Our Blog

Treatment of Hand Veins

Many patients have asked about treatment of hand veins.  From a cosmetic perspective, the veins on the back of your hands can seem to be bulging out and give the appearance of a problem.  Most commonly, women report that their hands make them look a lot older than they feel.  There are basically 3 types of treatment for hand veins, with advantages and disadvantages associated with all.  I will explain these in the following paragraphs so that if your hand veins are bothering you, you can make an informed decision on treatment.

Unlike veins in the legs, hand veins sustain a lot more motion and mild trauma.  In other words, we actively use our hands much more than our legs.  In addition, there is an anatomical difference in the hands whereby the veins in the back of the hand (dorsum) connect to the veins on the palm of the hand, via the ‘palmer arch’, or to the deeper veins in the hand.

The shortest lasting and most expensive treatment involves using “fillers” to plump up the tissue around the veins, not treating the veins themselves.  This gives the appearance of the veins no longer being prominent, but the actual veins are not treated, and this can make the hands look puffy in some people.  As the dorsal hand is a fairly large area (compared to the lips, for example), the volume of filler is much more, thus the expensive cost.  In addition, the effect is usually short-term, and wears off in less than a year.  If you need to then repeat the process, it is again, very expensive.

The second option is to inject the veins with a sclerotherapy technique.  This can be done with a ‘straight’ liquid solution or a ‘foam’ solution, where the liquid is mixed with air or carbon dioxide, and causes the veins to close down.  This is routinely done for the leg veins.  In the hands, however, there is a small risk that some of the solution could travel from the superficial veins into the deeper veins, causing a blood clot that could lead to serious complications, or cause a superficial phlebitis where the veins we are trying to close clot off and cause discomfort (temporary, but could last a few weeks).  The advantage is that this procedure is quick and less expensive, but with someone who has active hands with increased blood flow, the veins could re-open over time, and require additional injections. 

The third choice is to remove the veins with a procedure called phlebectomy.  This is where the skin is injected with local anesthetic (like the dentist uses) and then tiny cuts are made over the veins, and the veins are then pulled out.  This usually takes 30-45 minutes in the office setting.  However, this is a permanent solution, as the veins that are removed will never come back.  After 1-2 weeks the bruising goes away and the hands look great! The cost is less than filler, but more than a single sclerotherapy session.  Plus, additional treatments are not necessary, so you won’t keep paying for the same results time and again.  At the Kimmel Institute, this is the recommended procedure of choice.

If your hand veins make you look older than you feel, call us today for an evaluation!