You can increase skin thickness with retinoic acid: This anti-ager improves skin texture and decreases wrinkles by speeding up cell turnover and boosting collagen production. The prescription strength has a reputation for being irritating, but don't dismiss it if you've had a bad experience. "I've found retinoids like Renova [$150 plus] are much easier on the hands than on the face," says Dr. Alexiades-Armenakas. Over-the-counter creams with the less powerful retinol or retinyl palmitate, like Yes to Blueberries Seed Fund Gardener's Hand Cream ($9, yestocarrots.com), are even gentler. Still, you may or may not see an improvement. Exfoliating also encourages new skin, but most body scrubs are too rough for hand skin; instead, look for a sloughing cream, like Philosophy Time on Your Hands ($18.50, Sephora), with glycolic acid. Chemical peels are a stronger route to cell renewal and offer a quick skin perk-up. If you go the at-home route, one option is Dr. Dennis Gross Skincare Alpha Beta Daily Body Peel ($78, amazon.com). A dermatologist's glycolic peel will cost more (about $200) and requires multiple sessions for maximum results, but the concentration can be tailored for fragile hand skin.
Only an in-office procedure can address protruding veins. Consider a laser like DioLite, which heats and shrinks vessels in one or two sessions, at $600 each. Or, for immediate gratification, try a synthetic filler, injected into the space between the tendons. The most popular these days is a gel called Radiesse, which is used off-label for hands (it starts at about $2,000). Once injected, it stays soft and melds with surrounding tissues, lasting a year or more. On top of instant plumping, it prods skin into producing more collagen. A 2011 study at Sadick Dermatology in New York City deemed it safe, with very minor side effects and impressive results. At nine months, 80% of the patients' hands were improved. A call to Dr. Fusco confirmed this: "I've never had a bad result with Radiesse."
I decided to give it a try. The process was relatively quick and painless, but right afterward, my hands puffed up like mittens. A week later — the swelling down and bruises gone — I found myself staring at my smooth, filled-out hands with admiration. There is still some redness across my knuckles, and I will continue to pamper and protect. Meanwhile, I've pushed up my sleeves and started wearing bracelets and rings again. Finally, after six months of treatments, my hands are ready for their close-up.