Hand Rejuvenation:

The best way to guess a person’s age is to look at their hands, not at their face. Although an effective skincare regimen and facial cosmetic procedures might help you look years younger than you really are, the wrinkly skin, prominent veins, and dark spots on the back of your hands might be telling a different story.

Our hands display visible changes as we age. As the epidermis thins, and collagen and elastin production decreases, the appearance of the tender skin on the back of our hand’s changes. The skin becomes lax and thin, and the underlying tendons, veins, and bones, called metacarpals, become visible. The culprits? External and internal factors, such as genetics, the environment, and your health, all contribute to aging hands. Even frequent exposure to chemicals can cause more rapid aging of the hands.

Sun exposure can make your hands look older faster, but the bigger problem is volume loss. Once the fat layer is depleted, the only option is to replace it.

Thankfully, new techniques in hand rejuvenation now allow dermatologists to treat these signs of aging. The peels, lasers, dermal fillers, and even fat grafting procedures that are used by medical practitioners to erase sunspots and replace lost volume in the face is now commonly being used to rejuvenate the hands as well.

Here at Appleskin, we look at the complete hand rejuvenation process, where we start with the top layer and remove brown spots, which may be freckling, lentigo (brown patches or spots), or seborrheic keratosis (skin barnacles), with a combination of peels, intense pulsed light, and sometimes a laser. Lasers are considered the gold standard when it comes to treating sun spots. In addition to removing brown patches and moles, clinical evidence has shown that regular treatments with intense pulse light (IPL) activate genes that make the skin more youthful, stimulating collagen and elastin production.

Next step is to restore the volume. Here, FDA approved dermal fillers are used. This injectable is made of calcium hydroxylapatite (CaHA) microspheres suspended in an aqueous gel carrier, which is broken down and absorbed by the body over time. The plumping effects are instant and typically last a year. The procedure has the added benefit of generating collagen, which can help reduce the amount of filler you need for subsequent treatments. The amount needed depends on the size and appearance of the hand, but most of her patients require two syringes per hand and a few drops for the fingertips.

At the heart of any effective anti-aging routine is a good retinoid. Anything you use on your face, you can also use on your hands. In addition to a retinoid, look for products with collagen-promoting ingredients, such as Vitamin C and copper peptides.

Neck Rejuvenation (Décolleté):

With aging comes fat and collagen loss around the neck that can lead to permanent wrinkles, sun damaged skin, and prominent neck bands. Sun damage, together with prolonged perfume, the application is the most profound factor in the development of aging of the neck. Signs of an aging neck are horizontal wrinkles, actinic bronzing (permanently bronzed skin), reddened skin (poikiloderma), age spots, and the development of vertical neck bands, loose sagging skin, loss of a good sharp neck angle and the development of a double chin or turkey neck. Fine textural lines scattered over the surface are partly due to the loss of collagen's integrity. Finally, there is laxity from the loss of elastic fibers.

A combination of treatments such as Botox, Dermal Fillers and Lasers can be used for complete rejuvenation as these treatments can be used to lift wrinkles, fine lines and tighten the skin.

Nefertiti lift: a non-invasive procedure that promises the same youthful jawline
as the Egyptian queen.

The muscles of the face each perform a different function — some lift up and some pull down. The Nefertiti lift works by using Botox to relax some of those bands plus the muscles that pull the corners of the mouth downwards. Botox will re-contour the jawline, accentuate cheekbones and recreate the face a woman had when she was young.

If the neck area is sagging or causing a turkey neck appearance, or if you have shallow horizontal lines across your neck, Botox can be injected into the platysmal bands to help smoothen and tighten these areas to reveal a more youthful neck. When injected into fine lines across the neck, Botox behaves the same way it would if injected into crow’s feet or forehead lines; the muscle is relaxed, smoothing the lines caused by those muscles.

For those deeper necklines, we can use dermal fillers. These fill in the lines, revealing a smoother area. By injecting fillers along the jawline and in front and below the ear, it can lift the skin a couple of millimeters making it appear tighter.

The procedure isn’t painful and an as most of the fillers nowadays have lidocaine, an anesthetic.

For the needle-phobic, a technique using radio waves or lasers can be used to tighten loose or sagging skin. They work by heating up the deeper layers of the skin, stimulating collagen and plumping it up — some patients say they see results for up to two years after.