Q: Dr. Eppley, I would like your opinion on something. Over the past few months I have noticed deep ridges in my forehead which run a long the forehead veins. I went to see a dermatologist for fear it was en coup de sabre, but was told the skin didn’t seem like that. I’m 46 years old, thin and female. I am extremely depressed about it as it looks like I’m a Klingon when I look at myself in shadowy light. in bright light it is OK. I was thinking of having a face lift in the UK later in the years so don’t know if anything could be done about it then. Is this something you could address? I was wondering whether maybe forehead cement but then would that be possible with the veins where the ridges are and would that push the veins up to make them bulging instead. Yours desperately.
A: Thank you for your inquiry. I would have to see pictures of them but most likely it is forehead veins and not linear scleroderma. I have seen this quite a few times. These veins, when deflated, can leave long vertical grooves in the forehead which is often paired. How to treat them is challenging. The concept of bone cement on the surface makes sense but would likely leave raised ridges and may likely cause its own aesthetic problem. The other alternative is fat injections placed around them. Since fat is injected with blunt cannulas there is little risk of entering the veins or disrupting them.
The key issue is what these forehead grooves look like in three positions, when standing up, laying down and then with your head bent over. (head lower than your heart) This will make the diagnosis that this is indeed forehead veins. Those three pictures would be very helpful.
Dr. Barry Eppley