Hi, Thanks for your question. As we age and the skin is exposed to years of environmental stressors (mostly UV radiation), the elastin and collagen (the main structural / scaffolding proteins in skin) begin to breakdown. As this happens the skin becomes more prone to bruising and develops pigmentation or "liver spots" (lentigines). Hand rejuvenation beings with preventing further damage by using sunscreen regularly or keeping the hands covered (driving gloves). You can try to use topical therapies, but they are not as effective off the face (tretinoin and hydroquinone). To help replace lost collagen / elastin use of a dermal filler would be effective. To help even out tone and texture I would speak with a board certified dermatologist about use of laser / BBL. I hope this is helpful! Best, Kevin Cavanaugh, MD