Treat Bulging Vessels on Hands

In this case, I would consider using Radiesse for the backs of the hands.  Radiesse is a great way to add volume between the vessels, resulting in a youthful appearance of the hands.  

Radiesse is a wonderful filler for the back of the hands to reduce boniness of the dorsal hand.  Vein removal is a less suitable, but available, option. 

Sclerotherapy of hand veins can be safe and effective when the appropriate technique, sclerosing agent, and sclerosing concentration are used. Treatment is sometimes not necessary if appropriate hand volume restoration is achieved, rendering prominent hand veins imperceptible.  I like to use either radiesse or autologous fat to revolumize the back of the hands when indicated.

There seems to be two suggestions from the panel - sclerotherapy and some form of hyaluronic acid (HA) injections and we fall in the camp that uses HA based dermal fillers. While we will not say which method is better, we can say that our patients that have undergone hand rejuvenation with dermal fillers are very happy with the procedures. The results are dramatic and immediate and the treatment is very easy.

Even if your face looks great, bulging blood vessels and prominent stringy-looking tendons on the back of your hands can betray your age. Sure, you could fade brown spots and remove small growths from the hands, but up to not that long ago, there was little that could be done to otherwise improve them. Happily nowadays that's no longer true.

The safest and most effective means in my opinion is to revolumize the backs of the hands, i.e. to restore the volume lost over time mostly due to wasting away of the fatty tissue that once masked the underlying veins and tendons.

Bulky hyaluronic volumizing materials, such as Juverderm Ultra Plus and Perlane have been used successfully to accomplish this. However, my favorite material for replenishing lost volume in the hands and for achieving a smooth and even result is Radiesse.

Radiesse is composed of calcium hydroxylapatite, a bone-like material that provides more volume per syringe and lasts considerably longer in this location than its hyaluronic acid counterparts.

The procedure is actually quite simple. A mixture of Radiesse and a bit of lidocaine (a local numbing agent) is injected between the tendony spaces on the backs of the hands and then literally molded like clay into place.

The masking effect of the Radiesse, i.e. it's effect upon masking the underlying bulging blood vessels and tendons is quite immediate. In addition, the restoration of volume underneath inflates somewhat the overlying skin surface and smoothes out some of the crinkling, as well.

I am not a big fan of sclerotherapy as a treatment for rejuvenating the hands. Sclerotherapy is the injection of an irritating solution directly into the blood vessels to irritate their lining, a process that lead to scarring and permanently shrinking and closing them off.

True, this approach will eliminate the appearance of the blue bulges on skin surface. However, at the same time it forever diminishes the number of blood vessels available for use later in life for intravenous therapy and blood sampling should these needs ever arise.

I find revolumizing the backs of the hands to be sufficient to camouflage the blood vessels and significantly improve and rejuvenate the overall appearance without the need to destroy the blood vessels.

The 3 procedures used are sclerotherapy, phlebectomy (removal trough tiny incisions) and fillers. They can be used in combination or one after the other. If your veins are really large, Radiesse will not cover them and sclerotherapy is not effective enough and will leave you with lumps for weeks. Phlebectomy is then the better option. For mild to moderate veins, sclero and then Radiesse 1 month later is perfect. 
 I treat veins everyday in Australia and was taught how to remove hand veins by Dr Bush from Florida. Very easy procedure. 

Thank you for the question! Currently sclerotherapy is the treatment of choice when treating enlarged and bulging veins. 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. Another minimally-invasive treatment option is Radiesse, an injectable filler that will reduce the appearance of prominent veins on your hand.
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! 
 

There are two treatment options that are available, sclerotherapy or fillers. Sclerotherapy will rid of the vein whereas a filler will plump up the skin around the vein so that it is not as visible. 

Thank you for your question. In my opinion, fillers and fat transfer work better than sclerotherapy to hide veins on the dorsum of the hand.
I hope this helps. Best wishes. Dr. Salameh (Plastic surgeon - Bowling Green, KY)

Hello,
While injection sclerotherapy with multiple different materials has been performed for veins on the hands since the mid 1950's by a limited number of doctors and more widely accepted and performed since the 1980's by others, it is in my humble opinion, somewhat unwise. Someday you are likely to need these veins for your medical care (inserting an "IV"). Don't underestimate the great importance of these "unattractive nuisances". Right now they can be somewhat camouflaged by injections of fat and fillers to enlarge the space between the veins and the skin surface. Until the day that blood tests and IV's are no longer needed, I would proceed with caution about minimizing those immensely useful veins!  Hope this helped!
Dr. S