Prominent under eye veins - what treatment will get me effective results? (photos)

Question

Are there any treatment options for veins close to the eye area? I’m extremely self conscious of these veins. I’ve been told undereye PRP injections, RF ablation and microneedling will help. I’ve tried them all to no avail. Is there anything that can be used this close to the eye that will actually be effective?

Randal Haworth, MD, FACS · Answer

When it comes to veins close to the eye area, it's important to exercise caution and seek advice from a qualified healthcare professional, such as a dermatologist or a vascular specialist. They can evaluate your specific situation and recommend appropriate treatment options. Here are a few possibilities that may be considered:

-Laser therapy: Certain types of laser treatments, such as laser vein therapy or intense pulsed light (IPL), can be used to target and reduce the appearance of visible veins. These treatments work by selectively heating and destroying the targeted veins while minimizing damage to the surrounding tissues.

-Sclerotherapy: This treatment involves the injection of a sclerosing solution into the veins, causing them to collapse and fade over time. Sclerotherapy is commonly used for larger veins but may not be suitable for very delicate or small veins near the eye area due to the risk of potential complications.

-Surgical options: In some cases, surgical removal or ligation of the veins may be necessary if other treatment methods are not effective or appropriate. This approach requires careful consideration and should only be performed by a skilled surgeon.

It's important to note that the effectiveness and suitability of each treatment option can vary depending on the size, location, and nature of the veins, as well as individual factors. Additionally, treatment results may vary, and multiple sessions may be required for optimal outcomes.

I hope this helps,
best of luck !

Mahmood Siddique, DO · Answer

Prominent under-eye veins can be challenging to treat, but there are effective options beyond PRP, RF, and microneedling, which generally don’t target veins directly.
The most effective treatments include:
Laser therapy (e.g., 532 nm KTP or 1064 nm Nd:YAG lasers) &mdash; These can selectively target and shrink superficial veins. They’re commonly used for facial veins and can be performed carefully around the eye by an experienced provider.
Sclerotherapy &mdash; Less commonly used in this area due to proximity to the eye, but sometimes considered for certain vein patterns.
Camouflage options &mdash; While not a treatment, medical-grade concealers can help if you want a non-procedural approach.
Since the under-eye area is delicate, it’s important to consult with a provider highly experienced in treating periorbital veins. Laser is typically considered the most effective and safest option when performed properly.

Barbara Padilla, MD · Answer

Thank you for your question! At our practice we use the Excel V laser to treat periorbital veins. As long as the vein is over a bony area then the laser may be used.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

E. Victor Ross, MD · Answer

Normally the best and only way to treat that type of vein is using a long pulsed Nd YAG laser. It must be done carefully and typically we would need to put an eye shield over your eye during the case. It is quite simple and there should be little downtime with exception of some mild swelling.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your questions and posting your photographs. The only procedure that I’ve seen work for the larger veins is injection of a sclerosing agent directly into the vein which then closes it. See an experienced vascular surgeon for proper guidance and treatment. 
Good luck,

Jason Emer, MD · Answer

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer​​​​

Amir Bajoghli, MD · Answer

Dear SkinconsciousAUS,We have been treating these under eye veins with a long pulse Nd-YAG (Gentle YAG is one brand) laser for over two decades with excellent results. The treatment takes less than 3 minutes, it's usually one or two sessions and very safe in your skin type. The laser specifically targets the vessels without causing collateral damage. The results last for several years with a very low chance of recurrence. Best regards,Skin & Laser DermatologyMclean, VA

Vincent Gardner, MD · Answer

You basically have three options. Laser treatment, sclerotherapy and microphlebectomy. All can be effective and have pros and cons. Laser treatment may require multiple sessions and can be painful because the energy has to be increased because these veins are larger than a spider vein. Also effectiveness depends on the wavelength of the laser being used. Sclerotherapy can also be very effective. It can also require multiple treatments. Lastly, microphlebectomy usually only requires one treatment, but you have to make a small puncture to access the vein, which may leave a small visible scar. Discuss all these options with your provider and find out which is best for you. M

Khalil Khatri, MD · Answer

For smaller periorbital veins, we typically recommend sclerotherapy as the safest and most effective method of therapy. Using a very tiny micro needle, we inject a solution directly into the veins to fade away over time.

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