Show of Hands

Anti-aging skincare is by no means a new field. Every day, new ingredients, procedures, and treatments are introduced that promise younger looking faces and rejuvenated skin. There is, however, one part of the body that is hands-down the most forgotten area when it comes to skincare, treatment, and prevention—the hands. “Many women learn to take great care of their faces when they’re still young but not their hands,” says Mitch Chasin, M.D., a cosmetic physician and laser specialist and the medical director of Reflections Center for Skin & Body (Bridgewater, NJ, and Livingston, NJ). “They are generally neglected, outside of being treated to a little moisturizer now and again. All of this leads to the hands showing the signs of aging before you see them in the face. Hands have a hard life!”

There are many reasons hands show a client’s age more readily than the face. First, most women start taking care of their faces at a young age, using sunscreen, hats, and makeup with built-in sun protection. Hands, on the other hand, are constantly exposed to the sun, cold air, and harsh cleaning chemicals. The result is clients who reach their early 40s and start to panic when they notice discoloration and age spots, followed by a loss of volume and the prominence of veins and tendons in their 50s and 60s, according to Dee Anna Glaser, M.D., F.A.A.D., a board-certified dermatologist and professor and vice chairman in the department of dermatology at Saint Louis University in St. Louis, MO, in her presentation at the American Academy of Dermatology’s Summer Academy Meeting.

The main culprit of this aging of the hands is the sun. “Collagen depletion happens naturally due to aging, but prolonged exposure to sunlight can also contribute to its loss, and our hands are typically the one part of our body that get the most rays during our lifetime,” says Chasin. “Four or more decades of sun exposure can add up to volume loss and visible sun damage, like sun spots and wrinkles, resulting in hands that look spotted, veiny, and old.”

Thankfully, a solution to treating older looking hands is well within reach via a combination of treatments. Chasin says he uses dermal fillers, like Radiesse, and skin-resurfacing lasers, like Fraxel Re:Store, to address granny hands. The laser attacks the surface of the skin, creating microscopic columns of wounds to a small portion of the skin cells. As the cells heal, sun damage, age spots, and fine lines disappear. Pair this with the immediate injection of Radiesse dermal filler below the skin to immediately replace volume right where it’s needed, and over time, it stimulates the growth of new collagen in the area to keep the hands looking full and healthy. “It’s a very effective one-two punch, and patients are thrilled with the results,” he says.

The side effects of the above treatment are quite minimal, according to Chasin, who reports that most clients exhibit redness for a few days but no bleeding. Still, for those clients who may want to try a less aggressive approach, Glaser suggests that some topical treatments containing glycolic acid and antioxidants like hydroquinone, tretinoin, and retinoids may stimulate some repair. It’s also important to remind clients to think about their hands when it comes to suncare and general TLC. Glaser advises having them 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, and to keep sunscreen in the car to apply prior to driving. She also advises wearing gloves when doing yardwork and housework to further protect hands from the sun and chemicals. Chasin adds that it’s important to use a quality moisturizer at least twice a day to keep the skin well hydrated and plump. All of these efforts are important, because “the backs of the hands are a tricky area to treat,” says Chasin. “I think it’ll be a while before we see something new that works significantly better than the great tools we have today.”

After all, while clients may admire the faces of celebs like Sarah Jessica Parker, her well-publicized granny hands should serve as a cautionary tale for clients. “She is a good example of a celebrity who has a well-maintained face but a pair of hands that look like she stole them from Betty White,” says Chasin. It’s all the more reason to use a firm hand when dealing with clients looking to do an about-face with their anti-aging efforts and give themselves a hand.