Many women go to great lengths to maintain a youthful appearance, whether it’s stocking up on expensive anti-aging creams for their face, having Botox treatments to cover up fine lines and wrinkles or visiting their hairdresser every six weeks to cover up those stubborn white hairs. Unfortunately, despite all of their fervent efforts, sometimes their hands end up giving away their true age.
Toronto-based dermatologist Fred Weksberg says there are several things women can do to avoid falling into this trap.
Q: What causes our hands to age prematurely?
A: There are a number of factors. Genetics plays a big role. This will determine how fast the skin thins with aging, how fast it will become fragile and how fast the elasticity will go. In addition, when you lose fat as you get older, you start seeing the tendons and veins and that adds to the aged appearance. The other major factor is sun exposure. We know that it will damage the skin enormously. So really the most important factors are the genetic background, the aging process and sun exposure. Then of course there are occupational hazards; someone who works construction or has a manual job where they are really getting a lot of exposure to chemicals rubbing on their hands will have much more older looking hands starting at an earlier time in their life.
Q: If sun exposure is a big factor, should we be putting sunscreen on our hands every time we go out?
A: There are lots of things we can do to keep our hands younger looking, but if I had to start with one item at the top of the list, it would be sunscreen. You want to use something that’s going to have a high SPF number, at least a 30. They should protect you against UVA and UVB light. If you’re doing a lot of sports, they should be labelled waterproof. You’ve got to reapply it during the day because with perspiration, it’s going to come off.
Q: What are other things people can do to make their hands look younger?
A: Some form of anti-aging treatment. You can’t change your genetic background. The sun exposure you can modify with your sunscreens, the aging you can’t change really so we want to use something that’s going to try to reverse some of the aging changes. Retin A is a prescription cream that comes under a different trade name depending on the company that manufactures it. The vitamin A acid certainly will have an anti-aging effect. Then there is this whole group of anti-aging creams that have antioxidants in them. In my office we carry lines called DCL and Pro-derm. Basically you want something that has antioxidant properties. Another major group, which is an antioxidant is the vitamin C type of compounds and they can start reversing and preventing the aging of skin. The third thing is the sunscreens and there are many specific kinds. There’s Neutrogena, Umbrel etc. You want to use one that’s waterproof with a high SPF number and remember to apply it repeatedly.
Q: Should we put cream on our hands at night before we go to bed and are there any specific kinds you suggest for daily upkeep?
A: You’re going to want to use something that moisturizes your skin because dry skin looks older and cracks the skin more. So definitely use a moisturizer on a regular basis and you should be fine. Not everyone is going to need a moisturizer. Some people have very oily skin and they’ll be fine but most people are going to require some sort of moisturizer or lotion in the winter and that will help to maintain a more youthful appearance. Fortunately there are lots of creams that contain moisturizers and sunscreens together. If you put on an AHA or Alpha Hydroxy Acid containing cream, that will help make your skin more youthful looking. We have moisturizers and AHAs together. You can buy them in the pharmacy. There’s Neutrogena and DCL brands as well as Pro Derm which is a line that I carry in my office. As far as the moisturizers are concerned, there is Cetaphil lotion, which is a very nice moisturizer and also a cleanser that doesn’t clog the pores. You can use it all over your body.
Q: What do you suggest to treat brown spots on the hands?
A: There are a number of things you can do, there’s cream you can use as well as procedures you can have done. There are the Retin A type compounds, the antioxidants and then AHA creams. All of those different types of chemicals have properties to reduce the brown spots. In many cases, patients want to be a little bit more aggressive because they don’t want this slow turnaround. Sometimes these creams are not 100% effective so there are procedures that we can do.
One of the procedures that works very nicely is called IPL or Intense Pulsed Light, which is a laser treatment that works on hands and reduces brown spots, reduces little veins and makes the skin texture smoother.
Another treatment that is not a laser but works very well for brown spots is liquid nitrogen therapy. It’s a cold spray, sort of like dry ice but colder, and we spray it onto these spots. It causes an instant little frostbite right over the brown patch and these little cells which have the brown pigment crust up. Over the next 10 days, it just peels off gently and the brown spot is gone very quickly.
Another treatment is Fraxel Laser. It’s a type of resurfacing laser. That’s a very nice treatment because it’s a laser that helps to treat the brown spots but it’s also affective in treating the very fine lines and wrinkles. It helps to tighten the skin and makes it look smoother. Not only is it taking away brown spots but overall, it’s making the skin look younger.
Q: How do you treat wrinkles, fine lines and hollowness on the backs of the hands?
A: This is basically anti-aging so we’re back to AHA, vitamin A and antioxidants as far as the creams are concerned. For treating the fine lines and wrinkles with lasers, we have the IPL and the Fraxel. Both of those are going to help fine lines and wrinkles but the Fraxel will be more effective. Hollowness at the back of the hands occurs because the skin is thinning and we’re losing fat. You see the very thin skin draped over the tendons and the veins. To improve the hollowness you need to inject something under the skin. You can inject fat or hyaluronic acid. Those are things that we can inject underneath that plump up the skin so that you don’t see the veins and tendons as easily and it makes it look younger. To tighten the skin on the hands, thermage can also be used. That’s another one of those laser techniques.
Q: How much do these treatments cost?
A: IPL for example for hands is about $350-$400 a session and usually you will need about five sessions so about $2,000 for the hands. The Fraxel may be a little more expensive, about $500-$600 a session.
Q: What kind of reaction have you had from people who have had these treatments on their hands?
IPL and Fraxel really make a big difference. It just makes the skin look tighter, smoother and takes away the brown spots. We’ve had patients who have been really happy with it. The key is to maintain it so you want to use effective sunscreens. We have patients coming in all the time for their hands because they treat their face also. And the other area that are neglected besides your hands is your neck. Those are the two areas that tell a patient’s age.