Even if your face looks great, bulging blood vessels and prominent stringy-looking tendons on the back of your hands can betray your age. Sure, you could fade brown spots and remove small growths from the hands, but up to not that long ago, there was little that could be done to otherwise improve them. Happily nowadays that's no longer true.
The safest and most effective means in my opinion is to revolumize the backs of the hands, i.e. to restore the volume lost over time mostly due to wasting away of the fatty tissue that once masked the underlying veins and tendons.
Bulky hyaluronic volumizing materials, such as Juverderm Ultra Plus and Perlane have been used successfully to accomplish this. However, my favorite material for replenishing lost volume in the hands and for achieving a smooth and even result is Radiesse.
Radiesse is composed of calcium hydroxylapatite, a bone-like material that provides more volume per syringe and lasts considerably longer in this location than its hyaluronic acid counterparts.
The procedure is actually quite simple. A mixture of Radiesse and a bit of lidocaine (a local numbing agent) is injected between the tendony spaces on the backs of the hands and then literally molded like clay into place.
The masking effect of the Radiesse, i.e. it's effect upon masking the underlying bulging blood vessels and tendons is quite immediate. In addition, the restoration of volume underneath inflates somewhat the overlying skin surface and smoothes out some of the crinkling, as well.
I am not a big fan of sclerotherapy as a treatment for rejuvenating the hands. Sclerotherapy is the injection of an irritating solution directly into the blood vessels to irritate their lining, a process that lead to scarring and permanently shrinking and closing them off.
True, this approach will eliminate the appearance of the blue bulges on skin surface. However, at the same time it forever diminishes the number of blood vessels available for use later in life for intravenous therapy and blood sampling should these needs ever arise.
I find revolumizing the backs of the hands to be sufficient to camouflage the blood vessels and significantly improve and rejuvenate the overall appearance without the need to destroy the blood vessels.