What are my options in treating this under eye vein? (Photo)

Under eye veins can vary in caliber and length, ranging from bluish varicose veins to light red spider veins. The treatment of larger varicose veins is very specialized and I have demonstrated my technique on the Doctors television show which can be found online. Treatment includes surgical removal with initiation of a skin brightening regimen to optimize skin thickness and collagen content.

Associated dark pigmentation on the lower eyelid skin can be due to melasma, bluish veins, hemosiderin deposits, and hyperpigmentation. 

Topical regimens include:

MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Additional therapies for undereye rejuvenation include fractional laser, fractional RF, Covalent peels, and LED microneedling with Replenish serum. The video demonstrates an analysis of varicose veins.

Best, 

Dr. Karamanoukian

Realself100 Surgeon

I would treat these veins with either sclerotherapy or topical Rf with the Ellman surgitron.  Often times I do a combination of both.  The sclerotherapy get the vein from the inside and the Ellman from the outside.

The options include either laser of sclerotherapy. At that location, laser is an option and usually causes a bit less bruising. 

Hi!
Laser is definitely the best treatment choice. You want to be certain to go to a well trained board certified dermatologist that is well versed in laser technology. I perform this treatment in my office often, it takes about 10 min, and the vein is gone after on treatment. I use a long pulsed Nd:YAG laser. 

Facial veins such as this are best treated with topical or superficial laser, and they tend to respond very well, typically with just a few treatments. Sometimes, if we are fortunate, they may resolve with a single session only. If the laser does not resolve them, they can be treated with injection sclerotherapy, but we prefer to avoid this whenever possible, particularly right around the eye. You should see an experienced vein specialist to ensure that the correct type of laser is being used to treat your veins, and not just the skin.

The treatment that we recommend for our patients with veins on your area of concern would be to use laser therapy. Treatment of facial veins with laser therapy requires a highly skilled doctor because arteries and veins run very closely together and there is a risk of complication. 
It is very important that you are evaluated first, prior to any treatment(s), to be certain that this is a treatable vein.Thank you for your question!

For veins like yours I like to use sclerotherapy.  It is safe and has good results.  I will also use microneedle RF for very small veins or broken capillaries.Lasers can do very well, but need someone with good experience to treat, but avoid burns.Good luck to you,Dr. Powell