Thin lips, sagging cheeks, eye wrinkles, forehead lines — aesthetic and beauty treatments tend to focus on the skin of the face. But signs of aging show up in other places, most notably on the relatively thin skin of the hands. Constantly exposed to environmental factors including the sun’s harsh rays, frequently immersed in chemicals to clean surfaces, manufacture items, and create art, and kept in constant use on everything from keyboards to steering wheels, human hands reflect a person's age, environmental exposure, and work history over time. Soft, supple skin becomes coarser in texture, loses volume, shows pigmental changes, exposes visible veins, and is often overlooked when considering rejuvenating treatments.
The condition of a person’s hands can have a major impact on their overall appearance, and patients are increasingly looking for special attention to treat these hard-working areas. The signs of aging can be prevented and managed proactively with sun protection and the use of gloves, of course, but patients are increasingly turning to aesthetic treatments such as resurfacing and pigment-correcting therapies, including chemical peels, lasers, and intense pulsed light therapies. For clinicians, offering customized noninvasive hand rejuvenation treatments is a great way to meet evolving patient needs.
Among nonsurgical aesthetic procedures, hyaluronic acid (HA) filler injection is one of the most popular hand rejuvenation treatments, providing immediate volume restoration that camouflages tendons and veins while hydrating the overlying skin. Dermal filler injections restore volume and contour, giving the hands a plumper, more youthful appearance.
Restoring texture and reducing age spots, volume loss, and visible veins can also be accomplished using other injectable fillers, as well as RF microneedling, energy-based devices, fat transfers, sclerotherapy, chemical peels, and intense pulsed light therapy (IPL), using layering or alternating treatments for optimal effect.
Fillers, however, offer noticeable results relatively quickly, making the hands appear fuller and smoother. Unlike surgical options such as a hand lift, filler injections involve minimal downtime and allow patients to return to their normal activities right away. Laser treatments, intense pulsed light, and photodynamic therapies tend to focus on improving surface texture, but fillers restore the volume and structure many patients are looking for in hand aesthetics.
“Severe complications in the hands are quite rare, and most patients are very satisfied with their treatments,” says David M. Ozog, MD, director of cosmetic dermatology, Division of Mohs and Dermatologic Surgery, and vice chair of the Department of Dermatology at Henry Ford Hospital. “However, minor complications including transient post-treatment swelling are quite common and should be discussed prior to treatment."
Dr. Ozog pointed out that most injections of the hands cause some degree of temporary swelling, but post-procedure swelling can be minimized by wearing compression gloves or elevating the hands. He added that “Some injectors will give anti-inflammatories such as prednisone," and a few suggest nonsteroidal anti-inflammatory drugs, though these can exacerbate bruising.
The anatomy of the hand is complex, and rejuvenation techniques require careful product placement. Injection approaches generally involve either tenting the skin, placing product over the tendons around the midpoint of the hand, and massaging firmly until the hand regains a natural contour, or injecting into the web space between the phalanges as the needle is withdrawn. Most clinicians use the latter technique to restore volume and hide veins and tendons, and they choose the injectable product that’s best suited for the patient’s skin thinness and desired results.
Currently, several injectable filler options are used for dorsal hand augmentation, including hyaluronic acid (HA) fillers and calcium hydroxyapatite (CaHA) fillers, both of which have demonstrated efficacy for restoring volume and improving the appearance of aging hands. Poly-L-lactic acid (PLLA) is also used by some injectors off-label for hand rejuvenation.
A recent comparison of fillers used in hand rejuvenation found that HA, CaHA, and PLLA all have a good safety profile and provide acceptable aesthetic outcomes associated with high patient satisfaction. The study noted that “HA fillers provide instant volume restoration and hydration, whereas CaHA and PLLA are advantageous when it comes to texture and skin quality improvement."
Patient counseling on available options and choosing the most appropriate filler that aligns with patient expectations, the study continued, “are crucial to successful outcomes.”
Whether clinicians use injectable fillers, energy-based treatments, or other rejuvenating techniques, interest in hand rejuvenation continues to grow. Hand rejuvenation helps patients extend their youthful look right down to their fingertips while giving clinicians the opportunity to provide comprehensive treatments that enhance how patients look and feel.
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