Aging Hands: Why Veins Become Visible and How to Treat Them
As you get older, physical changes such as lower energy, joint stiffness, and even the need for reading glasses start to occur. One thing that can make you look older is bulging veins in the back of the hands. While hand veins can appear at any age, they become even more common as you age. In fact, about 50% of women and 40% of men over 50 notice more visible hand veins.
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Visibility increases because, as you age, the veins enlarge and the body loses the subcutaneous fat that camouflages and protects the veins. Additionally, the outer layer of skin becomes thinner, making it much easier to see the veins underneath. Individuals who spend a lot of time working with their hands, whether it be wringing out towels, golfing, or weightlifting, are more likely to notice enlarged veins. Thankfully, these veins are mainly cosmetic. Nonetheless, everybody deserves to feel confident in their skin. There are treatment options to remove these bulging veins, as well as a few things to look out for that can indicate a medical issue rather than a cosmetic one.
Cosmetic versus medical
The vast majority of the time, visible hand veins are just a cosmetic issue. However, fat acts as a cushion, protecting the veins from trauma. When that fat is gone, it’s possible that hitting these veins can cause swelling and bruising. Shrinking the veins down avoids this problem altogether. Many people worry that these veins in the hands can indicate a blood clot, but that’s not the case. If a blood clot were occurring, the arm and hand would be swollen. If you notice weakness in the hand, swelling, and pain radiating up the arm, that could indicate deep vein thrombosis (DVT), a blood clot deep in a vein in the arm or shoulder. If you experience this, you need to see a medical professional.
If left untreated, DVT can lead to a pulmonary embolism, which happens when a piece of the blood clot breaks away, travels through the bloodstream, and blocks an artery in the lung. This is a medical emergency and can be fatal. If you’ve noticed a swollen arm and are experiencing shortness of breath, chest pain, unexplained dizziness, or a rapid heart rate, you need to call 911.
Treatment options
Sclerotherapy is one of the most popular treatment options for spider veins in the hands. It’s a minimally invasive procedure that involves an injection of dilute medication into the veins, which causes them to collapse permanently and disappear.
The injection closes the vein, so blood can’t get through it. Depending on the severity, multiple treatments may be required to reach full closure. In fact, the average patient needs 2-3 sessions, approximately one month apart, each lasting about 20 minutes. If performed correctly, there are a couple of possible side effects, including temporary mild aching, bruising, or swelling at the injection site, although less common complications can occur.
An Ambulatory Phlebectomy is another option people consider. A phlebectomy is when the doctor surgically removes bulging veins by making microscopic cuts in the skin. The issue with phlebectomy is that removing the veins all at once can impair drainage in the fingers and cause them to swell. This happens because it takes time for the deeper layer of veins to mature and facilitate drainage. This is one advantage of sclerotherapy.
Another option available is to inject the hand with dermal fillers. This is best used when the patient lacks subcutaneous fat. The fillers add volume back to the hand, so the veins become less visible. Adding filler to hands that already have enough fat can make them look puffy. Hand filler results typically last anywhere from 6 months to 1 year. You will need to repeat maintenance injections roughly every 9 to 12 months if you want to continuously hide the appearance of your hand veins.
While bulging hand veins are common and a natural part of life, you don’t have to live with them if they are constantly bruising or affect your confidence. Modern treatments make it easier than ever to restore a smoother, more youthful look to your hands. The most important step is simply consulting a qualified specialist to tailor a cosmetic plan that fits your specific needs.
Dr. Lawrence Presant is the Chief Medical Officer at Arizona Vein Specialists in Phoenix and is a certified diplomate of the American Board of Venous & Lymphatic Medicine.
