Hemorrhagic Telangiectasia is also referred to as HHT or the Osler-Weber-Rendu Syndrome. It is a rare disorder and is present at the time of birth, i.e. it is congenital in nature. There are no precise tests for pointing towards the possibility of Hereditary Hemorrhagic Telangiectasia in a newborn.

The disease has hereditary traits wherein it passed on to members of the family. However, it is very difficult to trace as to which member of the family carries the maximum risk of being a carrier of Hereditary Hemorrhagic Telangiectasia. Further, HHT is also known to skip generations which makes its prognosis rather challenging.

Symptoms of Hereditary Hemorrhagic Telangiectasia are widespread since the entire balance of circulatory functions in the body is affected. This includes blood supply to critical organs like the brain, liver and lungs. The skin and the mucous membranes develop reddish spots that later give way to fine, red-colored lines that are dilated blood vessels. These are facial veins and they tend to progress rather rapidly during the initial years (childhood). Such patients suffer from a decreased ability to regulate the internal pressure of blood, which causes frequent nosebleeds.

Facial Veins in HHT

The widespread formation of facial veins is among the primary symptoms of HHT. Telangiectasia begins rather early in the patient, being more defined along the edge of the nose. Further, some swelling of blood vessels is also seen along the abdomen. The facial skin develops small dots that have a purplish hue which has a tendency to change coloration into dark, red shades when exposed to sunlight.

The cause of telangiectasias (small facial veins) in HHT is a bit different from other genetic causes of facial veins. Yes, the unregulated blood pressure does induce the dilation of blood vessels in HHT, but this pressure is due to excessive branching of the existing blood vessels. In many other genetic disorders that cause facial veins, the malfunctioning genes have been identified and the wrongful DNA coding has been understood to some extent. However, the genetic-level mechanism causing HHT-related mutations in the genes is still not clear.

Unlike other causes of facial veins, Hereditary Hemorrhagic Telangiectasia-related telangiectasias can be very discomforting, i.e. apart from the aesthetic perspective. These facial veins often mature into dark lines that appear like lesions. The lesions along the mouth can are more defined and may even bleed during a nosebleed episode. Further, the skin lesions quickly spread towards the lower limbs, like the hands. They seem to me more concentrated in areas that are usually exposed to the sun.

Diagnosis and Treatment

Please note that the concentration and color intensity of facial veins in HHT vary across the kind of HHT symptoms an individual is diagnosed with—these symptoms are categorized under HHT Type 1, 2 and 3 symptoms. The severity of the facial veins, their tendency to spread and their appearance can be treated to some extent using advanced treatments like electro-surgery.