How can I reduce the appearance of bulging viens on my hands? (photos)

Question

I am an athlete and 35.. the viens on my hands and forearms bulge a lot. My hands look like I'm 100 years old. I'm interested in a treatment that can reduce their promenance and bring them more in line with my age. Interesed in doctors recommendations. Thank you very much.

Andres Zavala, DO · Answer

Dorsal hand veins or veins on the back of the hand become more visible as we age due to volume loss (fat loss) around them that causes them to appear larger along with tendons and other visible hand structures. The veins are not abnormal or diseased veins and this is very common, especially in thin individuals. If you really dislike them, they can be treated with sclerotherapy to get rid of them.  A better option in my opinion would be to use either fillers or fat grafting from another site to plump up the hands, this not only hides the veins but preserves them and also gives the appearance of even younger hands since younger persons generally have more volume.

Raffy Karamanoukian, MD, FACS · Answer

Laser therapy has evolved to address small and medium sized abnormal veins. In fact, endovenous laser therapy is useful for the management of varicose-vein associated venous insufficiency. Sclerotherapy using foam sclerosants are ideal for the treatment of minimally-refluxing varicosities and reticular veins. In our office, we combine these less-invasive modalities with microphlebectomy and vein surgery in order to minimize scarring and remove unsightly varicosities.

Dr. Karamanoukian
Realself100 Surgeon

Dr. Karamanoukian
Realself100 Surgeon

Craig Schwartz, DO · Answer

There are several treatment options for hand veins, but first you need to understand that these veins, by definition, are not abnormal, they are just more visible, most commonly due to soft tissue volume loss on the back of the hand. If you are determined to have them treated, options include injection sclerotherapy, where a chemical is injected into the veins to get them to shrink down over time. This approach is the least invasive and simplest, but will likely require multiple sessions over time. Another option is a limited phlebectomy, or micro-incisional resection, where the veins are removed through tiny, needlestick incisions. This approach is somewhat more invasive, but is a one-time procedure, with very short recovery period. The most invasive approach would be to perform limited laser ablation of the veins. This is also a one-time procedure, but will have a bit longer recovery. An alternative approach is to leave the veins alone, and simply restore the lost soft tissue volume by injecting dermal fillers, such as Radiesse. you should see an experienced vein specialist, who has all the various options available, and can help determine which is best for you.

Gabriel Goren, MD · Answer

Your age is much too young for having bulging protruding veinson the dorsal side of your hands. However,  since you are in physical fitness and possibly doing weight lifting or push-ups, it can happen at your age too. I imagine being fit you have a healthy low percentage of body fat meaning that the layer of fat pad ( we all have) in your hands is low as well thus the veins bulge even more.Generally speaking, I see this condition much later in life the reasons being thinning (atrophy) of the skin as well as the already mentioned disappearing fat pad that this time, coming with the maturity that is inevitable; of course, flaunting, showing it is optional.There are three ways to take care of the condition. One is to use fillers, artificial ones, (Restylane, Juvederm,Sculptra, etc. etc.) or own fat transfers harvested by liposuction. Both will do nothing to the bulging veins, just puff up your hands in kind of make-believe, veins still there, less visible. The fat fillers will last longer, the artificial will need to be frequently repeated, and they are not inexpensive. 
Only two procedure target the veins directly. One is sclerotherapy, either chemical (liquid or foam) or heat ( laser) and the other removal of the bulging veins. I will not dwell on injections or heat; in both several sessions are needed weeks apart thus the convalescence is much too long, the results are questionable, many times not long lasting, skin pigmentation and distant deep ( arm) veins  blood clots (especially after injections) could be unpleasant complications.Personally, I prefer to remove the veins. The procedure, "Rejuvanad," is a minimally invasive method, done in the office, both hands in the same session and in local anesthesia. No convalescence is needed, all my patients drive away if they have not requested a tranquilizer. The method is similar to the ambulatory phlebectomy I use for leg's varicose veins since 1989 (over 4000 cases) with excellent results.Through tiny entry points not more than 2 mm (1/16 of an inch) with the help of specially designed hooks the bulging veins are removed in entirety. No stitches are needed and the results are remarkable, indeed.In over 500 procedures of the kind, I have seen only one patient with recurrence. She was young, also an athletic; lifting weights, push-ups, you name it. I have certainly redone her (that was two years ago), and so far I have not seen her back, but I am sure I will. Based on this statistic I consider "Rejuvahand" the best and ONLY available permanent solution. Back to your specific case, not examining and talking to you, being young and an athlete, I would caution you if you can't change your athletic routine. Of course, the procedure can be done; you will be pleased with the immediate results, but you have to take in consideration that you are exposing yourself to early recurrences.

Bruce E. Katz, MD · Answer

Thank you for your question. Sclerotherapy is one option to treat your veins. Sclerotherapy treatment involves an injection of a chemical that will cause your vein to contract and become scarred internally. The vein will disappear from your body after some time. Generally, it takes about 8-10 weeks for the vein to disappear. You could also try dermal fillers such as Radiesse to help plump the hands. For more information, I recommend getting a in person consultation from a board-certified dermatologist.

Gary Nackman, MD, FACS · Answer

Prominent hand veins are a frequent complaint.  In most people, the skin of the back of the hand thins as we age, leaving the veins and tendons more visible.  Treatment can address both issues. Sclerotherapy can be used to eliminate the veins. Fillers, such as Radiesse can be used to "plump" the hand.

J. Daniel Jensen, MD · Answer

Another option for disguising hand veins is to use fillers, such as Radiesse, which are indicated for treatment of the backs of the hands. You are young and don't have much volume loss on your hands, but this would be a simple option.

John Landi, MD · Answer

Hand vein treatment is a large part of my practice.  I treat these veins with sclerotherapy, endovenous laser and, more commonly, a combination of both.  The results are cosmetically very acceptable with high patient satisfaction. The procedure is done in the office under local anesthesia with minimum down time. You should be able to find a physician near you who treats hand veins.

How can I reduce the appearance of bulging viens on my hands? (photos)

Answers (8)

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