Rejuvenation of the Hands

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Our hands can give our age away as much as our faces. Many of the changes are due to damage from the sun. Others simple from the aging process. Frequent hand washing, exposure to harsh weather (extreme cold or heat), and chemicals all take their toll.

The epidermis thins as we age. Lentigines, actinic keratoses and seborrheic keratoses, general dyschromia, and textural roughness appear. Capillary fragility may make bruising common. Fat atrophy may make tendons and bony prominences more noticeable and the veins appear to bulge.

There are several procedures that can be done which can help rejuvenate the hands, all are on an out-patient basis and some may be performed with local anesthesia.

Prescription-strength skin care like Retin-A can help repair sun-damaged skin, cause spots to fade, improve transparent skin, and stimulate the production of collagen. As with the face, use of sun protection is extremely important to protect the improvements gained and to prevent further sun-damage.

Chemical peels are available in a variety of forms: glycolic acid, Jessner’s solution and trichloroacetic acid (TCA). These are useful in addressing the mild pigmentary and texture changes of the skin.

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Fractional skin resurfacing, IPL treatments, and Laser treatments can be used to treat spots, spider veins (IPL), and improve the texture of the skin.

Soft tissue augmentation can be performed with fat cells taken from other parts of your body and transplanted to your hands. Synthetic fillers can also be used (Sculptra, Restylane, Juvederm, Radiesse). Results are immediate. The duration of improvement depends on the size and location of the area treated, as well as on the material used.

Sclerotherapy can be used to address the veins, but often the veins do not need treatment if appropriate soft-tissue volume is replaced.

Microdermabrasion is a superficial skin polishing that improves the appearance of aging skin and spots. The results are immediate. Maintenance treatments are required.

Thermage is a non-surgical procedure that uses a radio frequency (RF) system to gently cause the collagen in your skin to contract and tighten. The result is smoother, softer looking hands.

Use of sun protection before and after is important, but difficult as the hands are washed frequently during each day. Use of a good hand moisturizer daily helps protect the skin.

Source
Combination Hand Rejuvenation Procedures; Aesthetic Surgery Journal, Vol 29 (5), pp 409-413, Sept/Oct 2009; Shamban, Ava T. MD

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