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The Hands Of Time, Smoothing Out Wrinkles

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The Hands Of Time, Smoothing Out Wrinkles

The Hands Of Time, Smoothing Out Wrinkles
September 18
23:23 2017

Article Highlights

  • An outdoors person and spends a lot of time gardening, and they get a lot of sun exposure, then they’ll have a lot of changes in their hands, especially in the back of the hand, where the tendons are
  • Chronic sun exposure without sun protection can induce not only skin cancers, but also extensive wrinkling, pigmentation, blood capillaries and overall loss of skin elasticity
  • You can improve the tone, texture and quality of the skin by using intense pulse light treatments

We have all seen her before. She is a beautiful, mature woman who seems to defy age and gravity, with her still-smooth skin and youthful face that hides the years well. “How old is she?” we wonder, examining her closely, but our guesses miss the mark by far.  Then, she takes off her gloves, and so much more is revealed.

Dr. Claudio DeLorenzi, a plastic surgeon at the DeLorenzi Clinic in Kitchener-Waterloo, said that skin that is thinner, such as the skin on the hands, neck and décolletage areas, tends to show signs of aging more quickly than thicker skin on other parts of the body. This thinness, combined with lifestyle and habits, which includes excessive exposure to ultraviolet radiation and sunlight, accelerates the aging process in these areas significantly.

“If someone is an outdoors person and spends a lot of time gardening, and they get a lot of sun exposure, then they’ll have a lot of changes in their hands, especially in the back of the hand, where the tendons are,” Dr. DeLorenzi continued. “So you’ll see age spots and thinning of the skin. There’s loss of subcutaneous fat in the hand. The hands generally start to look sinewy and knobby, if you will.”

Dr. Andrei Metelitsa, a cosmetic dermatologist and the co-director of the Institute for Skin Advancement in Calgary, expanded on the toll the sun can take on the skin.

“Chronic sun exposure without sun protection can induce not only skin cancers, but also extensive wrinkling, pigmentation, blood capillaries and overall loss of skin elasticity,” Dr. Metelitsa maintained.

He pointed out that although the hands, neck and décolletage areas do age quickly, the face also ages quite fast and should be considered as one of the faster aging parts of the body. Some common concerns for women include the formation of smoker’s perioral lines and the loss of cheek fat volume.

Dr. Metelitsa and Dr. DeLorenzi concurred that how fast your skin ages depends on genetics. If you happen to be genetically programmed to have dryer skin, for example, your skin is going to look dryer and you’ll have more fine lines than someone who has more oily skin.  Also, people with darker skin have fewer signs of aging everywhere, as they have more melanin in their skin, which protects them from ultraviolet light, elaborated Dr. DeLorenzi.

The main complaints that patients typically have with the neck, décolletage and hands are fine wrinkling early on, loose skin, discolouration, brown and red spots, as well as extensive pigmentation spots scattered on their hands, and the bony appearance of their hands.

Neuromodulators can relax the muscles that cause wrinkles on the neck. Botulinum toxin A injections can be used to soften the lines on the neck, and they usually require three re-treatments per year, said Dr. Metelitsa, also mentioning that a rare risk associated with these injections includes difficulty swallowing and this should be discussed with a patient prior to a procedure. Ultherapy is another treatment than can help tighten the neck, he added.

Laser procedures can be utilized on the hands, neck and décolletage to improve skin tone and to make pigmentation more even.

“These lasers can either involve IPL [intense pulse light] technology and non-ablative fractional resurfacing for pigmentation and texture, or alternatively KTP [laser], and pulsed dye laser if only redness is a concern,” stated Dr. Metelitsa.

To improve the appearance of skin on these areas, Dr. DeLorenzi noted that he would typically start a patient on a program that helps to get rid of the discolouration of the skin and fine wrinkles. After that, depending on how severe the wrinkles are and if a patient wants that treatment, he would progress to treating the very deep wrinkles. Intense pulse light treatments can treat the brown spots and small blood vessels (capillaries), which cause red spots.

“You can improve the tone, texture and quality of the skin by using intense pulse light treatments. Those are probably the least invasive,” Dr. DeLorenzi said. “Then, you can actually progress towards resurfacing, where we actually remove the sun damaged skin. And, the idea is that you’re replenishing the skin from the reserves that are held in the oil glands and the sweat glands. Because those skin cells, the stem cells, have not been damaged from ultraviolet light, they’re the ones that come up to replenish the skin after you’ve treated it with a laser.”

Risks with lasers include persistent erythema, loss or increase of pigment post-treatment and in rare cases, infection and scarring, explained Dr. Metelitsa. In addition to lasers, both Dr. Metelitsa and Dr. DeLorenzi use injectable fillers to restore volume to the skin on the hands.

“The volume changes, you know the thinning of the fat pads that are underneath the skin, that make the hands look bony,” Dr. DeLorenzi noted. “That can be restored either with fillers or with natural fat in fat grafting treatments.”

With injectable fillers, bruising can happen but typically resolves in seven to ten days, and in very rare cases, skin nodules can occur, Dr. Metelitsa expanded. Dr. Metelitsa said that he prefers fillers over fat grafting treatments for a few reasons.

“Although fat grafting can be employed, the procedure requires more steps and carries a higher risk of side-effects so at the present time, non-fat based injectables often have treatment time duration, cost and safety advantages,” he stated.

Dr. DeLorenzi added that although all the procedures for these areas are very safe, nothing is completely risk-free, which is why it is important to consider all of the possibilities available when discussing possible treatments. Moreover, these treatments for the neck, décolletage and hands can help reverse the hands of time, but they are not a substitute for taking good care of your skin.

“The best treatment is prevention,” Dr. Metelitsa maintained. “This includes daily sun protection to prevent photoaging, skin moisturizing (especially during winter months) and use of topical agents, like retinoids, to enhance the overall texture of the skin.”

It is vital for women to exercise a consistent skin regimen, which includes the application of anti-aging creams, including retinols, glycolic creams and antioxidants, he urged.

Dr. DeLorenzi emphasized that it is also imperative that women avoid tanning booths and beds, which emit harmful ultraviolet radiation. But that’s not all.

“In terms of other things to prevent aging, all the things that your mother used to tell you: get proper rest, eat a nutritious diet, exercise regularly and avoid cigarette smoking. All those things do make an important biological difference,” he summed up.

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