Sometimes the veins on the back of my hands look huge! Other times, I hardly notice them. Should I be concerned?A
Probably not. Veins bulge or diminish in size depending on many factors. The older we are, the more likely they are to bulge from time to time. That’s because our skin gets thinner and we lose collagen and subcutaneous (under the skin) fat, which can make our veins much more noticeable.
In addition, the following can lead to bulging hand veins…
Hydration. The more hydrated a person is, the more visible veins are. Your veins will be less prominent if you become dehydrated.
Body temperature. Hot weather and vigorous exercise also can cause your veins to bulge. When you feel hot, your veins become dilated (and may appear to bulge) near the surface of your skin, which helps dissipate heat to cool you off. When you feel cold, veins become less noticeable because they constrict to try to maintain heat and move blood toward your body’s core. That’s why veins in your hands may not be as noticeable in cold weather. Exercise often leads to a loss of body fat, which can make veins more prominent.
Hand position. If your hands are hanging down at your sides, you may notice bulging veins when you glance down at them. Veins protrude more when hands are in a downward position than when they are above your heart. That’s because gravity allows fluids to accumulate in the hands, making the veins more noticeable.
Most likely, your bulging hand veins are due to a combination of these factors. If the appearance of your hand veins bothers you, veins will look less prominent with the injection of fillers in the hands around the veins to add back some fullness to the tissue. While a solution that causes scarring of the vein could be injected by a vascular specialist into the veins to close them off, preventing the bulging, I generally do not advise this—your hand veins may be needed at some point for intravenous medication or fluids, and the procedure blocks off the veins.
Important: If your hand veins start to ache or seem to be prominent all the time, consult a vein specialist (also known as a phlebologist). In some cases, bulging hand veins can be due to phlebitis, a condition that causes the vein to become inflamed, or deep vein thrombosis, resulting from a blood clot deep in an arm vein. Varicose veins are usually found on the legs but also can occur in the upper extremities. Varicose veins appear when faulty valves allow blood to pool and veins become enlarged and twisted.
Varicose vein treatment may include the use of a scarring solution to close off veins (described above) or laser therapy. To find a vein specialist near you, consult the American College of Phlebology.