Hand rejuvenation is becoming increasingly popular due to the constant visibility of the area. Genetic and environmental factors contribute to the appearance of the hand. Dehydration, sun exposure, and occupational hazards can decrease the quality of the skin on the hands causing wrinkles, brown spots, and chapping. Aging, malnutrition, and hereditary factors can lead to thinning of the skin which can expose the underlying veins, tendons, and bones.
There are multiple techniques to combat the appearance of aging hands. Lifestyle choices such as drinking plenty of water and keeping a healthy diet rich in anti-oxidant foods can optimize skin quality. Using preventatives like a high-quality moisturizer, sunscreen of SPF 30 or greater, and a topical retinoid are part of good hand hygiene. Protecting against occupational exposures or extremes of temperature can also preserve the youthful hand. Once the signs of aging appear, treatments such as skin resurfacing, laser therapy, and volume restoration with dermal fillers or fat can be used to improve the appearance of the hands.
- How fast do hands age and what should patients do early on to take care of their hands?
Hands age at different rates. This is based on a blend of genetics and environmental factors. Sun exposure is a common culprit for the premature aging of hands. Everyone should take care of their hands by wearing a sunscreen of SPF 30+ daily. Dehydration and thinning skin on the back of the hand also lead to an aged appearance. Drinking plenty of water, consuming a diet rich in anti-oxidants, and frequent moisturizing can keep the skin healthy, hydrated, and prevent chapping. Additionally, using a topical retinoid on the backs of the hands is a great way to increase skin turnover and improve skin quality.
- At what age do patients start to come in looking for hand rejuvenation treatments?
Most patients who seek rejuvenation of the face are also candidates for hand rejuvenation, as both areas are highly visible and sun-exposed. Generally speaking, after age 40 the skin starts to noticeably thin and the veins and tendons on the back on the hand become more prominent. As aging continues, some people develop “age spots” from sun exposure.
- What treatments would you recommend for patients in their 20s, 30s, 40s, and above?
Early on, prevention is important. I would recommend daily sunscreen for everyone. Hands are exposed to the sun and its UV rays every time we go outside. Additionally, moisturization to prevent chapped or dehydrated hands is important. If one develops “age spots” or areas of darker pigmentation this can be treated with topical bleaching agents, chemical resurfacing, or laser therapy.
As aging sets in and the skin thins, volume restoration is key. There are two principal ways to achieve this. The first is volume restoration with dermal fillers such as Radiesse or Juvederm. The second method of restoration is with autologous fat transfer.
- Is there a certain age that you recommend waiting until to get a specific treatment? Especially with fat transfer or pigmentation/dark spots.
No, usually early intervention is key. I would recommend treatment at the first appearance of volume depletion or decreasing skin quality.
- How long do the common treatments (fat transfer, IPL, filler, laser therapy, chemical peels) last?
Each treatment has its pros and cons. Topical treatments such as bleaching agents, resurfacing, or laser therapy improve the appearance of the skin, but do not address volume loss. Dermal fillers and fat transfer restore volume but may not address skin quality. Often, a combination of therapies is needed. With removal of exposure, most topical treatments have long-lasting effects. Resurfacing or laser therapy may require several sessions to achieve the desired effect, but are usually curative. Dermal filler volume restoration can last up to 1 year. Fat grafting which can occasionally require more than 1 transfer, is a permanent solution to volume loss.
- What do you recommend patients do to ensure their treatments last as long as possible?
Post-procedure care and removal of exposures are important to optimize results. Follow your physician’s instructions carefully, which can include topical creams, compressive bandages, and elevation. Avoiding sun and other environmental exposures will help maintain skin quality after treatment.
- What do you recommend patients do daily to take care of their hands?
Every day choices such as drinking plenty of water and keeping a healthy diet rich in anti-oxidant foods can optimize skin quality. Using a medical grade moisturizer, sunscreen of SPF 30 or greater, and a topical retinoid are part of good hand hygiene. Protecting against occupational exposures or extremes of temperature can also preserve the youthful hand.
- Are there any products you recommend for your patients such as creams, hand masks, lotions to better take care of their hands?
There many quality products on the market and everyone’s needs are different. Therefore, I hesitate to recommend a particular product or brand. My advice is to try a few unscented, medical grade moisturizers, sunscreens, and retinoids for daily wear and choose the products that suit your needs.
- Is there anything that patients should not do when it comes to enhancing the appearance of their hands?
Unprotected sun exposure is definitely a no-no. If you work in extreme environments or with harsh products gloves should be worn to protect your hands. Smoking should be avoided since it is generally caustic to your health, including the appearance of your hands.