When is the last time you put sunscreen on your hands? (We’ll wait . . . ) Just kidding! This isn’t an exercise to make you dig through the depths of your recent memory. Rather, it’s to make a point: While the skin on your face gets a lot of the skincare love — from serums to lasers and everything in between — this lavish attention rarely gets showered onto your hands. Amid all the hand-washing, dishwashing, and, these days, ample application of hand sanitizer, they receive the brunt of the everyday damage, but none of the same care.
On top of that, nothing damages the skin on the hands quite like sun damage. “Chronic UV exposure is the number-one cause of age acceleration [in skin],” says Terrence Keaney, MD, FAAD, a board-certified dermatologist in Arlington, Virgina. “Clothing typically does not cover your hands, [and] people often forget to put sunscreen on the back of their hands.” Your hands, meanwhile, are exposed to sunlight in daily habits, such as driving. Fortunately, certain procedures can help turn back the, uh, hands of time. They tend to target individual concerns, such as crepey skin, sun spots, and visible veins. Here, some of the best treatments for each issue.
Issue at Hand #1: Dark or Brown Spots
While it’s tempting to file away all dark blotches as simplistic “age spots,” there are two common types that can appear on the hands — and they each require their own dedicated treatment. A disclaimer: Since they can often be confused with one another, it’s worth seeing a board-certified dermatologist to get the correct diagnosis before trying to treat them.
First, there’s seborrheic keratosis, which tends to pop up in people over 50. For these, your best bet is a chemical peel. “[One of] the most commonly used [treatments] for the backs of the hands is trichloroacetic acid (TCA) peels,” says Suneel Chilikuri, MD, a board-certified dermatologist in Bellaire, Texas. However, TCA tends to be available only in pro peels. For at-home treatment, try Dr. Dennis Gross® Skincare Alpha Beta® Extra Strength Daily Peel ($88), which combines salicylic, lactic, and glycolic acids.
For sun spots, also known as solar lentigines, chemical peels can help — but lasers are even better. “Brown spots can be treated with either intense pulsed light or a picosecond laser, depending on how dark or prominent the spots are,” says Dr. Keaney. “These laser and light treatments will temporarily make the brown spots darker, and then they will flake off after five to 10 days, so plan accordingly.” If you’re having trouble determining which treatment is right for you, talk to a doctor to see what might be the best option for you. For example, IPL is best for those with fair skin, while picosecond lasers are ideal for those with medium to dark skin tones, says Dr. Chilikuri.
Issue at Hand #2: Bony hands and visible veins
Skeletal hands are a dead giveaway of age. “You have to consider the structure within, where the skin is so thin that [hands] look veiny or bony,” says Dr. Chilikuri. Not only is the skin to blame — more on that in a bit — but the loss of fat over time also doesn’t help. That’s where replacing lost fat with a fat transfer can help. “It’s going to camouflage [bones and veins] and make skin look plumper and healthier,” he explains. It’s a surprisingly quick procedure that entails drawing fat from a pocket of fat (such as the abdomen or thighs) under local anesthesia using a syringe. The fat is then injected into the hands. There may be swelling for a few weeks following the procedure, but otherwise the side effects are typically minimal — and the results are permanent, minus the progression of age.
Issue at Hand #3: Thin, crepey skin
Thin, nearly translucent skin on the hands is the work of two things: sun damage and, well, age. The combination slows down production of structural proteins like collagen and elastin. Conversely, “we can increase collagen and elastin production by injuring the skin in a controlled manner, so the skin heals itself by creating more of those key structural proteins,” says Dr. Keaney. He prefers to do this using a fractional non-ablative laser. “This technique injures the skin via heat generated by the laser, so the skin recovers [in a few] days,” he notes.
If skin thinness isn’t so bad, Dr. Chilikuri is also a fan of using retinoids, a type of vitamin A, to get similar results. Not only is retinol proven to spur collagen production, but it “will also help protect that area and improve the overturning [of skin cells],” he says. He recommends starting with three applications a week and working your way up; although skin on the backs of the hands generally isn’t as sensitive as that of the face, it may still require a little acclimation period. Try Beauty Pie® Super RetinolTM Anti-Aging Hand Treatment ($8), which has a slow-release retinol to minimize irritation.
Retinol shouldn't be used by women who are pregnant, considering getting pregnant, or nursing. Please consult with your doctor before use.
Dr. Terrence Keaney is a paid Allergan® consultant.