I am 38 with very pronounced veins in my hands and arms. Is there anything I can do to make them less pronounced? (Photo)

Although treating hand veins is one of the most enjoyable things that I do in my practice, I would be cautious about treating yours. The enlarged veins overlying your fingers and forearm, despite being of relatively normal weight for your height (and not extremely thin), may imply that there is an issue with blood drainage from your hand. In fact, one of the possible (albeit rare) side effects of sclerotherapy of hand veins is compensatory enlargement of finger and forearm veins, often because the other deeper veins of the hand that should have then taken over the process of draining blood from that area were not working well to begin with. Treating these veins may therefore lead to real (not just cosmetic) problems. If you understood the risks of treatment and still wished to proceed, I would recommend VERY gradual treatment (only one vein at a time), with the smallest and most distal veins first. I hope that this helps. 

Thank you for the question! Treating this particular area requires a great deal of finesse so I would recommend doing your research go to with an experienced board-certified specialist. Sclerotherapy remains the treatment of choice when treating superficial veins on toes. It uses a sclerosing solution that causes the vein to shrink. Usually it takes only 1 to 2 sessions to achieve fading of the undesirable veins.  
An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and obtain expert medical advice. Best of luck!

These veins are routinely treated as cosmetic adjunct procedures, mostly for patients who have had 'other cosmetic surgery' and the hand veins 'give their age away' - or in someone like you who is young, lean and has little body fat and the veins are more prominent. Combination of sclerotherapy, sometimes microphlebectomy and laser therapy (EVLT) can treat these. Again, they are cosmetic and not covered my medical insurance. 

Many patients do not like the look of their veins in their hands.  I can treat the veins in the hand and arm with sclerotherapy.  First, I must evaluate the patient and decide if sclerotherapy is an option for you.

I see women every week with hand veins that look jjust like yours. The treatment of these veins is actually quite easy. I use a combination of laser therapy for the big veins and sclerotherapy for the smaller veins.The results are very cosmetically acceptable and the things to remember are that it may take several treatments to get to the end result and that this is purely a cosmetic procedure.