I have these bulging blood vessels of the backs of my hands that I really don't like. What can be done about them? Can I have them injected with sclerotherapy? Is it safe to do so?
Treat Bulging Vessels on Hands
Doctor Answers 16
Disguising vessels on the hands
Before you go so far as to render the large veins on the backs of the hands unusable, I would consider doing a filler like Radiesse for the backs of the hands to disguise the veins and tendons we see most commonly. We have had excellent results and patients are very pleased and don't compromise their circulation.
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Sclerotherapy on hands
Sclerotherapy injection is a great way to improve the appearance of bulging veins on the hands. Sotradecol is a choice agent for sclerotherapy on the hands. The hands are elevated slightly during treatment and afterwards the hands are wrapped with gauze and elastic bandage to keep pressure on the treated veins. Often the hands are swollen and red in the areas treated for several days after sclerotherapy. Somtimes at about 2 weeks after injection, we will have the patient return to drain any clots that have formed in the superficial veins. This speeds healing and reduces discomfort.
Treatment of Hand Veins
Treatment of hand veins by sclerotherapy can be very successful when performed correctly. The proper sclerosing solution should be selected at the appropriate strength. It can be quite successful, we have been following patients in which their hand veins have been gone or reduced to normal size for over ten years. Fillers can be used to help to reduce appearance of "bony" hands but they will typically not disguise enlarged veins.
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Sclerotherapy for hand veins - things to know about sclero solutions
- Polidocanol, 0.5% - 1%
- Sodium tetradecyl sulfate 0.2% - 0.5%
- Saline and dextrsoe (Sclerodex)
- Hypertonic saline
All of these are used for sclerotherapy with varying success. They each have advantages and disadvantages.
Glycerin is classified as an osmotic agent. Hypertonic saline and Sclerodex are hyperosmolar agents. Polidocanol and Sodium tetradecyl sulfate are classified as detergents.
Trade names for Polidocanol are Sclerovein. Trade names for sodium tetradecyl sulfate are Sotradecol, fibrovein and thrombovar.
Sclerotherapy is best option
What a coincidence that I was sent this question by Realself.com! I am doing the lecture at the upcoming meeting of the Amercian Academy of Dermatology on the subject of sclerotherapy of the hands.
This is a very safe option when performed by an experienced dermatologist or plastic surgeon. There are precautions and a few contraindications (such as previous lymphatic surgery in the arm for breast cancer), but your doctor can discuss the details at consult. Another option is to inject filler (Radiesse is excellent) and that procedures plumps the skin over the veins and the don't show through as much. My website has some examples of results.
Endovenous laser and sclerotherapy work well.
Enlarged hand veins are common concern especially in women. They tend to get larger with age as volume is lost in the hand and also due to hereditary factors. If the vein is large enough to accommodate a laser fiber then it can be lasered just as we do the saphenous vein in the leg. The smaller hand veins are then treated with sclerotherapy. The results are cosmetically very acceptable with minimum discomfort and down time.
Vein removal and hand rejuvenation
Radiesse is a wonderful filler for the back of the hands to reduce boniness of the dorsal hand. Vein removal is a less suitable, but available, option.
Treatment for hands
In this case, I would consider using Radiesse for the backs of the hands. Radiesse is a great way to add volume between the vessels, resulting in a youthful appearance of the hands.
Sclerotherapy of hand veins can be safe and effective when the appropriate technique, sclerosing agent, and sclerosing concentration are used. Treatment is sometimes not necessary if appropriate hand volume restoration is achieved, rendering prominent hand veins imperceptible. I like to use either radiesse or autologous fat to revolumize the back of the hands when indicated.
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