How Can Large Veins Under the Eyes Be Treated?
Doctor Answers 8
Fillers are a better option than lasers to reduce under eye veins
Large veins under the eye are an annoying look that many people would like to correct. However, the problem is difficult. Traditional methods of making large veins disappear are often more risky that they first appear- with both sclerotherapy (injection of solution in unwanted leg veins) and with lasers, there is a small but real risk that large veins could send a small clot or embolus to the retinal veins and cause serious eye problems. Although this is a rare side effect, it deters most physicians from offering this type of treatment for large veins under the eyes. Another approach that is safer is the use of filler injections, like Restylane, to act as an in between layer between the vein and the areas of lost volume in the "tear trough area" which can help obsure the bluish color and fill in the volume in these sunken in type areas. For other areas on the face, there are several very good vascular lasers that can be used away from the eyes to reduce red vessels (arterioles) and purple vessels (venules). Some of the better lasers for vessels on the face include the Versapulse and the V Beam laser.
Treating Under Eye Veins
The skin under your eyes is the most delicate of anywhere in the body. Because it is very thin and prone to damage, it’s very common to develop noticeable veins in the area earlier than other place on the body, like the legs. As a board certified dermatologist and laser vein treatment specialist, I often use the CoolTouch Varia to remove unwanted facial spider veins for my patients. The treatment is completely non-invasive and provides excellent results.
Dangers in treating veins around eyes
I agree with other surgeons/physicians in NOT treating veins around eyes with lasers. Even with metal corneal protection shields, the angle for treatment of these veins, and well as the variable depth of penetration of lasers on thin skin, make them particularly hazardous. In addition, sclerotherapy can also be dangerous as the variable venous drainage anatomy may cause retinal vein thrombosis, or worse yet, intracranial extension. I do believe that micro, micro phlebectomy would be the best treatment if the vein is close to the eyes. :)
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Veins around the eye
You need to treat these veins with a great deal of respect. Typically improvements for large visible veins require lower lid bepharoplasty. Injecting these veins can cause very serious complications.
Have a complete evaluation by a board certified plastic surgeon or oculoplastic surgeon.
I hope this helps.
Lower Eyelid Varicose Veins; Spider Veins - Laser Treatment
The lower eyelids have a very thin dermis and are prone to early atrophy, development of visible varicose and spider veins, and accumulation of hemosiderin or melanin deposits.
I am frequently asked to treat patients with varicose and spider veins in the lower eyelid. Although the skin of the lower eyelid heals well, I generally do not advise laser treatment for larger and blue varicose veins. The problem is that the overlying skin may hyperpigment, and more importantly, may burn.
Sclerosants are typically not recommended in this area because of the small risk of embolization.
The preferred treatment is laser for smaller capillaries, telangiectasia, and veins. For larger veins, I would advise selective surgical excision of the vein under local anesthesia.
Large veins do not respond well to lasers
There is a delicate procedure where the veins can be directly excised. This seems to have the best effect for the veins themselves. Lasers do not work well for large veins. When the laser is turned up high enough to ablate larger veins, the overlying skin often gets burned.
Often, veins appear because of hollowness under the eyes and drooping of the cheek. In our practice, we often treat this with a LUSIC cheeklift, a limited incision cheeklift with grafts of the patient's tissues to the hollow regions. Often this reduces the appearance of hollowness and veins.
Hypertonic saline or sclerotic agents are not recommended for this area since it drains into the cavernous sinus of the brain, and an injection could potentially cause cavernous sinus thrombosis, a potentially fatal condition, or embolization to the opthalmic vein, causing blindness.
Large under eye veins can be excised
Veins in the area of the eyes, especially lower eyelids can be excised with a tiny puncture wound with excellent cosmetic results. Hardly ever is this wound apparent after it is healed. Phlebologists who deal with vein problems do not recommend that sclersant solutions be placed in these veins because they are associated with rare but significant complications from thrombosis extension into the brain.