Hands look ugly and so old. What is the best treatment? (Photo)

Question

I'm 40, I overworked my hands for long time that I just realized that they look so ugly. I want my hands to be back but I'm confused about all those hands treatment. What is the best for my hands. I already have carpal tunnel problem. I did filler 2 years ago but it last only for a month!

Jack G. Bertolino, MD · Answer

There are two great options for hand rejuvenation. Radiesse filler has been used for years and is relatively inexpensive and quick. The more long lasting option is the ALMI procedure which uses micronized nano-fat to fill the hands with a longer lasting natural fill. Hope this helps. JB

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Stanley Okoro, MD · Answer

Thanks for your question and the photos your provided. You need to have redundant, looser skin around joints so you can bend your wrist and move your fingers. Your skin appears within normal limits. Around the age of 30 we stop producing collagen naturally, so at that time I you may consider microneedling like Morpheus to build collagen/elastin in your skin. Make sure you consult with a board certified plastic surgeon at that time, good luck!

Jason Emer, MD · Answer

Thank you for your question. The hands can be rejuvenated with a combination of fillers like Radiesse and Belotero, fat grafting with platelet-rich plasma (PRP) and lasers like Fraxel. I recommend getting a formal evaluation with a cosmetic dermatologist to develop a personalized treatment plan that works for you. Best, Dr. Emer

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question, and the photos. We get this question often. Radiesse is supposed to last 1 year.  Those who move their hands excessively will have it wear off sooner.  Each patient is different, and may need more or less product.  In Las Vegas, we get many card dealers who take pride in the appearance of their hands, as that is what the public sees.  Often the aging had will have more visible vessels and tendons.  The hands may also have solar damage, or just aging changes to the skin.  We often will inject patients with Radiesse to add volume to the hands and decrease the harsh appearance of the vessels and tendons.  Radiesse is FDA approved for this.  We often will follow this up with appropriate peels to help smooth the coloration and give the skin a more vibrant look.  Best to see a Board Certified Plastic Surgeon.  They have had multiple years of hand surgery training, and know hand anatomy and function well.   Some, (like our office), have had additional hand fellowship training.   They are also well versed in how to best treat the skin, as they diagnose and operate on it.Jeffrey J. Roth, M.D., F.A.C.S.Board Certified:  American Board of Surgery, American Board of Plastic SurgeryLas Vegas Plastic Surgery

Andrew T. Lyos, MD, FACS · Answer

Hello and thank you for your question and photos!  I would recommend a consultation with a board certified provider.  Based on your photos, you seem to be a great candidate for PRP injections.  However, a consultation to further explore your desired outcome would be the best avenue for you.  I hope this information helps and best of luck to you!

Aldo Guerra, MD · Answer

Hi Mary.Perhaps using PRP injections is an option. I don't think adding more filler will help. Best wishes, Dr. Aldo

Camille Cash, MD · Answer

You may want to consider Renuva!  This treatment is similar to traditional HA fillers with a big twist.  Like fillers you will see an immediate effect, however over time this product is gradually replaced by your own body fat giving you longer lasting results.  Visit my website or a provider near you to learn more.

Aurora DeJuliis, MD · Answer

Radiesse is a FDA-approved product for hand rejuvenation. The injections should be performed by a certified physician in hand rejuvenation. The results are natural and very pleasing. Other fillers can be used as well such as Juvederm and Restylane.

Lisa Jenks, MD · Answer

You have several options that will improve the appearance of your hands.  First, make sure that you put medical grade products onto your face and save enough to also cover the backs of your hands.  These should include topical Vitamin C, good moisturizers, Retin-A and a physical block sunscreen. 
Laser procedures and/or chemical peels will improve the appearance of brown spots and soften the texture.  If the fillers you used several years ago did not last long, you can always consider fat transfer into the hands or PRP injections.
Best of luck to you.