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Red spots on the skin

When red spots appear on the skin, the question often arises as to whether the changes are a sign of illness or are harmless.

In the course of life, changes in the superficial blood vessels can occur in the face, chest, back and legs. The most common vascular changes are couperose, rosacea and spider veins. There are also port-wine stains and spider marks. Port-wine stains are congenital malformations of the smallest blood vessels and spider marks are benign new blood vessels in the skin.


Couperose is a French term and means "copper rose" or "copper fin". It describes a genetically caused enlargement of the small superficial blood vessels in the skin, usually on the cheeks or nose. The skin tends to be red, dry and sensitive. Typical are individual, temporarily visible small veins up to diffuse redness - the so-called "flushing" - on the face and décolleté. Other symptoms include a burning sensation on the skin, itching and dry, tense and sensitive skin. Initially, couperose can only occur temporarily, but this can progress due to increased weakness of the vessel walls and connective tissue.

Couperose is considered a mild precursor of rosacea, as it progresses it can change - to a chronically inflammatory and permanently occurring rosacea.

As a rule, couperose is more of a cosmetic problem. We recommend special skin care products that can soothe very sensitive skin, reduce redness and strengthen the skin's protective barrier. The skin should always be supplied with sufficient liquid, gentle drying is recommended and consistent sun protection is important since solar radiation can intensify the symptoms. If the suffering of those affected is very high, a gel with the active ingredient brimonidine can be used. As a result, the dilated vessels narrow again and the redness goes down. Alternatively, there is the dye laser and the IPL laser (Intense Pulsed Light), whereby the dilated capillaries are sclerosed by the intense light and the redness also decreases here.

In summary, it can be said that couperose is not curable, but harmless. Over time, it can progress to rosacea, so regular maintenance and avoidance of the trigger factors are recommended.

Causes of couperose

  • a hereditary predisposition

  • Environmental factors such as frequent temperature changes, wind, sun or humidity

  • Psychological factors such as increased anger or stress

  • Mechanical factors such as friction or pressure on the skin

  • external factors such as fragrances, detergents or topical medications, physical exertion, too much alcohol, spicy food or caffeine


In contrast to couperose, which only shows up as slight temporary redness, roscea is a strong permanent reddening of the nose and cheeks with the proliferation of the sebaceous glands, papules, purulent pustules and wheels. Bulbous changes in the nose and extreme dryness of the eyes can also occur in connection with itching and burning. It is a chronic, inflammatory and relapsing skin disease that can be triggered by various trigger factors. A provocation occurs through stress, alcohol, nicotine, caffeine, UV light or temperature extremes.

The disease should not be confused with acne, as similar inflammatory skin changes appear. However, no blackheads, so-called comedones, form with rosacea. Rosacea can be divided into three stages (see box) based on its symptoms.

Another form is ophthalmo-rosacea, here the eyes are affected, regardless of the facial skin involvement. It is manifested by dry eyes and eye inflammation (conjunctivitis, iritis, keratitis, styes).

The therapy initially includes avoiding triggers, and if there is no improvement, the use of topical antibiotic creams and gels, for example with the active ingredient metronidazole. Alternatively, other therapy methods are available, such as laser treatment - especially with the dye laser, sclerotherapy, photodynamic therapy or surgery. In particularly serious cases, the use of systemic therapy may also be necessary.

In summary, it can be said that the disease rosacea has a chronic course and cannot be completely cured. With proper treatment, care, and avoidance of the trigger factors, flare-ups can be reduced and symptoms controlled.

Spider Veine

Above all represents an aesthetic impairment for many patients. The causes of this are usually a family predisposition and are positively influenced by standing for a long time, obesity, weak connective tissue and pregnancy. Before treatment, a basic philological examination of the superficial and deep leg veins using duplex sonography is recommended in order to rule out general venous weakness in deeper veins. There are currently two therapeutic methods that are suitable for removing spider veins:

· with sclerotherapy or

· using laser therapy.

The standard treatment is sclerotherapy of the small varices. In this case, local vascular wall damage is caused by injecting a tissue-toxic liquid, the varicose veins are converted into connective tissue and thus closed. Several treatments are necessary. A possible side effect of this sclerosing treatment can be brownish skin discolouration at the puncture sites, which usually disappears within a few weeks.

The cosmetically disturbing spider veins can also be treated as part of laser therapy. The small vessels can be closed and removed using a so-called Nd-YAG laser. The vein walls stick together due to the heat from the laser. This also requires several sessions.

In general, spider veins are usually medically harmless and have no health effects, so removal is more of a cosmetic treatment. It is important to know that new spider veins can form in other places, especially if there is a predisposition to do so. Ideally, such a treatment takes place in the winter months, since UV radiation can cause pigment disorders in the treated areas.

Spider marks

A spider mark, also called spider naevus or naevus araneus, is a stellate, enlarged, benign arterial neoplasm on exposed skin and upper trunk.

The cause is unknown, but they mainly occur in chronic liver diseases as liver skin signs and in pregnant women, whereby they usually regress in pregnant women after childbirth.

Spider marks are harmless and do not cause any symptoms. Treatment is usually not necessary, but if desired for cosmetic reasons, they can be removed using a dye laser or an electric needle.


The birthmark, also called nevus flammeus, is a congenital benign malformation and expansion of the capillary vessels below the top layer of skin. It is a circumscribed red-livid coloration that is harmless and can appear shortly before or after birth. The lesion may get bigger, smaller, or change shape. It can also recede with age.

In general, it can be summarized that the port-wine stain is completely harmless and does not require any treatment. However, it can be perceived as cosmetically unsightly, especially in visible areas. Laser therapy can help here, which can obliterate the dilated blood vessels. The dye laser is recommended here. However, this requires several sessions.

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