Aging Hands: Fillers aren’t just for the Face
The hands are an important aspect of one’s image and are an important means of communication. Certainly this is most important for some speaking with American Sign Language but I’m sure we all have a friend that is very animated and “talks with their hands”. This can also be important in the business world: think of all the handshakes that occur daily. If one looks through magazines many photographs tend to have the hand in view as a point of focus.
Changes to our bodies with aging occur throughout the body although most of us tend to focus on the face. Looking at someone’s hands can be a giveaway of their age especially if they’ve had previous treatments to their face. General changes with the skin include thinning of the dermis with loss of components within the skin such as collagen and elastin. There is also a general atrophy (or loss) of underlying structures such as fat and intrinsic hand muscles. This combined can create a hollow appearance to the spaces between the fingers with a relative deflated appearance to the skin. It also allows the underlying structures such as joints tendons and veins to become more apparent. The skin also may take on dry lackluster appearance. The pigmentation of the skin may change with the appearance of senile lentigenes or “age spots.”
The best means of reversing the clock with aging hands is by appropriate prevention. The most important thing that we can probably do is by applying sunscreen. This not only decreases the risk of skin cancer (yes you can get skin cancers on the hand) but it also reduces the amount of solar damage to the skin. Avoiding tobacco and nicotine-containing products can also help prevent many of the tell-tale signs of aging. One can also utilize appropriate skin care products such as Obagi or ZO. These product systems contain cleansers exfoliants and moisturizers as well as specific therapeutic agents that can reverse aging such as retinols. Often “age spots” can be lightened through prescription agents such as hydroquinones.
Resurfacing of the skin of the hands can produce positive results. Typically this process involves removing the outer layers of the skin allowing new skin to grow with better more youthful qualities: tighter and with more even pigmentation. This process can be through of multiple means: laser treatments chemical peels or dermabrasion. The level of “injury” procures the most drastic results and also generally has the greatest downtime. Another treatment is the SkinPen which involves microneedling to improve collagen and elastin synthesis. These treatments all will address the changes in pigmentation.
Fillers have been used extensively to improve volume loss and aging of the face. Off-label use in the hands has been used for years to combat the same changes in this part of the body. Radiesse is a dermal filler composed of calcium hydroxylapatite (CaHA) microspheres suspended in a gel carrier and is the first and only filler approved by the FDA for use in the hands. It has previously been used for improving deep nasolabial folds in the face. The medication is injcected into the back of the hands into the web. Seventy-seven percent of patients reported an improvement of at least 1 point (Figures 1 abnd 2) on the Merz Hand Grading Scale at 3 months at 68.2% at 1 year. The most frequently reported side-effects are swelling pain redness and bruising which all resolved without sequelae.
The appearance of your hands may be a giveaway of your true age. There are many options currently available to most patients to deal with aging hands. If you are concerned about the aging appearance of your hands or would like more information about any of the discussed procedures contact the office of Dr. S. Travis Greathouse for further information.