Rejuvenating Your Hands--The Winning Hand
Posted: Wednesday, September 27, 2006
by Nelson Lee Novick
Nelson Lee Novick, M.D.
Next to the face, your hands are the most exposed area of the body. You can’t hide them in clothes or behind high collars, like a chest or a neck, and, while your face may not betray you, your hands can give away your age like the rings of a tree. According to an Allure magazine article, up to very recently, the hand was called the “last virgin body part" because so little was done or could be to rejuvenate them. Fortunately, all that has all changed.
The backs of the hands of young people are unwrinkled and plump and are not mottled with dark patches and splotches. By contrast, older-looking hands appear frail, thin, boney, and wrinkled, with bulging veins, and clearly visible tendons. So, anything we can do to lighten or eliminate dark spots, diminish the prominence of the blood vessels, and mask the tendons and bones can wipe years off the apparent age of your hands.
“Liver spots," or solar lentigines, are flat, dark, freckle-like patches that appear gradually on the backs of the hands. They are believed to result from an interplay of genetic predisposition and chronic sun exposure.The use of topical bleaching creams, alpha hydroxy acid products (containing glycolic or lactic acids), tretinoin (the main ingredient in Retin A), and bleaching creams (containing hydroquinone or kojic acid) are excellent first line therapies to lighten or eliminate them. For best effect, these products must be applied daily for several months accompanied by the diligent use of sunscreens to prevent recurrence. For more resistent spots, your doctor may recommend removal by a variety chemical peels, cryotherapy, or laser therapy.
Actinic keratoses and seborrheic keratoses can also mar and age the skin of your hands. Sometimes called “sun spots," actinic keratoses are scaly red patches that result from chronic ultraviolet damage. Considered early stage malignancies, these unsightly growths may be eliminated by the application of topical prescription agents, such as Solaraze, Aldara, or Carac or destroyed by scraping them off, freezing them, laser treatment or electrosurgery.
Seborrheic keratoses are benign, thick, brown, crusty, barnacle-like age spots linked to a strong genetic predisposition for their development. They are amenable to being scraped (curetted) off, under local anesthesia, or treated by means of laser or electrosurgery.
Prominent, enlarged veins on the backs of the hands respond well to sclerotherapy, or the injection of a sclerosing agent. This usually consists of instilling a very high concentration salt solution directly into the unwanted blood vessels. You might experience a slight burning as the sclerosant goes in, but no local or even topical anesthesia is generally necessary. By irritating the walls of the blood vessels, the sclerosant solution causes them to seal together and eventually shrink away. Several treatments spaced at monthly intervals are usually neccesary to achieve the desired results.
It is only relatively recently that we have come to appreciate that restoring volume to the backs of the hands is a must for achieving a more youthful appearance. Volume loss around the bones, blood vessels, and tendons is largely responsible for the prominence of these structures over time and the appearance of frailty and wasting.
Autologous fat transfer (i.e. fat taken from your own body and reinjected elsewhere) was first used for this purpose as much as a decade ago. The downside of fat injections is that they necessitate a minor surgical procedure, akin to a mini-liposuction, in order to harvest the fat from the abdomen or thighs before processing and reinjection into the hands.
Recently, cosmetic dermasurgeons have turned to the newer dermal filling agents and volumizers to restore the hands. Restylane, a synthetically produced hyaluronic acid derivative whose molecules have an enormous affinity for attracting water, is an excellent choice for hand rejuvenation. Its use does not require pre-treatment allergy testing and its very smooth texture, in part due to the large amount of water it attracts and binds, imparts a natural appearance and feel. The obvious advantage of Restylane is that comes pre-packaged and may used right off the shelf without the need of any minor surgery.
Before treatment, the wrist and the troughs between the bones on the backs of the hands are numbed with local anesthesia. Restylane is then injected directly into spaces between the bones to plump and re-elevate the skin above. It is next massaged and molded to ensure smoothness and adequate and uniform coverage of the underlying structures.The entire procedure for both hands usually takes no more than ten minutes.
Following treatment, you may experience some redness, mild swelling, and tenderness, which may last one to two days. Occasionally, you may develop slight bruising that can last several days. This is easily masked with appropriate coverup makeup. Strenous excercise should be avoided for the next 48 hours and the hands should be kept elevated as much as possible during that period. The effects of the treatment are immediate, and more than 90 percent of patients are extremely gratified with the results after just one or two sessions. Improvement generally lasts several months before a touch-up is needed.
Happily, you no longer have to look at your hands and feel depressed. You needn’t continue to lament, “They can never guess my age until they look at my hands." A veriety of simple, non-surgical techniques now available can go a long way to rejuvenating your “misplaced" hands--dramatically improving their appearance and your overall look in just a matter of minutes.
Dr. Nelson Lee Novick is a Clinical Professor of Dermatology at Mount Sinai School of Medicine in New York City, an Attending Physician, and a former OPD Clinic Chief within the department of dermatology of the Medical Center. He also maintains a private practice in Cosmetic Dermatology and Cosmetic Dermasurgery on Manhattan's Upper East Side. His biography has been included in the most recent 46th through 61th editions of Who's Who in America, and he has been listed in Consumer Research Council of America’s Guide to America’s Top Physicians--2003-2006. He is also the author of nine trade books, over a hundred by-lined articles, and more than a half dozen audiotapes on skin care. He has written for many popular magazines and newspapers, such as Good Housekeeping and Reader’s Digest and has been quoted in all the major print venues, including the The New York Times, The Washington Post, and USA Today. He is a familiar face to network media and has been featured with Oprah Winfrey, Paula Zahn, Matt Lauer, and Joan Hamburg. http://www.skinsavvy.fromyourdoctor.com
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