Blue Veins Above and Under Eyes? (photo)

Question

Is there treatment for these blue veins that run above and under my eyes. I have had laser treatment done before on these veins, with little improvement.

Sabrina Fabi, MD · Answer

I prefer to use the long-pulsed Nd:YAG with cryogen cooling, which allows one to use effective energy settings to treat the vein, while protecting the skin. Depending on the laser and settings used, a treatment could possibly not be as effective. I would see a board-certified dermatologist with a larger laser practice, who can customize the treatment your skin type and problem, with the appropriate laser.

Brian S. Biesman, MD · Answer

Blue veins on the eyelids typically respond extremely well to laser therapy. I treat this condition frequently and find that 1-3 treatments are typically required to achieve best outcomes depending on the size and location of the veins. I do not believe there is a role for IPL in the treatment of these vessels for reasons of both safety and practicality. Sclerotherapy is preferred by some physicians but concerns have been raised about injecting into blood vessels that drain behind the eye on account of the potential complications that could result. Due to the delicate nature of the eyelids and eyebrows and the proximity of the treatment area to the eye itself, laser treatment of blue veins in the eyelids should only be performed by someone with a great deal of skill and experience. Do not hesitate to ask your physician how many patients with a similar condition they have treated previously. .

Hratch Karamanoukian, MD, FACS · Answer

Since laser treatment has not been successful in your case, I recommend that you see someone who has expertise with sclerotherapy.I use sclerotherapy for such veins and have had significant success in treating them. The key is someone who is versed with using more than one technology - we have RF, Ohmic thermolysis, long pulse Nd YAG laser, sclerotherapy and microphlebectomy in our arsenal of treatment options for periorbital veins and use them selectively depending on size, location, depth ... Rarely do I use microphlebectomy for UPPER eyelid veins.

John Landi, MD · Answer

This is a commonly asked question and there are many options to treat these veins including laser, micro needle radio frequency, pulsed light and sclerotherapy. Since laser was unsuccessful, you may want to try fine needle radio frequency (Ellman, VeinWave or VeinGogh). I have been most successful with both sclerotherapy using a very fine needle and the Ellman micro needle radio frequency. Both of these procedures should be done by someone with experience performing them.

Jeffrey C. Poole, MD - Account Suspended · Answer

Be very careful in treating veins in this area.  You MUST use and intraocular eyeshield (between the lids and the eyeball) or you run the risk of significant eye injury.  Also, I would not recommend sclerotherapy in this area--- the risk to the skin or eye is far to great.

	Laser would be the best potential option--- what laser was used?  The Pulsed Dye laser (such as the V-Beam) may work for the thinner, redder vessels.  My preferred laser would be the long pulsed Nd:Yag (such as the GentleYag).  It may require a number of sessions, as I would prefer to "under treat" and increase energy level with subsequent treatments if needed, as opposed to "over treat" and risk blister, skin break down or scarring.

Blue Veins Above and Under Eyes? (photo)

Answers (5)

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