A Handy Way to Look Years Younger

Experts say nothing gives away your age like your hands. Discover why -- and what you can do about it!

From the WebMD Archives

You spend a small fortune on fabulous skin care, antiaging makeup, and a youthful new haircut. And one glance in the mirror tells you that 50 really is the new 35, until you look down at your hands.

Like rings in a tree trunk, lines, creases, dark spots, and bulging veins on the back of your hands are the sneaky little tattletales that give away your age!

"The hands are one of the first places where we see the signs of aging, and also the area most people neglect when it comes to skin care," says dermatologist Rhoda Narins, MD, professor of dermatology at the NYU School of Medicine in New York and the president of the American Society of Dermatologic Surgery.

One reason for the telltale signs, says Narins, is that hands are frequently exposed to sunlight and all its photoaging effects.

"While we would never consider exposing our face to sun without a sunblock, we often don't remember to treat our hands to the same protection," Narins tells WebMD.

That little act of forgetfulness, she says, can leave them looking even older, with not only wrinkles, but those birthday give-away "age spots" -- also known as "liver spots" or medically as "letigines."

In fact, experts say because the skin on the back of the hands is so much thinner than on our face or neck, it not only succumbs to the aging impact of the environment, but it also is more susceptible to the aging process in general.

"As we age, our skin gets thinner -- but when you're dealing with the backs of the hands, where skin is already thin, any loss of fat underneath is obvious right away -- with loose, wrinkly skin," says Bruce Katz, MD, a professor of dermatology at the Mt. Sinai School of Medicine in New York City and director of the Cosmetic and Laser Surgery Clinic at Mt. Sinai Hospital.

Moreover, Katz says that as skin thins, dark spots and pigmentation begin to appear, while veins and tendons become more obvious -- a look that is often associated with a few extra candles on the birthday cake.

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Defy, Don't Deny: The Antiaging Revolution

The good news is your hands can hold your birthday secrets and you can look as young as you feel. It all begins, say experts, with dedicated use of a sunblock with SPF15 or higher. Choose a product that is also a good moisturizer and you're even more ahead of the game.

"Then you have to make a commitment to use it every day, every time you go out in the sun, in winter, in summer, all the time, " says Narins. Doing so, she says will help halt at least some of the damage that comes when the ultraviolet rays of the sun gobble up collagen -- the molecules that help give skin a plump, youthful appearance.

Next up: Whatever you're using on your face, save a little for the backs of your hands and apply liberally.

"Day cream, night cream, antiaging serums -- whatever you're putting on your face, neck, and décolleté, put it on the backs of your hands as well," says Katz.

But if you're thinking of trying to fade those age spots using an over-the-counter bleaching or whitening cream, you may be wasting your time and money. Both experts say it's not likely to do any good.

Indeed, Katz tells WebMD, "You need professional treatments for these brown spots; you can't get rid of them on your own."

And while some experts suggest the new home microdermabrasion kits can help keep hands looking young, Narins says they won't do much except polish the skin and leave it looking smoother for a few days.

"That goes for the professional treatments as well; microdermabrasion doesn't really do much for the hands," she tells WebMD.

Katz agrees and adds that we should also stay away from any treatment -- at home or in a doctor's office -- that causes skin irritation.

"The skin on the hands is much more delicate than on the face, so it heals much more slowly. You want to stay away from any product that could do damage," says Katz.

Though for many folks the same antiaging products that work on their face are all their hands need to remain youthful, for some, it's just not enough. Moreover, by the time some of us recognize just how "old" our hands look, so much damage has been done that topical creams and lotions simply aren't potent enough to do the job.

When this is the case, experts say there are a number of professional treatments that can help. While they can be a bit pricey, results are said to be excellent, and some are very long lasting.

For the woman -- or man -- who has taken steps to keep their face and body looking youthful, Narins says the hand treatments can be an important finishing touch.

Continued

A Professional Guide to Hand Rejuvenation

To help you learn more about your antiaging hand care options, both Katz and Narins helped us put together this guide to the professional treatments that can help.

1. Plumping Treatments. The goal here is to replace the lost fat under the top layer of skin on the backs of the hands with a "filler." This works to plump the skin, taking away what Narins calls that "bony skeleton look," and fills out wrinkles. "It's also a great way to hide those bulging veins and tendons, which also age the hands," says Narins.

The two substances of choice, say doctors, are either analogous fat -- taken from your own fat cells -- or a man-made filler known as Restylane.

How It's Done: If your own fat is used as filler, doctors use a thin needle to extract a tiny amount from your buttocks or thighs (and no, you won't end up thinner there!). That fat is then injected through a tiny hole made on the top of the wrist.

When Restylane is used, Narins says, the filler is injected much the same way. "We use only a local anesthesia and there is basically no down time," she says.

What You Can Expect: Immediately fuller, less wrinkled hands. Results can last anywhere from six to nine months for the Restylane filler; three years or more for the fat filler.

Cost: One fat injection treatment for both hands can cost between $2,500 and $3,000. One Restylane injection starts at $500 per hand -- and could be higher depending on how much plumping is needed.

2. Laser Treatments. Depending on the type of laser device used, several different types of treatments can be administered, each addressing a different problem. For brown spots and highly pigmented areas, Katz recommends an Alexandrite laser beam, while Narins suggests the YAG laser.

To tighten loose skin, Katz recommends a combination treatment with the TITAN and Cool Touch lasers. "This produces new collagen, thickens the dermis, and tightens the skin," he says. Narins likes the effects of the intense pulsed light (IPL) device, a nonlaser light therapy that works in a similar fashion.

What You Can Expect: Following brown spot therapy you will develop small, light scabs which disappear within a week and leave no scars. For the skin-thickening treatments results will appear gradually over weeks and months, but there's no scabbing and no down time.

Cost: Brown spot laser treatments: $400-600, one session. IPL, or TITAN and Cool Touch plumping - four to six treatments ranging from $500 to $800 per treatment.

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More Antiaging Techniques

3. Chemical Peels. Best used for brown spots and age pigmentation, this treatment relies on various chemicals to burn away the top layer of skin. Though some doctors -- like Narins -- say it's a superb and safe treatment for age spots, others, like Katz, believe it's too harsh for the skin on most people's hands.

What You Can Expect: Some redness and irritation that usually subsides within a few days. Katz says there is a high risk of scarring if your skin is very thin or sensitive.

Cost: $500- $700.

4. Sclerotherapy/Laser Ablation. The goal of both these treatments is to obliterate the unsightly and bulging blood vessels in the back of the hands. In sclerotherapy a mild irritant is injected into the vein, blocking blood supply and causing it to shut down and shrink from view. In laser ablation, a beam of light is used to accomplish the same thing.

What You Can Expect: Both treatments are relatively painless with no down time, but it can take up to several weeks to see full results. Because these veins are necessary in the event that you are hospitalized and need an IV port, most doctors shy away from this treatment unless the veins are very tiny and superficial. Katz says this therapy is best used to eliminate spider veins only. To help hide larger veins both he and Narins recommend fat injections to plump the area around the vein, causing it to recede from obvious view.

Cost: $300 - $500 per treatment; one to two treatments needed.

WebMD Feature Reviewed by Brunilda Nazario, MD

Sources

Published Oct. 17, 2005.

SOURCES: Rhoda Narins, MD, professor of dermatology, NYU School of Medicine, New York; president, American Society of Dermatologic Surgery. Bruce Katz, MD, medical director, Juva Skin and Laser Center; director, Cosmetic and Laser Surgery Clinic, Mount Sinai Hospital, New York. American Academy of Dermatology Resource: "Non Facial Aging Skin-Treatment Options." Fisher GJ. Cutis, February 2005; vol 75(2S): pp 5-9.
© 2005 WebMD, Inc. All rights reserved.

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