At A Glance; Aging Hand Rejuvenation
- Best Results1-3 sessions
- Treatment RecoveryVariable
- Procedure Time30 minutes
- Skin SpecialistDermatologist, Dr Davin Lim
- Duration of Results18 months to 5 years
- AnaestheticNumbing
- Back to WorkImmediately
- Cost$- $$$
Aging Hand Rejuvenation
This involves a series of procedures to turn back the clock on the backs of the hands. With age our hands will develop brown spots, wrinkles & prominent veins. Lasers, dermal fillers & fat transfer can effectively turn back time. Lasers are effective in treating skin texture, and improving pigmentation & wrinkles. Dermal fillers including collagen stimulating fillers & autologous fat transfer will re-drape the skin, hiding exposed tendons & volume loss.
FactsFacts on Aging Hand Rejuvenation
- Volume loss & laxity increases with time. The hands are not exempted from this process
- Hands are often exposed to sun, with very little or no UV protection
- Rejuvenation involves thickening the dermis with collagen-stimulating fillers
- Age spots, pigmentation & laxity can be addressed with various lasers
- Fat transfer can be considered in cases of marked atrophy
- Most patients require only one filling session
- Lasers can be combined with IPL/BBL for better outcomes
Why Aging Hand Rejuvenation?
Hand rejuvenation combines treatments designed to turn back the clock on the backs of the hands. The thinner skin in this area can experience changes faster than other areas, resulting in protruding veins & tendons, brown spots, sunspots & wrinkles.
Lasers improve the skin quality, namely wrinkles & pigment.
Dermal fillers stimulate collagen production in the deeper layers to replace loss fat & hyaluronic acid.
Why are dermal fillers used for hand rejuvenation?
As we age, we deplete dermal collagen & adipose tissue (fat). This decreases the support for the overlying skin. What this means is that skin becomes thin, easily bruised, with accentuation of veins & tendons. Volume loss coupled with ‘spots & dots’ from pigmentation results in the signs of accelerated ageing.
Dermal fillers replace loss collagen. This thickens our dermis, masks the skeletal look of ageing & increases volume. My dermal filler of choice is a collagen stimulating filler known as Calcium Hydroxyl Apatite. This filler lasts longer than the traditional hyaluronic acid fillers & provides more collagen over time.
How do I perform dermal fillers for hand rejuvenation?
I use a cannula to deliver fillers with one entry point. The filler solution is premixed with local numbing agents to ensure this procedure is painless. I prefer collagen stimulation for the hands over the traditional HA fillers because of the longevity & volume I can deliver with the former.
| Filler Type | Longevity | Costs vs Volume | Use |
| Hyaluronic Acid | Up to 2 years+ | ++++ | Finesse & contours |
| Collagen stimulating Ca OH Apatite | 3-5 years | ++ | Volume & bulk increase of collagen |
How can fat transfer help rejuvenate hands?
For those who elect not to employ the use of dermal fillers, fat transfer is another sensible option. This procedure involves taking fat from areas such as the flanks, abdomen or thigh area. This fat is then processed through sedimentation & filtration, then re-injected in key areas such as the hands, cheeks, temples & tear troughs.
The advantage of fat transfer is that we are using a natural substance. Additionally large volumes can be used, with a relative cost saving to the patient. Fat also contains millions of stem cells known as ASC or adipose stem cells. These cells can produce new skin, stimulate & produce collagen as well as new fat. Hence skin quality & volumes can be addressed with this procedure.
The disadvantage of fat transfer is that 50% or more of the volume injected will be resorbed within the first few months of injection. In some cases, the volume is more, in others it is less. Hence fat grafting is less predictable than dermal fillers. The pros & cons will be discussed during the time of consultation.
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How can lasers help with hand rejuvenation?
Lasers can help improve skin texture or skin quality, namely addressing pigmentation, spots, & sun damage. The aim of the laser is to blend, without the signs of sharp demarcation lines.
Lasers are best for flat brown spots. Raised spots may require surgical techniques including shaves & curettes. The laser device most often used is a fractional laser such as Fraxel. I also employ ablative erbium or CO2 fractional lasers in some cases. Most patients require 2-4 sessions for best results. Treatments are spaced 3-6 weeks apart.
Can IPL or BBL be used on the hands?
Yes. The biggest downside of IPL is that demarcation lines are universally seen after this treatment. This gridding is due to the rectangular shape of the IPL applicator. No big issue as subsequent treatments can blend this in.
A better treatment is to combine IPL-BBL with a fractional laser. This is termed Pulse-Fraxel or hybrid laser resurfacing. By combining two treatments we address both deep & superficial pigment as well as delivering a blend to the area. This reduces demarcation lines.
This guide was first coined by Kate Sommerville, resonated by the great Caroline Hirons then repurposed by me. Holds true for the majority of people with a few exceptions. See below👇🏻👇🏻👇🏻
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🔬📚There are many types of retinoids, including prescription topicals as well as retinol, retinyl palmitate, retinaldehyde and granactive formulations (hydroxypinnacolone retinoate)
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👀Function: Retinoids are essential for #healthyskin. They regulate cell turnover, play a role in oil production, skin inflammation, immune function & regulation of skin pigmentation
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👉Use: limited by skin irritation. Related to concentration, & patient factors as well as co-application of ingredients such as AHAs, BHAs, ascorbic acid. If you understand your skin’s irritation threshold, the use of AHA-BHAs can be useful to increase the efficacy of topicals as it aids in penetration.💯
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🦮👨🦯Guide: In the context of anti-aging, this application frequently holds true. Exception is if you have #acne. In this context, nightly use (as tolerated) , even in your teens is advocated. Another time in one’s life to modify retinol-retinoid application is around menopause where flushing & blushing may increase your skin’s sensitivity. Though rules are great as a guide, always pay attention to what your skin is telling you
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🎬📒Action: If you are really serious about skin care, buy Caroline Hiron’s book entitled ‘Skin Care. It retails for around 30 bucks. It will save you many years, tears & lots of coin- as well as a trip or two to a dermatologist. Buy it. Read it twice. Follow it🙏🏼🙏🏼
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😎Dr Davin Lim
Dermatologist 🇦🇺
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How can PDT or photodynamic therapy be employed in treating hands?
PDT or photodynamic therapy is another method dermatologist employ to treat sunspots. PDT is best for scaly, raised & symptomatic lesions such as solar keratoses or sunspots.
1-2 sessions are recommended. This treatment can be combined with BBL-IPL or Fraxel laser resurfacing.
How long will it take to heal after laser treatment?
5-10 days depending on the treatment & your age. We will give you an accurate projected downtime prior to treatment.
How many treatments will I require?
Extra facial areas (meaning ‘away from the face’) require more treatments due to the lack of densely packed follicular units. These follicles provide new growth of skin, hence why treatments are gentle for areas such as the chest, neck, decolletage & hands. As a guide, 2-4 sessions will provide the optional outcome.
What is the best hand cream for ageing hands?
Protect– keep things simple, firstly prevent ageing with the regular use of sunscreen. Choose an SPF 50+ that you like to apply. My suggestion is the La Roche Posay line of sunscreens as they are cosmetically elegant. Other good sunscreens include Invisible Zinc or Cancer Council SPF.
Hydrate. Simple vitamin E creams can reduce wrinkles & add subtlety. For more hydration, a barrier repair cream such as Neutrogena Norwegian Formula can be used at night.
Repair– Discuss options with your treating dermatologists. Bespoke formulations containing Beta Hydroxy Acids, as well as Alpha Hydroxy Acids can repair & reverse early sun damage.
My formulations contain salicylic acid or lactic acid in a proprietary base, often with 5-8 percent olive oil.
Davin’s Take on Hand Rejuvenation
Hands can tell a story of sun damage and age. Over time skin thins out, tendons & veins become more apparent in addition to easy bruising due to loss of collagen around the blood vessels & skin.
In most cases I combine lasers, IPL, photodynamic therapy as well as dermal fillers in the one session. Energy devices such as lasers treat skin texture & improves the quality of skin. Superficial pigmentation responds well to these modalities. Dermal fillers, as the name suggests, thickens the dermis, hiding veins & tendons. My go to filler is one called calcium hydroxyl apatite (Radiesse) as this filler can be formulated according to the level of atrophy (loss of tissue). For severe cases of ageing a stronger formulation is required, whilst for mild to moderate cases I have the option of hyper dilution.
Another sensible option is fat transfer. This is especially so if larger volumes are used. Longevity of fat (once past the initial 3 to 6 months), is often longer than fillers.
Prevention is important post procedure. Sunscreens & repair formulations can prevent & treat future sun damage. People often overlook the importance of hand creams & skincare.
