I have large visible veins under the eye area and I am so confused on the best treatment to make them less visible? (Photos)

Under eye veins can vary in caliber and length, ranging from bluish varicose veins to light red spider veins. The treatment of larger varicose veins is very specialized and I have demonstrated my technique on the Doctors television show which can be found online. Treatment includes surgical removal with initiation of a skin brightening regimen to optimize skin thickness and collagen content.



Associated dark pigmentation on the lower eyelid skin can be due to melasma, bluish veins, hemosiderin deposits, and hyperpigmentation. 



Topical regimens include:



MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream


Additional therapies for undereye rejuvenation include fractional laser, fractional RF, Covalent peels, and LED microneedling with Replenish serum. The video demonstrates an analysis of varicose veins.



Best, 

Dr. Karamanoukian

Realself100 Surgeon

As you have been advised, there are various was of treating these type of veins.  The most commonly used and safest method however would be the use of laser; this however can sometimes take several sessions to work.  Sclerotherapy is also an acceptable method if laser by itself does not work and often can be combined with laser for more resistant veins with good results.  I would not recommend micro-phlebectomy or cutting out of these veins. Make sure you see an experienced vein specialist.

Infraorbital facial veins such as these are very common, and are best treated very easily by superficial or topical laser. Treatment generally requires several sessions, although sometimes we are fortunate, and a single session will do. If the laser does not resolve the veins, they can be treated by injection sclerotherapy, but we prefer to reserve this as a final treatment option, particularly around the eyes. However, not just any laser will be effective, so you should be seen by an experienced vein specialist, who will use the right energy type for veins and not just treat your skin.

The treatment that we recommend for our patients with veins on your area of concern would be to use laser therapy. Treatment of facial veins with laser therapy requires a highly skilled doctor because arteries and veins run very closely together and there is a risk of complication. 
It is very important that you are evaluated first prior to any treatment(s) by a board certified provider to be certain that this is a treatable vein.

I would treat the posted vein with a combination of sclerotherapy to obliterate the vein from the inside and topical RF to treat the vein from the outside.  This combination works well.  I would not recommend microphlebectomy.  See a vein specialist.