Due to the high exposure of hands to the environment, specifically the sun, the hands tend to age at a more rapid rate than the rest of the body. This ageing process manifests itself on three different levels with most patients having a combination of concerns often requiring various combined treatments.
Epidermal damage results in abnormalities in
pigmentation of the skin. The skin can also form a
rough texture. For discrete pigmented areas, the
treatment typically used is laser treatment and
there is normally only a single treatment required.
Fractional laser resurfacing is used where hyperpigmentation is more generalised.
For more information see FRAXEL
All of the pigmentation treatment programs should go hand in hand with daily sunscreen which helps prevent the recurrence of the pigmentation. In some cases which are particularly resistant to laser treatment, a prescription cream may be required in conjunction with the regular treatment. This needs to be applied nightly. Abnormalities in skin texture including roughness of the skin can also be due to an age related reduction in the content of water in the skin combined with skin damage due to the sun. Superficial peels can help to improve this situation.
Dermal damage resulting in wrinkling. Wrinkle
formation often occurs on the hands before they
occur in other areas of the body. To help control
this process, superficial peels can be used by
applying them every night. Clinical peels can also
be used to stimulate dermal collagen.
For more information see PEELS
Fractional laser technology can also stimulate collagen production, helping to prevent dermal damage. In these cases, typically 4 to 6 treatments at monthly intervals are used.
Level three is where there is a loss of volume and
elasticity in the skin. It is also characterised by
veins in the back of the hand being much more
prominent. Loss of skin elasticity can be treated
with deep tissue heating with radiofrequency
treatment. Volume loss can be treated using dermal
fillers. Fillers include hyaluronic acid which can
replace the lost volume of the hand. This is a
simple technique which requires a couple of syringes
per hand which may need repeating once or twice a
For more information see DERMAL FILLERS
Particularly prominent veins on the backs of the hands can also be treated by using a very fine injection technique. This is called sclerotherapy, a treatment which is also used on leg veins. Each hand is treated in separate sessions and elastic bandages need to be worn for several days after treatment has being carried out. To get a satisfactory improvement, typically a series of treatments are required.