Bulging veins in the hands are common signs of aging; but a variety of other conditions could be the cause, some of them potentially harmful. However, in many cases, particularly those having to do with teenagers, the cause is something more benign, such as excessive activity. Due to the potential risk involved, consult a doctor to rule out a more-serious disorder. Veins are responsible for taking deoxygenated blood back to the heart and lungs to be reoxygenated. Unlike arteries, veins have valves in them that control the flow of blood. When veins bulge — on the hand or anywhere else in the body — it is because the blood is pooling in the vein, either due to a problem with the vein itself or an underlying condition. Bulging veins are more common on the leg, but they can occur anywhere on the body. If a teen is active in sports, such as lifting weights, it can cause the veins in the hand to bulge temporarily, which is usually not a cause for concern. Other causes that could be to blame include excessive inactivity, obesity, pregnancy, high blood pressure, structural problems with the veins, injury, and thrombophlebitis, a swelling caused by a blood clot. It could also be a hereditary condition, which could be more noticeable in a thin teenager. If bulging veins in the hand is accompanied by other symptoms, an underlying medical condition is more likely the cause. Symptoms that accompany bulging hand veins can include pain, warmth and redness in the affected area, which is common in thrombophlebitis.
If diabetes is the cause, symptoms can include slow-healing wounds and ulcers on the skin. Veins that bulge as the result of a structural problem in the veins are usually always swollen and slightly engorged. Even if no other symptoms are present other than bulging veins, it does not rule out a more serious medical condition. Bulging veins in a teen\’s hands are not always a cause for concern, but a doctor should be consulted to rule out an underlying medical disorder. Treatment for the condition will depend on the underlying cause. If the cause is genetics, no treatment is usually given, although cosmetic procedures are available to remove the veins. Bulging hand veins accompanied by symptoms of infection — including redness and swelling in the affected veins, pain, a pulling sensation or bleeding from the vein — require immediate medical attention.
Mark A. W. Andrews, professor of physiology at the Lake Erie College of Osteopathic Medicine, offers this answer. Contrary to expectations, perhaps, bulging veins during exercise have nothing to do with an increase in either blood volume or pressure in these vessels. In fact, both are known to decrease during stepped-up activity, including exercise. To explain the prominence of veins during exercise, it helps to understand the vascular system and its components. Blood that circulates throughout the body is pumped from the left ventricle of the heart. It first enters into the high pressure arteries, where systolic blood pressure, the highest pressure exerted there, is recorded around 120 mmHg (millimeters of mercury), and diastolic pressure, the minimal pressure exerted in these vessels, is recorded at around 80 mmHg. (Thus, normal blood pressure is typically around 120/80 mmHg. ) The blood flows into smaller and smaller branches of arteries called arterioles.
As it continues along, its pressure decreases due to the resistance of the walls of the arterioles themselves. The blood then enters the capillaries–the smallest blood vessels–which provide nourishment to, and remove waste material from, active cells. There are more than one billion of these in the human body and they are extremely small and thin. The pressure exerted by the blood as it enters the capillaries is approximately 30 mmHg. This pressure decreases even further as the blood completes its nourishment functions and then leaves the capillaries to flow back toward the heart via the smallest veins–the venules. The venules combine into larger and larger veins until they feed into the right atrium of the heart as the vena cava. By the time blood enters the largest veins, pressure exerted by the blood stream is only a few mmHg and its return to the heart is moved along more by muscle activity and breathing than its own inherent force. When exercise begins, the heart\’s rate and strength of contraction increases and blood is quickly pumped into the arteries. As this is occurring, systolic blood pressure increases linearly with exercise intensity, rising to nearly 200 mmHg during high intensity aerobic exercise (and to more than 400 mmHg during weight lifting).
Diastolic pressure, on the other hand, changes very little with aerobic exercise (although it rises during weight lifting). Simultaneously, the internal diameters of veins and venules narrow in a process called venoconstriction, forcing the flow of blood forward to the heart and enhancing their ability to receive blood coming from the capillaries. Overall, this process helps decrease the pressure in the venules and veins to at most about five mmHg. Venous volume and pressure thereby decrease and are thus not the basis for the bulging. Instead, the process occurring in the capillaries as a result of the rise in arterial blood pressure during exercise causes plasma fluid otherwise resting in these tiny tributaries to be forced out through the thin vessel walls and into compartments surrounding the muscles. This process, known as filtration, causes a swelling and hardening of the muscle that is noticed during exercise. As a result of this swelling, cutaneous veins are pushed toward the skin surface, flatten to some extent, and appear to bulge. Such veins are more visible in persons with less subcutaneous fat. This bulging is neither good nor bad but simply a result of normal physiological mechanisms that result from the rise in arterial blood pressure during exertion.