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Temple Veins
Seems his usual anger is gone, less veins are popping on his ...temple.
Temple veins - as spider veins - are basically just a treatable cosmetic nuisance that not too many practitioners are eager to tackle.
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From a practical point of view these veins are too “big” to burn them with lasers yet too “small” to be removed by ambulatory phlebectomy. Therefore, the only remaining practical modality is good old-fashioned injection sclerotherapy using the correct sclerosing agent in a proper volume and concentration. If there is a case where “less is more” it is in this delicate area.
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Like in case of spider veins, in average 2-4 sessions may apply. One has to be very careful, as a small, bulging, tortuous branch of the temporal artery may be present in the same area together with the veins. Injecting it by mistake could cause severe skin slough with residual scarring as well as blindness on the same side!
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If needed I will use Doppler ultra-sonography to sometimes convince an insisting patient that indeed "the bulging and undesired structure" is a pulsating artery and a “no-no” to inject.