You know all those hours you log in at the gym and the small fortune you're dropping on skin cream? If you're not taking care of your hands, you're still spilling the beans on just how many candles will be burning on your next birthday cake.
"Hands not only are susceptible to the first signs of aging, but very often age even faster than the face," says Ellen Marmur, MD, chief of dermatological and cosmetic surgery at Mount Sinai Medical Center in New York City. That's because the skin on the back of the hand is much thinner than that on your face.
"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.
The end result, say experts, is wrinkly, crinkly crepe-like skin texture and the noticeable appearance of bulging veins, which also grow larger over time.
"Depending on how much sun exposure you had as a child and young adult, aging also brings out brown spots, known as liver spots -- pigmentation problems that give away your age," says dermatologist David Goldberg, MD, director of Skin Laser & Surgery Specialists of New York and New Jersey.
But you don't have to throw up your hands and give in without a fight. WebMD asked medical experts for top strategies to turn back the clock on your mitts, from pumped-up pampering at home to the latest developments in professional treatments.
Home Skin Care for Your Hands
If you're like many women, your at-home hand care is limited to using dishwashing detergent with moisturizer and maybe a drugstore hand cream now and then. But experts say with just a bit more effort, you can improve the appearance of your hands right now -- and 20 years from now. "There are certainly products and key ingredients that can make a temporary difference in how your hands look, and there are some exciting advances that could help make a real difference in your skin," says Goldberg.
Cream of the Crop
Among the newest advances are creams containing growth factors, mostly derived from plants. "These are creams that appear to promote new collagen formation -- you're not going to get what you would with a [medical treatment], but it's not a bad idea to begin using these creams every night starting at around age 40," says Goldberg.
Science backs this up. One recent study, published in Journal of Drugs in Dermatology in 2007, reported 83% of women between ages 35 and 65 who tried creams containing growth factors found improvement in their hand wrinkles after just 60 days. Creams containing growth factors include:
- Regeniskin (50 mL/$29.95)
- SyCream by Syprex (2 oz/$39.50)
- Neocutis Bio-restorative Skin Cream (50 mL/$120)
- SkinMedica TNS Recovery Complex (1 oz each of cream and serum/$185)
If you prefer to skip pricey creams, experts say to aim at least for daily use of a simple moisturizer. That alone will improve the appearance of your hands.
"Your hands really need more moisture than any other part of your body because they are exposed to the elements more, all year long, plus you are washing them frequently, which also tends to cause a loss of the skin's protective oil mantle," says Marmur.
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 in these products include shea butter, macadamia nut oil, olive oil, vitamin E, and glycerin. 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.
Moisturizing products containing a healthy dose of these key ingredients include:
- Eucerin Plus Intensive Repair Hand Cream with gylcerin and alpha-hydroxy acids, offering moisturizing and exfoliation (2.7 oz/$5.49)
- Lubriderm Advanced Therapy Hand Cream with Vitamins E and A, delivering protection that lasts through multiple hand washings (3.5 oz/$8.69)
- Nivea Smooth Indulgence Hand Cream with macadamia nut oil and glycerin (3.5 oz/$5.99)
- Skin Milk Hand Lotion with SPF 15, milk proteins, and retinal palminate (4 oz/$4.99)
- Terralina Body Lotion with olive oil and shea butter (8 oz/$28)
What about all those topical treatments promising skin lightening? The key ingredient is hydroquinone, but dermatologists are split on how helpful it can be. "For some people they work wonderfully well -- and significantly lighten the brown spots; for others, they don't work at all," says Marmur.
More worrisome is that some studies have begun questioning the safety of hydroquinone. In 2006, the FDA announced a proposed ban on over-the-counter hydroquinone products, based on lack of data for safety or effectiveness. And though the ban has not been put in place, some doctors advise skipping this treatment, while others approve of its use while under a physician's care. "At this point you are much better off going with a professional treatment -- it's quicker and safer," says Goldberg.
Doctors agree one key to keeping young hands looking young is to avoid direct sunlight. The next best thing is to coat your hands with a good sunscreen several times a day.
Among the newest and most protective products are sunscreens containing Mexoryl SX (ecamsule), developed by L'Oreal, and Helioplex, a technology created by Neutrogena. Both offer long-lasting protection from UVA and UVB rays responsible for brown spots and wrinkling. Sunscreen products to look for include:
- Neutrogena Healthy Defense SPF 45 Daily Moisturizer (1.7 oz/$11.99)
- Neutrogena Ultra Sheer Dry-Touch SunBlock SPF 70 (3 oz/$9.99)
- L'Oreal Dermo-Expertise Revitalift UV Daily Moisturizing Cream with Mexoryl Sunscreen SPF 15 (1.7 oz/$22)
- Lancome UV Expert 20 with Mexoryl SX Daily Moisturizing Cream SPF 20 (3.4 oz/$35)
It used to be a luxury reserved for the rich and glamorous -- VIP pampering in a heated paraffin wax hand bath. Now this helpful treatment is within easy reach for everyone, thanks to the availability of small, portable units for home use.
For as little as $50 for the unit, plus the cost of wax, you can give your hands a daily dip that promises to rehab even the driest cracked skin. "These treatments can be very useful for deep moisturizing, and I would recommend them as more effective than a simple hand cream," says Buford.
Why wax? According to Marmur, it coats the skin, offering a form of protection you don't ordinarily get from a cream.
Reasonably priced home paraffin wax units are available from companies such as HoMedics; Therabath, which offers wax in luscious scents such as vanilla cupcake, rose petal, and lemon; and Artemis Woman, specializing in wax infused with shea butter.
Professional Anti-aging Skin Care Treatments for Your Hands
Not quite satisfied with the results of your at-home hand care? You may be ready to consider professional options. "Some of the most exciting new anti-aging advances in face and neck care are turning out to be amazing treatments for the hands," says Marmur.
Pro hand care is on the rise, say experts. But regardless of what treatments you consider, be certain they are done under the guidance of a board-certified dermatologist or plastic surgeon.
WebMD asked experts for a short list of the most effective professional procedures for those in search of youthful hands.
Medical Fillers for Hands
Because the skin on the back of the hands is extremely thin, losing even a minimal amount of fat padding creates a crepe-like, aged look.
"It's a lot like letting the air out of a balloon -- it just deflates, and skin no longer has the support structure it needs to look and feel firm the way young hands do," says Marmur.
That's why the No. 1 professional hand care treatment to date is medical fillers, those same wrinkle-filling injections used on the face. "However, unlike the face, where you're filling a line, when you treat the hands you're filling space, adding volume, and putting back some of the cushion under the skin that has been lost through the years," says Goldberg.
Among the most popular fillers are Radiuses, Sculpture, Per lane, and Juvederm Ultra Plus. "You're looking for thicker fillers with a much heavier consistency than what you would use for lines on the face, such as Restylane," says Marmur.
Once injected, Goldberg says, the filler is massaged across the back of the hand and "fanned out" to plump up and fill in the entire area. The treatment takes less than 20 minutes, and results are visible in a couple of weeks.
Initially, results can last from one to two years, longer than in the face, say experts, because the back of the hand has fewer muscles and less muscle activity capable of breaking down the filler. Buford says there is also evidence the injections stimulate the body's own production of collagen and elastin, so as time goes on you may need less filler less often to maintain the youthful look.
The Risks of Medical Fillers: Buford cautions about a theoretical risk of tiny lumps of filler and skin that form under the skin and that require surgery to remove. So far, no cases have been reported. Also, African-Americans or others who may have a tendency toward the formation of scar tissue or "keloids" should use only under the care of someone experienced in treating ethnic skin, says Buford.
The Cost of Medical Fillers: Depending on how much you need (men usually require three injections per hand, women about two), the cost can run from $1,000 to $6,000 per pair.
Laser Skin Resurfacing
For those who are needle-shy, or who want to amp up the impact of their filler treatments, experts say a few zaps from the new fractional laser skin resurfacing tool can do the trick.
Unlike laser treatments in the past that caused deep wounding and long recovery time, the new lasers create miniscule pinholes in the skin that inspire your body to begin producing its own collagen and elastin, without scarring, redness, or recovery time.
"You get the benefits of laser resurfacing -- still the best way to remove wrinkles -- but without the down time and complication rate," says Goldberg.
But how do they keep hands looking younger? Marmur says by stimulating new collagen and elastin to grow, the treatments restore the skin's underlying support structure, making wrinkles disappear. Within several weeks you replace some of the firm, tight look of youthful skin.
An added bonus: Marmur says laser treatments help re-texture the skin itself, so your hands look younger and fresher almost instantly.
Your new collagen and elastin are permanent, but since the aging process and sun exposure continue to break them down, lasting effects vary. Marmur says with good care and judicious use of sunscreen, you could see the improvement up to five years or more.
The Risks of Laser Skin Resurfacing: In one study of 961 patients published in the journal Dermatologic Surgery in 2008, doctors reported that about 7.5% of those treated with fractional lasers on the face developed complications. The most common were temporary acne breakouts or local recurrences of the herpes simplex virus. Patients with darker skin were at greater risk for temporary inflammatory hyperpigmentation. The study's researchers noted that there was also a small risk of scarring reported.
The Cost of Laser Skin Resurfacing: Expect to pay approximately $750 per pair of hands, per treatment. Most people need three to five sessions.
Getting Rid of Liver Spots on the Hands
One sure sign of aging: those pesky brown spots or liver spots that appear on the back of the hand as early as your 30s -- and grow more prominent and darker with age.
"This is just a natural part of the aging process, but it's definitely influenced by the sun -- and the more sun exposure you had when you were young, the more brown spots you're going to see as you age," says Goldberg.
The professional treatment of choice: Lasers designed to rid the skin of excess pigmentation. Goldberg adds that IPL (a pulsed light treatment similar to lasers) also works to remove brown spots.
Although IPL treatments are generally regarded as safe and effective, a small but significant study published in the March 2008 Archives of Dermatology suggests there may be room for caution: Researchers from the University Hospital of Geneva found IPL treatments dramatically increased the level of free radicals in the skin similar to the results of exposure to UVA rays -- the kind of sun damage linked to both premature skin aging as well as skin cancer.
As long as you use sunscreen, the effects of both lasers and light sources are permanent -- on the spots treated. However, "since the induction time for a brown spot is 20 to 50 years, others could appear as time goes on," says Goldberg.
The Risks of Lasers: Although rare, treatments carry a small risk of discomfort, redness, mild swelling, and pigmentation problems. If you are prone to keloid or scar tissue formation, it's even more important to consult a board-certified dermatologist or plastic surgeon before having this treatment.
The Cost of Lasers: About $500 per session, with up to three laser sessions needed for complete fading. IPL treatments are less -- around $300 -- but take up to eight sessions to fade brown spots.