Thermocoagulation is a procedure to get rid of veins, and some doctors are using it for the tiny thread veins and redness from rosacea.
Spider veins, especially those on the legs, have been treated with a variety of techniques over the years, and that's what this was developed for originally. The tiniest veins were always the hardest to treat--sclerotherapy, for example, requires that a needle puncture the vein to inject and collapse the vein. But for a teeny-tiny vein, it was impossible to do. For those, laser has been used, but it's not ideal.
Thermocoagulation uses a tiny insulated needle to puncture the skin near the vein, but it doesn't actually puncture the vein itself. Then the vein is collapsed by heat from the needle. It's good for small veins, not really big ones, but with rosacea, we're usually talking small anyway.
It may be hard to find a doctor near you who uses this specifically for rosacea. But if you have visible facial veins, call and ask if you could be a good candidate.
From what I find, it has to be better than laser for facial veins--from a pain perspective, as well as cost, and also the whole skin lightening aspect of lasers. Facial veins are very thin and superficial, so it would be easy to pinpoint them. For most of us, those veins show up around our noses and on our cheeks. That's exactly where you get red when you're out in the cold because the skin whitens temporarily, showing off the blood vessels underneath. I haven't seen anyone with it on their foreheads where the skin is thicker.
Plus, healing is much better. While you'll read that there's absolutely no down time, that's a bit exaggerated. It is shorter than sclerotherapy or laser, for sure. Sclerotherapy patients have to wear compression stockings after treatment for several days, and laser leaves you really red and even raw. Compared to those, it's much easier to recover from thermocoagulation, which can still leave you a bit red from the heat for a day or so. You may use some concealer on the area because the skin itself is not damaged, just red from the heat.
What I wonder about is generalized redness, which, of course, is caused by veins close to the surface of the skin. Ultimately, the veins often end up showing more distinctly, but before that, could this really help? I do have a facial vein I'm not in love with, and if it gets any bigger, I'm getting rid of it...somehow.