Q: My brother is 44 years old and just started experiencing severely bulging veins in his arms and hands with some tingling sensations. The condition stops if he raises his hands above his heart. No other symptoms seem to be present. Any thoughts?
A: Bulging veins are unusually large veins that appear at the surface of the skin. When veins are visible and have a swollen appearance, they are referred to as varicose veins. While they commonly appear in a person’s legs, they can also be found in other parts of the body as well, such as in the arms, chest, and face. Bulging veins may be due to a rise in blood pressure in the veins. This rise in venous blood pressure forces plasma out of the walls of the blood vessels, causing the surrounding tissues to become swollen and hard. In turn, the act pushes subcutaneous veins to the surface of the skin where they become more visible and in those individuals with low body fat, the effect becomes even more noticeable. When the legs are involved, symptoms that include pain that may worsen following sitting or standing for extended periods, skin darkening, cramping, swelling and rash may occur. Increased weight of an individual and inactivity can exacerbate symptoms.
Bulging veins may appear because the valves in the veins are either weakened or defective, leading to poor circulation, or valve function may be inadequate, allowing blood to pool. Veins have valves that act as one-way flaps to prevent blood from flowing backward. The walls of the veins may be weak, a condition that will allow the blood to pool, or because of other medical conditions that may cause them to appear enlarged. The condition, which may appear abnormal or unsightly, is a common cosmetic issue, not necessarily a medical one; however if accompanied by other symptoms such as pain, tingling, warmth or redness, a physician should be consulted to rule out thrombophlebitis, diabetes, a blood clot, or other disorders.
Veins in the hands can bulge during exercise but they will commonly return to their normal size once the exercise ceases or when a person raises his or her hands in the air above the heart. Age also can cause veins to appear to bulge because the skin becomes thinner and less elastic, causing it to settle over the veins and bones in the backs of hands.
Bulging veins may be completely harmless, or on the other hand may be due to serious underlying medical issues. They may also cause serious complications and permanent damage, so it will be in your brother’s best interests to visit his health care professional. Once a history and examination is performed, he or she can make a determination if follow-up testing is appropriate or if nothing need be done.
Your brother then has options if he perceives his hands are unattractive or offensive to look at. A treatment known as sclerotherapy is a non-surgical injection offered by many physicians. No anesthesia is necessary and the procedure takes about 20 minutes. Afterward, a compression glove or wrap is worn for a few days and the patient’s activities return to normal thereafter. The benefits are, for the most part, purely cosmetic. Again, he should speak with his physician to determine if there is an underlying medical condition to be addressed.
