“As we age, our hands tend to lose their firmness and volume and the veins and tendons
become more pronounced,” says dermatologist Dee Anna Glaser, M.D., FAAD, director of cosmetic and laser surgery and vice-chairman and professor at the department of dermatology at Saint Louis University. “In addition, changes in texture where the skin appears crinkled or is marked with spots, commonly called liver spots or age spots, are the hallmarks of an aging hand.”

As more individuals become conscious of how their hands may disproportionately show their age, dermatologists are applying rejuvenation techniques to the hand that have long been successful in treating the face. While these techniques are approved by the U.S. Food and Drug Administration for treating the face, they are not yet approved for use on the hand.

For years fillers have been used to restore volume loss in the face, specifically to the cheek, to smooth the crease that forms along the bottom of the nose to the corners of the mouth. Applying a similar approach, dermatologists are now using fillers to re-establish fullness in the hands.

“Fillers are a great option to rebuild volume and add shape to the hand when a patient has thin, sunken skin — giving the appearance of raised veins and tendons,” says Dr. Glaser. “The fillers add volume to the back of the hand, lifting the skin and diminishing the appearance of the veins and tendons to provide a smoother, more youthful appearance.”

Injecting fillers into the back of the hand is an in-office procedure lasting about 20 to 30 minutes that requires no anesthetic. While some patients may experience slight bruising, the injections offer immediate results that typically last about a year.

While the use of fillers is a one-step process that is more widely employed, Dr. Glaser notes there are circumstances when a patient’s own fat is used to build volume in the hand. For example, if a patient already is scheduled for liposuction, the fat that is removed during the liposuction procedure subsequently can be injected into the hand.


Lasers Target Texture and Pigment Changes

To treat uneven skin tone and texture as well as common pigmentation changes associated with aging, dermatologists are using new laser technologies. Similar to rejuvenation of the face, fractional lasers improve skin tone and smooth fine lines on the hand by targeting small sections deep within the skin. Surrounding skin is left untreated and helps stimulate healing.

Following this type of laser treatment, patients should expect the skin to turn red, resembling sunburn, for about a week to 10 days and then increasingly improve in appearance. Depending on the patient, three to six treatments with the fractional laser may be needed.

To treat dark brown spots, Dr. Glaser utilizes pigment-specific lasers that deliver a beam of light that penetrates the skin’s surface to treat the affected area of the hand. After treatment, patients can expect the brown spots to appear darker for about a week, after which they will lightly scab, fall off, and then turn pink as the skin begins to heal. One to two treatments with this type of laser may be needed.

 “There are many options available to minimize the appearance of an aging hand,” says Dr. Glaser. “But prevention truly is the best medicine, so don’t forget to apply a broad-spectrum sunscreen with an SPF 30 or more to all exposed areas of skin, including the backs of your hands.” 

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