Hand remodelling treatments
The hands are often one of the first areas to display visible signs of ageing, leading patients to seek rejuvenating treatments. Debbie Thomas explores the ageing process and what can be done to regain a more youthful appearance
Invariably hands will show the first signs of skin damage caused by UV light and other free radical causing aggressors, visually ageing faster than the face and other areas of the body. That is because the skin itself on the back of the hands is not only much thinner than on your face, there is also very little subcutaneous fat present here, so even with a minimal amount of collagen or elastin fibre degradation, glycation and fat loss it’s going to have a noticeable impact on your hands.
The resulting effects are clear to see and feel, wrinkly, crepe-like skin texture that doesn’t bounce back, the noticeable appearance of prominent veins and the bones from loss of volume and pigmentation spots or mottled skin discoloration from UV and IR exposure. These visible changes in the skin are very strongly associated with ageing so clients become worried that it makes them look old, often trying to hide their hands as much as possible.
The majority of skin on the body and face will respond in a similar way to both negative and positive factors. The hands suffer as much as they do simply because we do not take as much care of them as we do as our face with carefully applied skincare, and they do not get the protection from the elements as areas of the body covered by clothes. We additionally readily expose them to a torrent of drying, irritating factors like water and cleaning chemicals.
For many a good home care regime started at a young age will dramatically improve the skin on the hands in later life. My recommendations for the hands are similar to the face; in the am apply a high quality antioxidant that will protect against free radical damage followed by a hand cream containing SPF 30 or above. The hand cream will need to be reapplied readily throughout the day, every two hours and after washing the hands. For pm, we need a renewing product so retinol works well or a AHA containing cream or serum.
In a professional clinic setting we tend to see clients once the area has already started to show signs of damage, this damage is associated with ageing but really are the signs of years of UV, IR, environmental and chemical damage.
Losing even a minimal amount of fat padding on the backs of the hand creates a aged look, the skin no longer has the support structure it needs to look and feel firm the way they used to
Traditionally the professional hand care treatment of choice is fillers. Fillers are used to add volume, replacing the lost volume and padding out the area. You would use a filler that is thicker in consistency, and once the product of choice has been injected it is massaged to smooth out bumps and be evenly spread. Treatment should take about 20 mins and the results will be visible after approximately two weeks. Unlike on the face with less moving muscles, on the backs of the hands the filler can last up to two years. Evidence now has shown that fillers can actually help stimulate your own collagen production so over time you may need less and less product.
The main risk with fillers is the formation of bumps under the skin. This is rare and can be avoided by massaging the area directly after treatment. Extra caution should be taken with ethnic skin that is prone to keloid scar formation.
Laser skin resurfacing
Unlike full ablative laser treatments—that cause significant trauma, long recovery time and a reasonable risk of adverse side effects—pixelated lasers create tiny pinholes in the skin that stimulate your body to produce more of its own collagen and elastin, with minimal redness and a very short recovery time.
By stimulating new collagen and elastin production, the skin’s underlying support structure is strengthened and fortified, resulting in smoother, plumper more youthful looking skin.
The new collagen fibres are permanent, but are not immune to the factors that break them down in the first place. A good home care routine will boost and prolong the results, while continued sun exposure will damage even this newest of collagen.
Due to the peeling nature of the laser it can also help reduce pigmented areas. Generally three to six successive treatments are needed to get the best result followed by one to three top-up treatments per year to maintain the benefits.
Age spots, liver spots, sun spots or solar lentigo—whatever you call them, no one wants these unsightly pigmented lesions.
These brown patches are a natural part of the ageing process, but UV light has a big part to play. The more sun exposure you have had, the more brown spots will appear with age. For those who think they will worry about it or be good “when I’m older”, the majority of sun damage happens when we are very young, so even if you look after your skin in later life the damage occurred during our younger years will eventually show. It is believed that solar lentigo take 20-50 years to show visibly on the skin, and new ones can continue to surface over time.
Various lasers and IPL have been designed to target and remove these excess patches of melanin in the skin. The melanin absorbs the light energy which turns to heat, this heat damages the melanin cells making them nuisance cells that the body will get rid of. Depending on the light treatment you opt for, it can take one to six treatments to clear the skin of existing pigment. You may need to offer one or two top-up treatments per year to maintain the skin and manage new pigment coming through.
Laser and IPL treatments carry a small risk of discomfort, redness, mild swelling, and further pigmentation problems especially in skin types 4, 5 and 6. No tan should be present at the time of treating and good sun care is strongly advised.
The EnerJet is an easy procedure suitable for all skin types that is performed in-clinic. The skin remodelling platform reverses the visible signs of ageing using Jet Volumetric Remodelling (JVR) technology to introduce and disperse a diluted hyaluronic acid dermal filler. The pneumatically accelerated jet penetrates the epidermis, and upon reaching the dermis, spreads laterally in all directions. The heavy HA molecules are directed sideways to create effective dispersion. These HA particles act as “nano bullets”, disrupting the dermal cells in their passage and initiating the wound healing process to provide collagen remodelling.
It delivers immediate and long-lasting aesthetic results without thermal heating or needles using precise and controlled pneumatic technology to deliver hyaluronic acid into the dermis. This facilitates absorption and retention properties to produce an immediate aesthetic improvement, making the skin appear fuller, hydrated and rejuvenated.
The JVR technology can also help restore the hands by removing visual veins (dermal thickening). The combination of kinetic energy and dermal filler effect, results in a wound healing process which simulates the skin to produce more collagen and helps restore the hands to a more youthful appearance by hydrating the skin and thickening the dermal layer.
Debbie Thomas is a Skincare Expert and Super Facialist. She is the Founder of the Debbie Thomas Clinic in Chelsea, London. W: debbiethomas.co.uk