Despite the many preemptive measures we take to slow signs of aging on our face, neck and décolleté, our true age can be easily detected with the wave of a hand. Thanks to some of the same treatments we’ve long relied on to even skin tone and texture, and a few fillers FDA-approved for the hands, an about face: Our most expressive accessories are primed to (finally) look as fresh as our complexions.
The Concern: Dry, Flaky Skin
Now more than ever, handwashing with the frequency of an overscheduled surgeon has become a necessary part of staying healthy. But while the practice goes a long way to ward off fungi, germs and bacteria, soaps can also suck the hands of their moisture. The result: dry, scaly skin with compromised barrier function that despite our best efforts, isn’t optimized to keep out bacteria, viruses and more.
“The skin on the hands don’t have as many sebaceous glands as the skin on the face and other areas of the body, so it’s more likely to become dry, and quicker,” says Beverly Hills, CA dermatologist Ava Shamban, MD. “You really should replace the moisture that’s lost in your hands after you wash them.”
The Fix: Proven Hydrators
To replenish hydration in the hands, look for a moisturizer with squalane, ceramides and antioxidants. Dr. Shamban’s favorites include La Roche-Posay Lipikar Eczema Soothing Relief Cream ($15), Restorsea PRO Intensive Hand Treatment 10X ($100) and Eucerin Advanced Repair Hand Cream for Very Dry Skin ($5).
The Concern: Hyperpigmentation on Hands and Knuckles
The main culprit behind blotchy brown spots on the hands? UV light. “The hands are not much different than the face,” says New York plastic surgeon Stafford Broumand, MD. “If you don’t protect them against the sun, age spots and pigment changes will develop.”
If brown spots appear on the knuckles, it could be related to a larger underlying health issue, such as lupus, prediabetes, Addison’s disease, scleroderma, dermatomyositis, or a drug reaction. For some, the friction created by frequent handwashing can also accelerate hyperpigmentation mid-finger. “Antibacterial soap, hand sanitizer and sometimes even gentle cleansers can act as irritants for some,” says Montclair, NJ dermatologist Jeanine Downie, MD. “Irritation leads to inflammation, causing a rise in melanocytes, the pigment-producing cells that show as dark spots.”
The Fix: Pigment Busters
If a consultation with a doctor shows contact dermatitis to be the cause of darkened knuckles, there are treatment options that won’t compromise cleanliness. To start, experts stress the use of sunscreen to prevent visible spots from darkening and additional hyperpigmentation from forming.
Topical serums and lotions containing kojic acid, tranexamic acid, hydroquinone and vitamin C can help temporarily lighten the spots at home, while in-office treatments like mild glycolic or TCA chemical peels, and lasers may provide more effective and long-lasting results when done in a series.
The Concerns: Volume Loss and Prominent Veins
Sun damage doesn’t stop at splotches: Along with the natural aging process, it can also render the skin on the hands crepey. “With sun damage, there’s an upregulation of some of the enzymes that degrade collagen,” Denver dermatologist Joel L. Cohen, MD says. “Some volume loss and structural support is age-related and some is related to movement.” The result is a more hollow appearance with visible subcutaneous veins and tendons that create a skeletal effect.
The Fix: Hyaluronic Acid Fillers
Though doctors have long used fat injections to plump sunken hands and many feel that conservatively performed micro-fat injections may produce the best long-term result, both Drs. Shamban and Broumand note this method can also create a puffed-up, mitten-like look over time. Instead, two fillers—Radiesse and Restylane Lyft—are FDA-approved to be injected into the backs of the hands and can be used to better regulate volume in the long run. “Both do a nice job of restoring volume, but the opacity of Radiesse tends to camouflage prominent veins a bit better,” says Dr. Cohen, who completed the FDA study for Restylane Lyft used in the hands.
After numbing the area with topical anesthetic, Dr. Cohen uses two entry points and a blunt-tip cannula to inject the filler, a technique that greatly reduces patient discomfort and the number of needle pokes per hand. The filler can last up to 12months, though Dr. Broumand suggests seeking additional treatment prior to total depletion so less filler can be used to maintain the look.
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