Helping Hands

By: Dr Martin Kinsella
Created on 08th October 2010

Dr Martin Kinsella, of the Re-enhance clinic in Hale, offers some tips on how to turn back the hands of time

With the advent of minimally invasive and non-surgical treatments, more and more people are turning back the clock on their skin. Well, facially speaking anyway.

With all the treatment options now available, even as a cosmetic doctor it can sometimes be hard to guess someone’s age, so to everyday people it must be impossible. Actually, no, it isn’t – just look at their hands.

It’s true that the hands are a giveaway of a person’s age and I find it amazing how much money patients will spend on their face, whilst completely neglecting another area that is constantly on show.

There are good reasons for this though, as for most doctors the hands are an area where they have fewer treatment options and ultimately less experience. To treat the hands successfully, we need a good idea of what is happening to them as we age.

The interesting thing is that any cosmetic specialist worth his salt should already know this. Why? Because it’s exactly the same as what happens to the face. So I’ll tell you the signs of ageing hands and if you read on I might just tell you what you can do about it.

So if you are a cosmetic specialist, you can thank me for the ‘helping hand’ later and if you’re a prospective patient then you can explain this to your practitioner, while they hold their untreated hands up with a baffled look on their face.

One of the most striking things is the loss of volume. Ringing any bells yet? This makes the bones of the hands look more prominent, which gives them a skeletal appearance and naturally causes the veins to become more pronounced.

The other area is the change in the skin itself. The dermis or middle layer of the skin becomes thinner due to the loss of collagen and elastin and this gives the skin overall a thinner and more crêpey appearance.

Both of these problems are part of the natural ageing process. But then there is the further complication of our patients’ bad habits… like sun damage. Yes everyone looks great with a tan but the long-term effects are not so great – actually they are devastating to our skin.

Sun damage causes increased amounts of pigmentation in the skin causing sun spots and increasing the number of so-called age spots. Neither of these sounds very good! So all in all it’s starting to sound very familiar.

Now we know what the problem is, deciding what we do about it becomes easy. Before any treatment though, the options should be tailored to the needs of the patient and not just a set regime for everyone.

Lost volume can be replaced with products such as Radiesse. This has a better lasting potential than conventional fillers in the areas under the skin. Just three or four injections in one visit can dramatically plump up the hands, reducing the boney appearance and hiding the veins.

Then there is the skin itself. This is a bit trickier and may require a couple of different approaches. My personal take on this is a combination of injectable hyaluronic acid options, like Restylane Vital or the newer Juvéderm Hydrate products.

These are injected directly into the dermis in micro-injections over the whole hand, improving the condition of the dermis by hydrating and maximising the existing collagen. This leads to a thicker, suppler, healthier looking skin and improves the crêpey appearance.

So far, so good. But what about pigmentation and skin that is seriously in bad shape? For this I use fractional CO2 laser. This really is the gold standard in skin resurfacing; just ask any plastic surgeon or dermatologist. Actually, don’t – only ask a good one!

The CO2 laser effectively drills tiny holes into the dermis. Unlike traditional ablative laser surgery the skin will return to normal very quickly, after around three to five days – it’s not always as bad as it looks on Ten Years Younger! This treatment also carries far fewer side effects than traditional laser procedures.

If there are just a few age spots then less aggressive laser therapy can be considered, such as IPL. Also the importance of topical skincare cannot be overlooked and the best idea, as with any treatment, is a combination approach.

If you are a patient who is considering hand treatment, then you need to select a practitioner who offers the whole range of therapies, so you receive the best combination to target your particular concerns.

So my take home message is simple: increase volume and improve the quality of the skin. Depending on your individual problem, you may require one or both of these treatments. That, I’ll leave for your specialist to decide!