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The EV guide to Hand Rejuvenation

Subjected to non-stop soaping and alcohol-dousing, hands have had a hard time of it – if yours need rescuing, aesthetic treatments can help

Like necks, ageing hands have a way of creeping up on you. Seemingly from one day to the next, age spots start appearing and veins pop out in a way previously only seen on your nana.

And after the near-two years we have had fighting Covid, your hands may be giving your age away even sooner than you bargained for.

Relentless handwashing and disinfecting will have stripped the skin of many of its essential lipids and healthy bacteria, allowing for dehydration and unfettered environmental attack.

Add to that the fact that only very few of us think to include our hands in our daily SPF-habit, despite them being as exposed as our faces, and you get why there’s a growing market for dedicated hand rejuvenation treatments.

But before you decide to try your favourite face tweakment on your hands (it’s all the same skin, right?), you’d do well to heed the medics’ advice: “I would say that some facial treatments can get great results on the hands, but there are others that have little or no effect,” says EV Expert Dr Ross Perry, Clinical Director at Cosmedics clinics.

“The skin on the hands is very thin and as a result, treatments need to be delicate and done with a duty of care. Some can be counterproductive, so you need to proceed with caution.”

Ageing-hand signals

The right option for you depends on the issues you want to tackle. “The most common ones include prominent tendons on the backs of the hands – this tends to be associated with age-related loss of muscle mass,” says Etre Vous Expert Dr Vincent Wong of Vindoc Aesthetics.

“The little fat you have in this area will also waste away with age, allowing veins to ‘bulge’. A lack of natural moisture and lipids can quickly make this ultra-thin skin look crepey, while the inevitable loss of collagen and elastin can make it go slack. Pigment spots on your hands are another big giveaway you’re no longer in your 20's.”

You could start wearing fingerless gloves like an 80's Madonna, but with targeted and effective aesthetic treatments for each of these niggles, why bother?

The best course of action for…

“When it comes to the brown dots or age spots that so often occur in people from the age of 40 or 50 onwards, intense pulsed light (IPL) is my go-to treatment,” says Perry. “It tends to work incredibly well to reduce the pigmentation, whether it shows as small singular spots or larger areas, because you can control the settings depending on what you’re working at.”

More resistant spots, he says, sometimes need treatment with the Q-switched Nd:Yag laser to break up the melanin clusters, or assiduously administered cryotherapy (literally, it freezes the brown spot). “Once treated, the lesions normally go a darker colour for about a week, but two weeks after that, they tend to be gone,” Perry says.

Skin-brightening peels are another option, but they need to be mild to, at most, medium-strength ones, performed with caution: the hand area has fewer sweat and sebaceous glands and is also less vascular than the face, which means that there is a chance of impaired wound healing and unpredictable results.

So, says bespoke skin peel specialist Dr Rabia Malik of the Harrods Wellness Clinic, “My base formulation would be a combination of mandelic and lactic acids. Non-aggressive, they are effective at managing hyperpigmentation and dark spots and also smooth and brighten skin, as well as helping to stimulate collagen,” she says.

“Depending on the formulation and concentration of active ingredients, peel treatments yield results within about four-six weeks’ time and I would usually do a course of three treatments for optimal results.” Malik also likes mesotherapy for mildly discoloured hands: “It’s great for brightening and has little downtime.”

“Patients with dry, crepey and thin skin on the back of the hands are great candidates for skin boosters, popularly known as injectable moisturiser, says Wong. “Profhilo is probably the most well-known of these, and a great choice.”  

Just a few injections of this specially treated hyaluronic acid are needed, which then spreads out through the deeper layers of the skin to retain glow-giving moisture. Plumped and irrigated, skin also goes through a process of ‘bio-remodelling’, with collagen and elastin fibres becoming more uniform, which leads to less crepey-looking skin.

“It’s extremely effective at restoring hydration, glow and thickness,” says Wong. With Profhilo, results are visible in one to four weeks and last six-nine months.

Malik favours PRP (platelet-rich plasma) therapy (also known as the ‘Vampire Facelift’, which re-injects your own, multiplied growth factors into your skin) for hands to restore plumpness: “It’s good for overall rejuvenation, and in my experience, particularly helps with improving skin crepiness. A combination treatment, such as collagen-stimulating microneedling with PRP, would be even better.”

Bulging tendons and veins
“Volume loss combined with loss of elasticity makes hands ideal candidates for Ellansé injections,” says Wong. A filler not made, like most, of hyaluronic acid, but of a substance called polycaprolactone, it doesn’t just immediately volumise gaunt areas, but it significantly stimulates the body’s own deposition of two types of collagen, making the padded-out results last up to four years.

Injected between the bones of the backs of the hands and lightly massaged,  Ellansé settles fast and almost instantly smooths and softens their look, minimising a look of sagginess in the process.  

Sagging skin
With intense skin-tightening tweakments such as Ultherapy and Fraxel attracting headlines and fans thanks to their ability to visibly rejuvenate and lift facial skin, you might think they’re a shoe-in for younger-looking hands.

Not so, says Perry: “The skin here is too thin for these technologies to be either safe or effective,” he says. “Ultherapy (high-intensity focused ultrasound energy) is useless as there is not enough tissue to contract.”

Ablative fractionated laser treatments like Fraxel, which remove small areas of skin to allow it to rejuvenate, can cause scarring and permanent pigment changes on hands. And, says Perry, “I don’t find it very effective on for removing pigment spots on hands because the pigmentation often runs deeper than the layers the laser treats.”

As said, peels also need to be approached with caution and should be administered by an experienced specialist, but they can help boost collagen and elastin production and tighten skin. “I often combine my peel-based treatments with microneedling as it enhances the benefits of the skin peels by allowing them to penetrate more deeply, with little superficial downtime,” says Malik. “It’ll take a few weeks to see the benefits, with full results apparent after about 12 weeks.”

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