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Reticular veins on the hand and arm (prominent veins) are quite common, occurring in over 40% of the population. Hand and arm veins become more prominent with aging, due to loss of volume (subcutaneous fat) in the hands, decreased tissue elasticity, decreased muscle mass and due to progressive sun damage over time. Hand veins typically occur on the dorsum of the hand.
The vast majority of people do not have any symptoms secondary to hand and arm veins. A small group of patients may complain of itching or pain over the veins. Some people find hand and arm veins unsightly and seek treatment to improve the appearance by eliminating the visible hand and arm veins.
Hand and arm veins can be treated successfully using injection sclerotherapy. Injection sclerotherapy involves the insertion of a very fine needle into the visible vein, followed by injection of a medication, which causes the target vein to close over a number of weeks. The medication utilized for sclerotherapy at The Vein Institute of Toronto™ is sotadecrol. After each treatment gauze is applied over the treated vein for 6 hours, to limit bruising. Typically a series of one to three injections separated by a six week interval is required to eliminate the hand or arm veins of concern. Following treatment, the normal reaction is some mild bruising, swelling and tenderness over the treated vein. This resolves over a one to three week period.
It should be noted that hand and arm veins are commonly used for intravenous access or blood sampling. Treatment of these veins with sclerotherapy will prevent further intravenous access of these veins and necessitate the use of other veins in the arms.
Hand & Arm Vein Treatment Protocol
  1. Before treatment you will undergo a repeat hand vein examination and sun exposure history to assess for any change.
  2. The area to be treated, will be cleaned with a alcohol swab. The veins to be treated, will be cannulated with a very fine needle and the sclerosant solution will be injected.
  3. If your hand and arm veins have not resolved by 6 weeks, you will require further treatment.
Pre & Post Therapy Protocol
What Should I Do Before My Sclerotherapy Treatment?
  1. Do not apply cream to your hands or arm on the day of  your appointment.
  2. Eat a snack one hour prior to your treatment.
What Should I Do After My Sclerotherapy Treatment?
  1. You can resume normal activities today.
  2. Keep you bandages on for 3 hours.
  3. No water contact for 3 hours after your treatment.
  4. No wearing jewelry on your hands or wrist for 72 hours after treatment
  5. You can shower in the morning but no hot baths, hot tub, sauna for 1 week.
  6. Bruising, pigmentation, local swelling, lumpiness and some tenderness are normal at sites of treatment.
    • If there is swelling, wrap ice in a cloth and apply to the affected area.
    • Bruising at a site of sclerotherapy may last from 2 weeks to a few months in some patients.
    • To reduce bruising/pigmentation and speed up healing, apply Derm-Lac ™ lotion followed by Essentia A ™ oil (available at our clinic) twice a day until bruising/pigmentation resolve. Also take Arnica ™ 30 CH five tablets three times daily for 10 days after treatment.
    • Please call the office or make a follow-up appointment if you have any questions or concerns after a treatment.
  7. Apply a 6o SPF sunblock, if you undergo any sun exposure to the area treated.
  8. If there is swelling, wrap ice in a cloth and apply to the affected area.
  9. You will not notice an immediate improvement.  Clearance usually occurs over a 2-week period and in some cases may take up to 6 weeks. It may require 1 to 3 treatments for complete resolution.
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