Periorbital Veins Treatment At; A Glance
- Best Results1-2 sessions
- Treatment Recovery20 minutes
- Procedure Time2 mins
- Skin SpecialistSpecialist dermatologist
- Duration of ResultsOften permanent
- AnaestheticCooling
- Back to WorkImmediately
- Cost$$ Medicare rebate applies
Periorbital Veins
Periorbital veins are the visible blue or green veins around the eyes, typically found under the eyes, along the temples, or near the upper eyelids. These veins become more prominent due to genetics, aging, thinner skin, or weight loss. While they are not medically concerning, many seek treatment for cosmetic reasons, as they can contribute to a tired or aged appearance.
FactsUnder Eye Vein Removal
- 90% of periorbital veins/veins around the eye can be treated in one session
- Results are long term, often permanent
- Laser treatment is well tolerated with no downtime
- The procedure takes less than 2 minutes to perform
- Results are immediate
- Laser treatment is the Gold Standard with a high safety profile
- Dr Davin Lim performs this treatment in Brisbane & Sydney
- Eye vein treatment carries a Medicare rebate
What is the best way to treat veins around eyes (periorbital veins)?
Special lasers called ‘long pulsed integrated cooling vascular lasers’ are the best way to remove periorbital veins (blue veins around eyes). Lasers provide immediate results with the least amount of discomfort & highest safety profile.
Periorbital vein removal is performed by a specialist procedural dermatologist who has extensive experience in laser dermatology.
Is the procedure painful?
Laser is well tolerated, akin to a rubber band flicking on the skin. The entire procedure takes less than 2 minutes, with the actual laser time of less than 25 seconds.
I exclusively employ lasers with cooling systems, ensuring comfort & safety. Gas cooling has much less pain than gel conduction cooling systems. There is no pain after the laser procedure.
What results can I expect from laser treatment?
Results are immediately seen after the procedure as the vein wall is collapsed with a laser. Best results are seen a few days after. 90% of patients require only one treatment.
What types of lasers do I use, & why is cooling important?
I exclusively use lasers with DCD or ICD (Dynamic or integrated cooling). These are more expensive to run as they require cooling gas, but they provide utmost comfort & safety compared to gel conduction cooling lasers.
In my option the DermaV laser is the best, followed by V Beam Prima in the 1064 wavelength.
- Best lasers: Lasers with gas cooling systems: eg. Derma V, Prima 1064
- Mediocre lasers: Lasers that use gel, Excel V, ClearScan
- Suboptimal devices: IPL, BBL, most vascular lasers
How are my eyes protected during the laser procedure?
Safety is our number one priority. Depending on the location of the eye veins, you will have either internal or external eye shields.
Internal eye shield: used when periocular eye veins abut the lid margin or if there are veins on the upper eyelid. These shields require local anesthetic drops in your eye.
External eye shields: are most commonly used. These are used when periocular blue veins occur under the eyes or the sides of your orbital rims. They do not require anesthetic as these are metal goggles.
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Why does Medicare cover part of the treatment?
Medicare covers part of the treatment if it is done by a doctor as it follows the 3 meter ruling, namely if a blood vessel or veins around the eyes can be seen at a distance of 3 meters. You are entitled to 4 sessions per year, acknowledging that in over 90% of cases, I only need one session to remove periorbital blue veins.
Treatment cost $920 per session, Medicare rebate of $130.
*Private health insurance does not cover this procedure as it is not performed in a hospital.
What are other ways to treat periorbital veins?
There are only 2 ways to veins under the eye, laser or sclerotherapy.
Periorbital vein sclerotherapy involves injecting a very small amount (less than 0.4 ml) of a low-concentration detergent sclerosant into the small, visible veins located around the eye. The needle is carefully directed away from the eye, with the solution injected outward, toward the ear. Once administered, the vein spasms and collapses, eventually undergoing sclerosis (permanent hardening), after which the body gradually absorbs it.
This procedure is not performed on eyelid veins, inner orbital veins, or forehead veins due to the significant risk of sclerosant entering the veins of the eye or being mistakenly injected into an artery. This procedure has been replaced with long pulse NdYag lasers over 2 decades ago.
More on sclerotherapy for veins
| Treatment | Treatment time | Side effects | Performed by |
| 1064 DermaV Laser | 2 minutes | Blistering, pigment changes; rare | Specialist procedural dermatologist |
| Sclerotherapy | 10-15 minutes | Blistering, pigment changes, more common. Blindness, extremely rare | Vascular surgeon |
Can veins on the upper eyelid be treated?
Upper eyelid veins can be treated, however they treatment is more involved as –
- A different laser is used (shorter wavelength).
- Intraocular eye shields are used to protect the eyeball (your eye is numb for one hour).
- Side effects such as blistering & prolonged swelling are more common, as compared to treating periocular veins on the sides of the eyes or under the eyes.
*I discourage chasing upper eyelid vessels as in most cases they can only be seen if the eyelid is closed. Unless you are a sleepwalker, most cases are not visible during activities of daily living (life).
Why does the size of the veins & blood vessels matter?
Upper eyelid veins are termed large caliber vessels. Other large calibre vessels are found lateral (sides) of the eye or orbital rim and on the temples.
Small calibre vessels are branches of larger vessels. They are seen on the upper & lower eyelids as well as on the cheeks.
Different lasers & wavelengths are required for different diameter sizes. Larger vessels are deep & require the 1064 (or 755) laser, whilst smaller vessels require 595 & 532 lasers.
Who performs this procedure?
I perform this procedure in Brisbane & Sydney. For more information on booking times, email the respective practices.
What are the limitations & post laser instructions following periorbital vein treatment?
Avoid sun exposure for 3 weeks either side of treatment, this reduces your chances of blistering & pigment changes. I will give you ice to apply for 10 minutes per hour, every hour for 4-8 hours after the procedure.
You can bathe, wash, exercise normally after the procedure & can wear make up 4 hours post laser. The impact on your lifestyle is minimal.
What are the risks of laser treatment?
This treatment has a well-established track record for safety & precision. Side effects are rare and typically short-lived, with the most commonly reported being mild swelling or redness, which usually subsides within a few hours to a day. The specific risks are assessed during the initial consultation. As with any surgical procedure, there is always a degree of risk, and minor complications may occasionally occur, though they generally do not impact the overall outcome of the treatment.
In summary the chances of –
- Prolonged redness lasting 24-48 hours: 10%
- Blistering: less than 2%
- Skin colour changes: 2% (more common in darker skin types or tanned individuals)
- Scarring: Much less than 0.1%
How does laser work?
Laser works by selective photothermolysis, namely matching settings to a target. Hence only certain wavelengths, power & settings are used to treat different types of blood vessels. For deeper vessels (often blue in colour, hence the name periorbital veins), a longer wavelength is required. Normal lasers are more superficial in their delivery & hence why most treatments are ineffective.
For effective removal of undereye – periocular veins we have to have the correct lasers in the correct settings.
Why do periorbital veins - eye veins occur?
Put simply, genetics. Some people have them, some do not. Eye veins are more prominent with-
- Age: thinner skin over time means more prominent eye veins.
- Lighter skin: more visible compared to darker skin.
- Weight loss: thinner tissue makes eye veins more apparent
Davin’s Viewpoint on Eye Vein Removal
Since the treatment of large, prominent veins around the eye is considered cosmetic, public hospitals do not provide it, making it available only through private healthcare in Australia.
As a result many dermatologists, vascular surgeons and plastic surgeons—are neither trained nor experienced in treating these eye veins. Only a small number of private medical centres possess the necessary expertise & licensing for this procedure.
This treatment requires specialized vascular lasers however not all lasers are equal. I exclusively use lasers with gas cooling, also known as dynamic or integrated cooling. This feature fires a squirt of gas millisecond before the laser. The result? Less side effects, less pain & faster healing. The lasers I use include the DermaV & V Beam Prima. We do have the Cutera Excel V & the Sciton Clearscan 1064, however these lasers require gel cooling via a sapphire plate. This increases treatment time, as well as pain levels. A 755 alex laser can also be used, however the results are not as predictable as the long pulse Nd Yag lasers as penetration of this wavelength is limited.
For smaller vessels (red veins), we have to use a different wavelength, namely one that treats more superficial vessels. For this job I use the DermaV 532 or the VBeam 595 over our Cutera Excel V 532, similar to treating periorbital blue veins, I firmly believe that gas cooling is the Gold Standard, over gel conduction.
Attempting treatment without proper experience can be dangerous, as incorrect laser settings may cause burns or scarring on the delicate skin around the eye. A specialist doctor must have extensive experience to accurately determine the appropriate laser settings, including depth of penetration, pulse width, and energy levels.
The only non-laser treatment option, sclerotherapy, is particularly hazardous in the eye area. The blood vessels in this region are closely linked to those supplying the retina, and injecting a sclerosant carries a risk of blindness due to compromised retinal circulation or air embolism. Some practitioners have attempted using sutures to isolate the vein before injecting sclerosant to reduce these risks, but this method remains highly complex, unpredictable, experimental, and dangerous. Given the high risk, most specialists strongly advise against its use around the eye.
By contrast, when performed by an experienced specialist, vascular laser treatment precisely targets the visible vein without posing a risk to retina occlusion. The Nd:YAG laser is considered the gold standard for the safe and effective treatment of large blue veins around the eye.
*Dermal fillers & veins. Can dermal fillers make periorbital veins more prominent?
Dermal fillers can make periorbital veins more prominent as pressure from below & volume displacement pushes the overlying skin upwards. This compression makes the deeper veins more prominent. This is usually seen in the temple area following deep injections, however can occur around the eyes. Most cases resolve in 2-4 weeks without intervention. As compared to periorbital veins around the eyes, temple veins are higher flow, larger diameter, they do not respond as well to vascular lasers.
