When I met my boyfriend for the first time, and I told him my age, he couldn’t believe it. One could be quick to point out that he might have been charming me; but when I asked him if this is something he told everyone he met, he immediately took my hands in his and said to me: “Look at your hands. These are the hands of a 20-year-old. If you want to know a woman’s real age, just look at her hands. And you just fooled me.” Two years later, and he’s still amazed at how young my hands look. Needless to say, I do facials for a living, so my hands have reaped all the benefits of my work!
MAKING HAND TREATMENTS AN INTEGRAL PART OF SKIN CARE
The hands are one of the most expressive parts of the body. Hands not only are the first part of the body to show the signs of aging, but very often age even faster than the face.
Our hands tell a story. Although they are often taken for granted, the hands reveal significant details. Women and men spend so much time and money today trying to “de-age” their faces, but according to Howard Sobel, MD, “The hands can reveal true age quicker than any of the fillers can plump up sagging skin. You need only to see all the pigmented spots on a woman’s hands that come from sun exposure to know that no matter how smooth the face, this person is way older than she claims to be.” And that’s exactly what my boyfriend said when we met the first time!
Why is this? First of all, “there is very little fat on the backs of the hands, so when even a small amount of collagen or elastin fibers begins to break down — which is part of the normal aging process and partly from sun exposure — it’s going to have a noticeable impact on your hands,” says Gregory Buford, MD, a Denver plastic surgeon. In addition to environmental damage, hands lose fat and connective tissue, and start to look thin and transparent over time. Veins also become more prominent and the skin becomes thinner and drier; a dead give-away to a person’s age.
Aging is no longer measured by crow’s feet and saggy jowls, but by the top part of the hands, where the skin is thinner and tends to wrinkle over time. And like any other part of the body, prevention is the key. Wearing protective gloves when doing household chores is a must. Let’s see…what else?
Your hands really need more moisture than any other part of our body because they are exposed to the elements more, all year-long, and we wash them frequently, which tends to cause a loss of the skin’s protective oil mantle. While a moisturizer won’t reverse sun damage or create new collagen, it can leave skin looking plumper and more youthful. Some of the ingredients you need to look for are shea butter, macadamia nut oil, olive oil, vitamin E, cocoa butter and coconut oil. Since all moisturizers work more effectively when applied to skin that is slightly damp, use them after a shower or bath or after washing your hands.
What applies for the face and décolleté (chest area) might be even more important for the hands: sunscreen. The face is actually slightly more protected with makeup and face creams that contain sunscreen, whereas most people do not pay attention to their hands during their morning routine. So coat your hands with a good sunscreen several times a day, especially when driving. Look for long-lasting protection from UVA and UVB rays responsible for brown spots and wrinkling. I personally like to wear gloves when I drive.
Among the newest advances are creams containing growth factors, mostly derived from plants. These creams promote new collagen formation, and it’s not a bad idea to begin using these creams every night starting at around age 30.
DRY HAND HELPERS
There are many good hand creams on the market, but using an emollient sunscreen during the day provides double bang for your money. I cannot emphasize enough how important it is to apply moisturizing sunscreen to the hands as part of an everyday routine, right after applying sunscreen on the face, just as you would brush your teeth and put on deodorant first thing in the morning. Sunscreen needs to be applied 30 minutes before exposure for maximum protection. Ideally, applying sunscreen right after a shower and before morning coffee will give it time to absorb.
AGE SPOTS AND SUN SPOTS
Spots on the hands can appear as early as age 30, especially for those who live in a year-round sunny climate. To treat lighter spots, a combination of prescription-strength hydroquinone and retinoid is the dermatological standard use during a three-month period. Hydroquinone blocks the production of tyrosinase, the enzyme needed to produce melanin, and the retinoid increases cell turnover to remove visible pigmentation. This protocol can be very irritating to the skin. CAUTION: Prolongued use of hydroquinone (over 8 weeks) causes ochronosis, a condition in which the skin becomes irritated, inflamed, reddened, thickened and more densely pigmented on the area affected. This type of chemical contact dermatitis is directly caused by hydroquinone and can sometimes begin or worsen due to sun exposure on the area.
Light peels featuring both lactic and glycolic acids can be used by skin care professionals as an in-spa treatment to increase the exfoliation of visible pigmentation. To avoid ochronosis, many professional skin care brands now make a skin-lightening formulation using herbal and botanical lighteners, such as arbutin, bearberry and kojic acid. Used in combination with light peels, these formulations provide cumulative lightening results. Diligent follow-up is needed to maximize results; therefore, recommended home-care formulations are a must.
For stubborn spots, many lasers on the market can target sun damage. Hand revitalization units deliver pulses of high-energy LED, causing acceleration in the turnover of visible pigment. Dramatic results can be achieved, but sun spots will return without proper use of sunscreen.
PRONOUNCED HAND VEINS
As fat is lost, the veins in the hands become much more visible. The fashion to be thin also exaggerates the prominence of veins.
Sclerotherapy, the same physician-administered treatment used to treat leg veins, can be used on the hands. A saline solution is most commonly used. It works by irritating the walls of the vein, causing them to collapse. Some stinging and burning is experienced, and hands will be bruised and swollen after the treatment. One to three sessions are needed, depending on the thickness of the vein. A more natural solution might be to keep the hands deeply hydrated so that the skin looks plumper.
As part of the aging process, not only does the face lose collagen and elastin, but all the skin on the body gets less tight. Choices for improving appearance range from laser treatments to fillers. Often, both treatments are used in combination for best results. As I mentioned earlier, growth factor serums can be used early on to prevent these drastic measures.
Pay attention to signs of fungus, yellowing or any dark spots on the nail, and resist covering up these symptoms with polish, because some can be a sign of health concerns. If you wear a lot of dark-colored polish, nails are often discolored, but this can also be a sign of diabetes, psoriasis or even liver damage that requires medical attention. Breakage and ridges on the nail can be signs of poor nutrition, or just the lack of treating hands with the same respect as the face. Cuticles are dry in most people and can be addressed by an overnight application of vitamin E oil or any other type of oil mentioned earlier.
There are now a myriad of hand treatments, like the “hand lift.” During the 5-10-minute procedure, which costs about $1,200, synthetic fillers like Radiesse, Juvéderm or Perlane are injected under the first layer of skin to plump it up, or a combination of fillers, intense pulsed light and CO2 laser resurfacing to remove sun spots (about $1,500) can also be performed. The effects typically last about a year.
Other techniques are the Fraxel laser to remove diffuse wrinkling or discoloration; Thermage for skin tightening; sclerotherapy, which involves injecting a solution directly into the vein to treat varicose veins; the Q-switched laser, which fires very rapid pulses and blasts away pigment spots, and injections of fat to plump up the hands.
Dermatologists also offer IPL lasers or a fractional resurfacing laser. These lasers emit a short pulse of intense red light, which absorbs the skin’s melanocytes—cells that produce the dark spots. The light breaks up the pigmentation into smaller particles that the body’s immune system can then remove.
As with any filler, potential complications exist, including infection, skin discoloration, nodule or granuloma formation, asymmetry and skin necrosis. But the most common reactions are local bruising and swelling.