When it comes to revealing a person’s age, hands down, the back of the hand is more telling than the face and neck.
“Women tend to forget about the hands when caring for their skin, but hands often can reveal a person’s true age,” says Dee Anna Glaser, MD, FAAD, a board-certified dermatologist and professor and vice chairman in the department of dermatology at Saint Louis University in St Louis.
While aging of the hands usually begins in the 40s or 50s, with discoloration and age spots (also called liver spots), hands can begin to show signs of aging earlier if they are repeatedly exposed to the sun without proper protection. And by your 50s and 60s, you may begin to lose volume in your hands, making prominent veins and tendons more noticeable.
“Exactly when the hands will start to show signs of aging depends on many factors, including genetics and history of sun exposure. We also find that women who are thin may notice their hands aging faster than heavier women because they naturally don’t have as much volume in their hands,” she says. “In addition, women who spend a lot of time in the car need to know that ultraviolet A (UVA) radiation can pass through window glass and penetrate the deepest layer of the skin. This could lead to the types of sun damage that prematurely age the hands.”
Fortunately, there are new technologies to add volume to the hand as well as remove dark brown “age spots” to reverse these telltale signs of aging. Women can preserve the appearance of their hands with proper sun protection, and dermatologists can treat aging hands with the latest aesthetic technologies.
Always use a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of 30 or higher on the hands, and reapply throughout the day — especially after frequent hand-washing.
Keep a tube of sunscreen in the car and apply before driving. Use a hand cream with added sunscreen to provide a base layer of protection to the hands.
Wear gloves when doing yard work or playing outdoor sports. Golfers should consider wearing a glove on each hand to cover the back of the hands.
Topicals for mild improvement & prevention
For women in their late 30s or early 40s, topical medications and treatments containing glycolic acid or antioxidants are an inexpensive way to stimulate repair from sun damage on their hands. However, topicals must be started early before damage is too extensive.
Hydroquinone, tretinoin and retinoids cannot completely reverse signs of aging hands, but these topicals can be used to improve the skin and prevent further damage.
Pump up the volume with fillers
Dr Glaser also says that fillers have been used for years 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 now are 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. Dr Glaser explains that while some patients may experience slight bruising, the injections offer immediate results and typically last for about a year. The instruments used to administer fillers have improved over the years. New cannulas with blunt tips help to reduce temporary bruising.
The use of fillers is a one-step process that is more widely employed, but Dr Glaser nots that 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 to rebuild the lost shape.
Lasers are spot on in treating texture & pigment changes
New laser technologies can treat uneven skin tone and texture, as well as age-related pigmentation changes — such as age spots or liver spots.
Fractionated or fractional lasers, widely used to rejuvenate the face, improve skin tone and smooth fine lines on the hand by precisely targeting small sections of the deep layers of skin. The surrounding skin is left untreated to help stimulate healing.
Depending on the patient, three to six treatments may be needed for best results. Following treatment, the skin will turn red for about a week to 10 days, and improvement in the appearance of the hand will increase gradually over time.
Pigment-specific lasers are used to treat dark brown spots on the hand by delivering a beam of light that penetrates the skin surface. Following treatment, brown spots appear darker for about a week then they will scab, fall off and then turn pink as the skin begins to heal.
Strict sun avoidance and protection is needed following most laser treatments. Dr Glaser says that one to two treatments with this type of laser may be needed to improve these common pigmentation problems.
“The hands are often overlooked because we put so much emphasis on our face, but our hands can be even more susceptible to the effects of aging,” says Dr Glaser. “With continued advances in dermatology, there are many options available to patients to minimize the appearance of an aging hand. But I always remind my patients that 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.”