Treat Bulging Vessels on Hands

I have these bulging blood vessels of the backs of my hands that I really don't like. What can be done about them? Can I have them injected with sclerotherapy? Is it safe to do so?

Doctor Answers 22

Disguising vessels on the hands

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Before you go so far as to render the large veins on the backs of the hands unusable, I would consider doing a filler like Radiesse for the backs of the hands to disguise the veins and tendons we see most commonly. We have had excellent results and patients are very pleased and don't compromise their circulation.


Sclerotherapy on hands

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Sclerotherapy injection is a great way to improve the appearance of bulging veins on the hands. Sotradecol is a choice agent for sclerotherapy on the hands. The hands are elevated slightly during treatment and afterwards the hands are wrapped with gauze and elastic bandage to keep pressure on the treated veins. Often the hands are swollen and red in the areas treated for several days after sclerotherapy. Somtimes at about 2 weeks after injection, we will have the patient return to drain any clots that have formed in the superficial veins. This speeds healing and reduces discomfort.

Vessels on Hands

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We now offer Radiesse filler in the back of the hands. It's the first FDA- approved treatment that makes the veins on the back of the hands disappear. This new treatment firms and plumps the thinned skin, making the veins go beneath the surface. This simple procedure makes the hands look years younger. It's painless and has no recovery time. Results are immediate and simply amazing!

Considering Radiesse

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Radiesse may be a good option for your concerns. As always it is best to consult your plastic surgeon, but many patients see results treating the visibility of veins and tendons in hands with the non-invasive procedure of Radiesse injections. The procedure can take as little as 15 minutes. 

Treatment for hands

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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.  

Sclerotherapy for hand veins or microphlebectomy or Fillers ?

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  • Polidocanol, 0.5% - 1%
  • Sodium tetradecyl sulfate 0.2% - 0.5%
  • Saline and dextrsoe (Sclerodex)
  • Hypertonic saline
  • Glycerin

All of these are used for sclerotherapy with varying success. They each have advantages and disadvantages.

I recommend microphlebectomy if they are large. I recommend sclerotherapy if they are intermediate in size. I recmmend Radiesse to hide them if they are small. 

Sclerotherapy is best option

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What a coincidence that I was sent this question by! I am doing the lecture at the upcoming meeting of the Amercian Academy of Dermatology on the subject of sclerotherapy of the hands.

This is a very safe option when performed by an experienced dermatologist or plastic surgeon. There are precautions and a few contraindications (such as previous lymphatic surgery in the arm for breast cancer), but your doctor can discuss the details at consult. Another option is to inject filler (Radiesse is excellent) and that procedures plumps the skin over the veins and the don't show through as much. My website has some examples of results.

Hand veins

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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. 

Treating bulging vessels on hands

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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)

Large Veins Can Come In Handy One Day! :)

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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

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.