Can Sclerotherapy Treat Facial Veins?

Is facial sclerotherapy a good treatment for a large vein under the eye (not spider veins)?

Doctor Answers 21

Sclerotherapy works great for periorbital vessels!

This is an area of the face which rightfully provokes much anxiety and concern. Injecting medicine into blood vessels around the eye? Couldn't that cause blindness?

Realizing that the anatomy of the periorbital tissues is separate and distinct from the eye is the first factor to consider. Sclerotherapy works wonderfully for vessels that are the proper size for this technique (small, like spider veins on your leg, but big enough to get a 30 gauge needle into). This includes facial or periorbital veins. Though some of my colleagues express concern about risks around the eye, this is generally because of lack of experience with sclerotherapy in this area, and naturally recommending a laser or procedure that falls within their own training.

I have done sclerotherapy for 30 years, and was extremely cautious when I first injected vessels around the eye. I can happily tell you that this is not only possible, but works quite nicely, just as with leg spider veins! The key difference with facial or periorbital vessels in particular is that they are somewhat more difficult to immobilize and accurately stick the needle into. Once that is accomplished, however, the vessel is gone. I have taught laser surgery for over 20 years, and can tell you that lasers work best only for the extremely tiny vessels of rosacea, port wine stain, or sun damage, and would not be applicable for larger vessels like you are describing.

Suture or stripping techniques are "overkill" in my opinion, though certainly effective, more costly, and leaving tiny but more noticeable scars than sclerotherapy.


Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Laser best for facial veins

Sclerotherapy is generally not a good treatment option for facial veins.  The risk of skin damage (ulcer, scar) or damage to surrounding structures (such as the eye!) is too great.

Lasers are my treatment of choice for facial veins.  For the deeper, larger, bluer veins, I find the long-pulsed Nd:Yag laser (1064nm) the best treatment, though a long-pulsed Alexandrite laser (755nm) is also quite effective in lighter skin types. 

Be sure you have proper eye protection in this area!  Some veins that are close to the eye may require a metal shield be placed between the skin and the eye to avoid eye damage.

Jeffrey C. Poole, MD
Metairie Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Sclerotherapy safe for facial veins.

There has been controversy between different specialties regarding the treatment of facial veins with sclerotherapy.  Sclerotherapy is very safe and works very well on facial veins.  With the newer sclerotherapy agents and smaller available sclerotherapy needles, injecting facial veins can be done quite easily with excellent results.  The most important factor in facial sclerotherapy is the experience and training of the physician doing the injections.  I have been doing facial vein sclerotherapy for years and I and the patients have been very pleased with the results.  If a vein is larger enough to accommodate the needle then it can usually  be treated with sclerotherapy.  The smallest of veins are treated with laser or micro needle radio frequency.

John Landi, MD
Naples General Surgeon
5.0 out of 5 stars 5 reviews

Yes, but...

the physician should not use a "foam" solution for this, rather just the liquid version of the same sclerosant.

i prefer to use an Nd:YAG laser for peri-orbital veins, this seems to work well in the right patient with no side-effects.

Cheers

Craig Crippen, MD
Kelowna Physician

Sclerotherapy is not recommended for the face

Depending on the size of the vessel and the color, there are at least 3 different lasers that I would consider using. The problem with sclerotherapy around the eye is that the the product that is being injected can cause vision loss or blindness, and this has been reported in the medical literature.

Care must be taken when using lasers around the eyes as well, but this is why it is extremely important that you go to a dermatology or plastic surgery office that specializes in these procedures. The physician should be performing the treatment and not deligating the procedure to someone else in his office (i.e. nurse, PA, technician).

Research the physician for Board certification and specialty and best of luck to you.

William Groff, DO
San Diego Dermatologist
4.8 out of 5 stars 46 reviews

Not the right treatment for the eyes unfortunately...

Hello,

While it may sound like it would be a good solution, treatment for veins under the eye should not be done by injection, as the risk of destructive chemicals entering the eye and causing blindness or even death is a remote, but very serious risk. Long pulse Nd:YAG lasers have been used with some success, but ONLY in the hands of the most experienced laser practitioners. In my experience using these devices (since 2002), extreme caution needs to be exercised in choosing the right veins in the right patient situations. This is always done on a patient by patient basis. My recommendation is to seek a highly experienced practitioner who is skilled in using lasers to treat the delicate eye area. Hope this information helped!

Dr. S

Bruce Saal, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Facial Veins

Ms Eva,

Thanks for your question. I too, have found great success with the long pulse Nd:YAG laser to treat various facial veins.  It works particularly well with the prominent ones around the eyes in people that have very thins skin and prominent blue veins. Try to find a practice that has experience in this area for your best results.  Good Luck.

Paul E. Goco, MD
Nashville Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Facial Veins

Sclerotherapy is the gold standard for treating spider and varicose veins on the legs, but it is not recommended for use on the face. A much better solution to get rid of your undereye vein is a specialized laser such as the CoolTouch Varia which can safely and effectively remove the vein without the risk of ulceration or blindness which is posed by sclerotherapy to the face. Lasers of course carry their own risks, but when performed by an experienced, board-certified dermatologist, these risks are significantly minimized and the end results tend to be very good. I recommend visiting a board-certified dermatologist for a consultation to determine which laser is best for your particular case.

Robert A. Weiss, MD
Baltimore Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Periorbital Reticular Veins

Perioribital reticular veins are best treated with a Nd:Yag laser. repeat treatments are necessary. Reocurrances may occur.

Gail Nield, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 6 reviews

Best Treatment for Facial Face Veins - Sclerotherapy, Laser / Thermocoagulation

The answer to your question is Yes, it is a possibility, but NO I would not recommend it.  Injection of veins on the face are associated with a much higher risk of complications due to the sensitive location.  The blood vessels around the eye are particularly high risk for sclerotherapy treatment.  I would stay away from sclerotherapy in this region.  My recommendation for smaller spider vein treatments around the eyes or face is either thermocoagulation with a laser or thermolysis device, such as the Veinwave or VeinGogh device, which has received FDA approval for these types of veins.  Special eye protection is used during these treatment to avoid any damage to the eye or retina.  If the vein is indeed larger than spider veins (as you describe) then your best option is probably a minor plastic surgical procedure known as microphlebecomty, in which the vein is surgically removed through a micro-incision in the skin overlying the vein.

 

I hope this information was useful.

Joel Gotvald, MD, FACS
Austin Vascular Surgeon
5.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.