Technology is on fast-forward when it comes to anti-aging treatments for hands and feet. Medical spas and alternative health clinics are adopting innovative therapies for age-old beauty problems that plague our extremities. Here’s a run-down of what’s going on behind closed doors today and what we will see in the future. By Erin Snyder Dixon Hands don’t lie — or do they? For years, medical spas, dermatologists, and even plastic surgeons have concentrated on the face as the center of anti-aging therapies. Lifts, tucks, serums, fillers, and more have been used to turn back the clock and present a more youthful appearance. Now, these same medical spas are turning to hands to cheat the effects of aging. Many therapies require a physician or nurse practitioner under the guidance of a physician, but others are done in alternative medical settings, or even salons. Here’s a quick breakdown of what’s out there and how to adapt your salon offerings to the current trend of therapies for young-looking hands at any age. Before expanding a salon menu into new treatments, confirm with your state board which treatments your professional license allows you to perform. Each state is different.

Injectable Fillers
Commonly known under names such as: Juvederm, Restylane, Radiesse, and Sculptura, fillers have grown in popularity, as well as using one’s own fat. Dr. Stephen Schleicher, founder of DermDox Centers for Dermatology and Teledermatology, located in Hazelton, Pa., uses fillers to plump up aging skin. “Dermal fillers are injected under the skin’s surface to correct creases and wrinkles, reduce scars, and plump. Fillers can last from several months to up to two years depending on the material used.” Dr. Scleicher has seen demand for these treatments in medical spas increase dramatically since their introductions over the last few years. “As we age, we lose collagen and elastin in our skin, giving it a thinner cosmetic appearance. Fillers can plump up the skin on the hands and reduce the appearance of veins.” His favorite pharmaceutical filler for hands is Radiesse. As with any medical intervention, Dr. Schleicher stresses the importance of researching the potential medical spas and the experience of the doctors and staff, as well as the level of supervision during treatments.

IPL (Intense Pulsed Light)
“Age spots or brown spots can be treated with photorejuvenation. This simple procedure breaks up the pigment and causes it to come to the surface where it can then flake off,” says Dayna Rossi, a clinical nurse practitioner at Iatria Spa and Health Center in Raleigh N.C., who helps clients turn back the clock on sun damage with these “simple and safe treatments that will provide a more youthful appearance to hands.”

Bioidentical Hormone Replacement Therapy
Working from the inside out to turn back the clock is also gaining in popularity. Balancing hormones can help with skin dryness and the overall appearance. Hands are one of the first places for dryness to appear since they are exposed to the elements and may not get the attention that facial skin gets. With the concern over hormone replacement therapies, people are turning to more natural alternatives. The Anti Aging Center offers scientific hormone testing. A client is provided with 11 vials in which to collect saliva samples, which are then sent to a lab for analysis of fluctuations in hormone levels. In partnership with a prescribing physician and a compounding pharmacist, a bioidentical hormone replacement plan is developed for the client. Stephanie Tippie shows the ease of testing as it can be done over a distance and coordinated with a client’s personal physician.

Sclerotherapy
Once used mainly on legs, sclerotherapy is increasingly being used on hands and arms. Accomplished with injections or other methods such as lasers, sclerotherapy can be used to reduce unsightly veins in the hands. Used in conjunction with fillers, doctors have seen good aesthetic results.

Lasers
Along with youthfulness, one may seek to remove evidence of youthful indiscretions, such as the unwanted tattoo. David McDaniel, M.D., an assistant professor of dermatology and plastic surgery at Eastern Virginia Medical School and the director of Skin Concepts Medical Spa and Laser Skin & Vein Center of Virginia, “uses lasers that emit high power but very short duration flashes of laser light to disrupt or destroy tattoo pigment. Different colors of laser light are needed to remove different colors of tattoo pigment.”

While the “ability to completely remove a tattoo is affected by skin color and ink color (green ink is harder to remove),” Dr. McDaniel says, “new tattoo inks are coming that are easily removed.”

Lasers can also be used for permanent hair removal. “It requires multiple treatments and dark hair on light skin color typically produces some of the better results.” Hair removal can be accomplished on most body parts — including hairy toes and knuckles or arms. Dr. McDaniel points out “with current equipment, white or blonde hair can be difficult to remove, but a product called Melamaxx (a lotion that is applied to light hair) may change that.

There is no salon alternative for laser tattoo/hair removal, but knowing what’s out there can help you when answering clients’ questions.

Microdermabrasion/Chemical Peels
Stephanie Tippie, co-director of the Anti Aging Clinic, in Lauderhill, Fla., uses her background in medical research as a springboard for the alternative healthcare center she and her husband David, an endermologist, built. Microdermabrasion, combined with natural alternatives to Botox such as Nujuvenate, bring back the appearance of youth by gently removing the top layer of cells revealing new, fresher cells below. The Anti Aging Center recognizes the importance of hands and offers complimentary hand treatments with facials.

Mechanical exfoliation using a variety of treatments is often the first line of defense in medical spas. Combined with chemical exfoliation (such as glycolic acid peels) and at-home care, dermabrasion can reduce the appearance of fine lines and wrinkles. Depending on the level of exfoliation, a client/patient may have little or no redness immediately following treatment.

Chris Ygay, owner of Revitalize Day Spa, in Birmingham, Mich., offers treatments combined with glycolic acid to increase the effectiveness of exfoliation. “Any of the treatments used on the face can be used on the hands and feet. Our philosophy is to offer equally effective skincare in a relaxing environment and to develop a total plan that is easy. If it’s not easy, clients won’t stick with it at home.”

Licensing needed varies depending on the equipment and chemicals used. While salt/sugar scrubs and similar methods can be used by most manicurists, deeper methods fall under the rules of esthetics or medicine and must be performed by the appropriate clinician.

Diagnostic Tools
Erika Mangrum, CEO of aesthetic and medical practices in Raleigh, N.C., is “utilizing a diagnostic tool called the IOMA Beauty Diagnostic System that assesses the quality of skin and then can compare the structure and quality to metrics and give a comparison to others the same age, etc.” This tool is fairly new and not widely used yet. As more information is gathered, more comparisons can be made. “We can then use this information to devise a treatment plan,” she says.

Anti-Aging in the Salon
With the trend in focusing on hands spreading in other treatment arenas, now is the time to concentrate on youth-renewing services. Give clients an array of offerings including salon services and retail products to incorporate into their anti-aging repertoires. Salons may pursue partnering with other facilities to create mutually beneficial referral policies. A few ideas:

The Ageless Manicure: Indulge clients past the elbows with this pampering option. Use a gentle sugar scrub to coax fresher skin cells to the surface. Follow up with a deep moisturizer and paraffin dip. Strips of muslin are dipped in paraffin and wrapped around the upper arm to achieve the ultimate treatment for elbows. Wrap in plastic and then a warm towel while the client relaxes. Follow up with a magnificent massage and polish.

Sole Solution Pedicure: Rough flaky skin and unruly calluses get the boot with this super deluxe pedi. Combine the benefits of mechanical exfoliation using a scrub and/or foot file with chemical exfoliators containing ingredients such as alpha- or beta-hydroxy acids. After soaking in a milk bath, trim toenails, massage, and apply polish.

Says Chris Ygay, owner of Revitalize Day Spa, “Educate clients on the youth-renewing benefits of the different exfoliation methods offered. Products and home care should be designed to save time while offering maximum results for the individual."

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