29 year old woman with big veins on hands, help! (Photo)

Sclerotherapy and fillers are both acceptable options for improving the appearance of hand veins.  I would say however that filler or fat grafting to the hand to hide the appearance of the veins is better because you can then preserve those veins if need later in life for IV access. 

Hand sclerotherapy can be done but often those veins are needed later in life for IVs so we typically camouflage the veins with fillers.  I suggest a formal consultation with an expert. Best, Dr. Emer

Thank you for your photos. A dermal filler like Radiesse is a great option to improve the appearance of your hand. Radiesse can also be used to fill in the hollows or sunken areas of your hands to renew a healthy and rejuvenated look there as well. It will also help hide prominent veins or tendons that may be visible in the back of your hands, giving you the youthful look that you desire. For more information, please make sure you get a in person consultation from a board-certified dermatologist. 

When discussing hand veins, please bear in mind that these are not abnormal veins, and there is always a consideration to leave normal veins alone, as you may require them down the road for IV access. But if the aesthetic appearance is that upsetting to you, they can most certainly be treated. There are 2 main approaches to treating hand veins - one is to treat the veins themselves, and the other is to use dermal filler to restore lost soft tissue volume to better "hide" the veins. In your case, there does not appear to be a loss of soft tissue volume so I do not believe the use of fillers would be warranted for you. There are also multiple options to treat the veins themselves. The simplest approach is to use injection sclerotherapy, which can take multiple sessions over time. More invasive options would include laser closure, or simple removal by microphlebectomy, where the veins are removed through tiny needlestick incisions under local anesthesia. You should be seen by an experienced vein specialist who has multiple treatment options available and can help you determine which is best for you.

I have found that the combination of sclerotherapy (injecting hand veins) and filler gives the best results for issues such as yours. That way, we reduce the size of the vein, and then fill in the area around it to further minimize its appearance. 

All the best,
Dr. Friedmann