Are aging hands spoiling your fun? Behold, the newest wave of hand-happy treatments.
By Beth Landman
At last, your hands can appear youthful and graceful, regardless of your age. Facial rejuvenation may have dominated the field of aesthetic medicine for a long time, but hand renewal is a new level of eternal youth. Here, we explore the latest cutting-edge approaches to the maintenance of beautiful hands.
HANDS UP
Many procedures have emerged over the years that promise to combat the aging process. “A lot of what we do for the face can be done for the hands,” says Francesca Fusco, M.D., a New York cosmetic dermatologist.
Some people are so self-conscious about aging hands that they keep them out of sight. “The next time you’re at a cocktail party, look around,” says Dr. Alan Matarasso, a Manhattan plastic surgeon. “You’ll notice people with their hands in their pockets. That’s not an accident.”
Hand-hiding becomes a habit because the hands age in a similar way to the face. For those among us who go to great lengths to retain the youthful appearance of our eyes, cheeks, chin, forehead, and neck, aged hands can often provide a sharp contrast.
“They lose volume, just like the face,” says Dr. Matarasso. “You see tendons, and because there is a rich vascular network, veins become more visible as well.” At the same time, skin’s elasticity weakens and causes wrinkling. Add discoloration and crepiness from years of sun damage, and hands betray the years in a major way. “Other body parts can be covered by clothing, but the hands, like the face, are constantly exposed,” notes Dr. Matarasso.
TAKING ACTION
The visible appearance of protruding bones and tendons in the hands can be addressed with fillers. “The safest option is a hyaluronic acid filler, such as Juvéderm. It gives a soft, full result and can be broken down with hyaluronidase if someone isn’t happy,” notes physician’s assistant Lauren Zeifman, who specializes in aesthetic medicine. “Fat can be used but isn’t as predictable. You don’t always know how much of it is viable.” She boosts the effects of hyaluronic acid fillers further with a new topical hyaluronic acid serum. “It’s a transdermal delivery system applied once a day that makes hands look fuller and softer,” she says.
Zeifman and Dr. Fusco like Radiesse, a filler that contains calcium hydroxylapatite, a component found in bones and teeth. “It’s a little stiff initially, but it softens up and lasts longer than hyaluronic acids,” notes Zeifman. “We inject it and spread it on top of the bone.” Dr. Fusco says that optimal results come when a doctor massages it properly. “It’s a beautiful, smooth lifter that plumps and camouflages,” she says, This treatment needs to be repeated every nine months for best effect. Dr. Paul Frank, founder and director of New York’s 5th Avenue Dermatology Surgery and Laser Center, uses cannulas (thin tubes that transfer filler into the body) instead of needles. “Hands tend to bruise and swell with needles,” Frank finds. “Blunt, thin cannulas reduce the chance of puncturing blood vessels.”
Some doctors prefer transferring a person’s own fat as filler. “The fat that stays lasts forever,” states Dr. Steven Levine, a plastic surgeon in practice with Dr. Daniel Baker, a pioneer in the hand rejuvenation field.
Juvéderm Voluma XC is a new filler option. “It’s less traumatic than fat and lasts longer,” says Dr. Howard Sobel, who recently started using Juvéderm on patients. “If you inject it very deep, you avoid bumps.”
VEIN GLORIOUS
In terms of visible veins, doctors tend to agree: “The treatment of choice is sclerotherapy,” says vein specialist Dr. Luis Navarro. (Sclerotherapy involves injecting a solution to close and shrink vessels.)
Dr. Navarro says that unlike veins in the leg, hand veins can be eliminated in just one visit. “They don’t usually come back for five years because they are not varicose,” he explains. “They’ve just become more visible.”
To boost elasticity and reduce the look of fine lines, some doctors use high-intensity radio frequency waves, as well as infrared or ultrasound therapy, which tightens skin by stimulating collagen production. “If you pinch the skin on your hand and it tents up, you have lost some elasticity,” points out Dr. Sobel.
BIG SMOOTHIE
For textural improvement, a number of resurfacing options exist, including lasers and chemical peels.
“Fractional resurfacing stimulates fibroblasts and collagen, and improves the appearance of fine lines by turning over new cells,” says Dr. Fusco.
Chemical peels leave hands red for about a week but provide an affordable alternative. “If someone doesn’t want to do laser, we can do a medium-depth precision peel,” explains Dr. Matarasso.
PHOTO FINISH
The final step in rejuvenating hands’ youthful look is to erase sun damage. “Women spend so much time and money on manicures and jewelry, then forget to put sunscreen on their hands,” notes Dr. Frank, who uses an Nd: YAG laser for spots and fractional resurfacing for discoloration. While TCA peels work and fractional resurfacing eliminate 80 percent of sun damage, prescription products help the cause tremendously. “The sun protection that you use on your face should be rubbed on the back of your hands twice a day,” Dr. Matarasso says. “I rotate between a retinoid, a glycolic, and a copper-based compound.”
Hypopigmentation— white spots from sun damage—are difficult to remove. While some doctors use the Excimer laser or phototherapy, areas that produce no melanin are stubborn. “Hypopigmentation is hard to treat and we usually don’t bother,” says Dr. Fusco. “If someone’s up for a hand modeling contract, you can inject pigment.”
Many spas and salons are now focusing on anti-aging hand treatments. Yasmine Djerradine, known for her electronic sculpting facials, now offers a Dangene Bailey, whose menu includes TCA and glycolic peels, fractional laser, and intense pulsed light (IPL). All the while, doctors such as Dr. Levine are offering beautification packages that are specifically tailored for the hands.
There’s no going back for the industry. “Patients once said they wished their chest and hands could look as good as their face,” Dr. Levine says. “The first person we treated said no woman over age 50 should be allowed to have her face done without doing her hands as well.”
