Hand Rejuvenation

Rejuvenating hands follows the rules of skin rejuvenation, namely, to improve skin texture, tone, & volume. 

• Skin texture: refers to the palate. This includes wrinkles, sunspots, age spots & pigmentation. The solution? Lasers, peels, or BBL. 

• Skin tone: how tight is the skin? To tighten skin, we use lasers & collagen stimulating fillers. 

• Volume: loss of fat gives rise to veins & tendons. We replace volume with collagen stimulating hydrators or autologous fat transfer. 

We customise a laser program based upon the severity of sun damage & pigmentation. 

• Light pigment, mild wrinkles: BBL Hero & Pico lasers
• Heavy pigment, more wrinkles: Fraxel laser
• Extensive sun damage & wrinkles: CO2 & Fraxel lasers

Factors we consider when choosing a laser include the amount of wrinkling, the presence of precancerous spots (solar keratosis), the type of pigmentation (age warts, sunspots, solar keratosis, freckles). 

Skin to comparing a fork or a spoon, it really depends on the application. 

• BBL is used for flat pigment on the background of minimal wrinkling. 
• Fractional lasers are best for raised pigmented areas with wrinkles & sun damage.

Our nurses & dermatologists are trained to combine both BBL & fractional lasers in the one session if it is indicated. This way we can address all aspects of skin aging.

Our nurses are highly skilled in all aspects of hand rejuvenation, including lasers & soft tissue fillers. Book for a FREE consultation. 

*T&Cs apply

Minimal. On a 1-10 scale, lasers rate as 2/10. We use numbing gel prior. The BBL has inbuilt sapphire cooling, lasers have auxiliary chilled air coolers. 

Unlike the face, where the jawline clearly delineates the face from the neck, there is no transition zone on the hands & arms. See how the sun damaged outside arm slowly transitions to the sun protected inner arm?

It is not about treatments not working, it’s about treatments working too well. Therefore, you can see the rectangular footprints of IPL & BBL. We can achieve blending with-

• Less passes to the periphery
• More treatments
• Fractional lasers
• Pigment correcting topicals 

Your treating nurse will discuss the projected timelines with you during the initial consultation.

It depends on the type of laser & the settings. As a guide-

• BBL Hero: 2-5 days of flaking & peeling
• Fraxel: 4-6+ days
• Hybrid CO2: 5-8 days

For deeper fractional laser resurfacing, you must limit wet work (washing, doing the dishes) for at least one week. 

You must avoid sun exposure for 2 weeks pre & post laser. 

For facial rejuvenation, in 95% of cases we get the job done in one session. For hands & forearms it can take up to 3 sessions for optimal results. This is due to –

• Poorer healing on the hands & arms

The need for blending to achieve a natural result 

As we age, we lose volume. The hands are one of the first areas to give away your age! Volume replacement cannot be replenished with lasers, microneedling or Growth factor injections. There are two ways to replace volume- hydrating treatments or fat transfer. 

We use 3 main groups of hydrators for hand rejuvenation. 

Calcium hydroxyapatite: this filler stimulates collagen production; hence it provides volume AND revs up your immune system to produce collagen & hyaluronic acid. You will see results immediately, but it continues to build over 3 months. 

Learn more (link to collagen stimulating hydrating treatments in the hydrating treatment section)

Poly-L-Lactic acid: this is also a collagen stimulating filler, but it is more fluid compared to calcium hydroxy. It is mainly used to address large volume defects. 

Hyaluronic acid: In Australia we have limited brands, a new HA filler is due in 2022 -23 that provides better tissue integration. The downside of HA hydrators is the cost & the longevity. They provide great tissue integration, but the results don’t last as long as collagen stimulating fillers.

Our dermatologists are highly skilled in fat transfer. This is another option.

Fat has the following advantages-

1. Natural source of volume
2. Large amounts can be harvested (>5-10 ml each hand)
3. No allergies 
4. Fat provides ASC or adipose stem cells

Stem cells can then form collagen stimulating cells or differentiate into skin cells that replace old cells. This can improve volume, wrinkles, as well as improve skin quality, namely decrease pigmentation, & sun damage. 

The major disadvantage of fat is the amount of natural resorption over the first 6 months. It can be greater than 50%, hence why fat transfer is a two-stage procedure. 

Absolutely, we can safely combine hydrating treatments, fat transfer, BBL & lasers on the same day. We normally conduct filling before lasers.  

Hand rejuvenating creams are different from anti-aging creams used on the face as they need to be stronger, given the thicker skin on the hands & arms. A simple routine is-

AM: Salicylic acid scrub, antioxidants, SPF.

PM: Neutrogena Hand cream before bed.

Dermatologists also compound creams with retinol, vitamin C, glycolic, lactic & salicylic acids. Creams are best used for maintaining the results post laser. The concentration of topicals will vary according to your age & clinical findings. 

Yes, but in this area, lasers do a much better job as they can blend in the surrounding skin better than chemical peels. 

Spot treatment of TCA 30%-50% can also be used to individually treat age spots. This treatment does not blend in with the surrounding skin. It can only be performed on lighter skin types. 

We do however use high strength AHAs post lasers to preserve the results for many years. 

Isolated sunspots are easy- liquid nitrogen, PDT, or a combination of treatments can give good results. 

Field changes (many sunspots on the background of aged skin) are more challenging. Solutions include-

• Pre-treatment with keratolytic exfoliant, usually salicylic acid
• Efudix, pulsed or allocated treatment cycle
• Curette with above
• Fractional lasers with above
• PDT with above

This age-related problem is super common. It’s a combination of a reduction of collagen secondary to age & chronic UV exposure. Blood thinners including anticoagulants, aspirin, warfarin & blood thinning supplements contribute.  Solutions include-

1. Herbal arnica topically
2. Compression stockings 
3. A series of gentle fractional lasers, 3-6 over 6-9 months
4. Collagen stimulating hydrating treatments
5. Vascular lasers for the bruising

Though common, bruising on the forearms & hands can be challenging to treat as we do not have the technology to globally thicken the dermis & provide targeted collagen to the blood vessel walls. 

Here is a quick checklist-

Aims of rejuvenation: Never start off with a treatment then try to match it with your concern. It is ALWAYS the other way around. Concerned with pigmentation? Explore lasers. Volume loss? Consider hydrators & fat transfer.

Blending: The hands go up to the forearms, then the upper arms. You need to BLEND, or it will look unnatural with a clear border.