Are there any effective lasers to effectively treat extremely crepey/wrinkled/loose skin on my hands? (Photos)

Question

I have extremely crepey/wrinkled/loose skin on my hands so I had them treated 5 months ago with the Lutronic ECO2 fractional laser. I was told a 30% overall improvement in the texture of my hands would be reasonable to expect, but 5+ months after treatment I only see a minimal improvement. Are there any lasers that can drastically reduce the crepey/wrinkled skin on my hands? Maybe a non-fractionating laser would be most effective with a fat transfer to minimize the knuckle wrinkles?

William Groff, DO · Answer

Thank you for your question and photos. While much of our attention goes to reversing signs of aging on the face, the backs of the hands can also take a beating. This is an area that is nearly always exposed to the sun and we rarely think about applying UV protection here. As a result, the delicate skin can become thinner, revealing prominent veins and multiple fine lines and wrinkles. In some cases, a combination approach is the best way to effectively turn back the clock on the hands. 
Since this is an area that tends to experience substantial volume depletion, injectable fillers can plump up the skin and smooth away many of the lines. I typically use Radiesse for this purpose, as the thicker consistency works well to create a smoother, more youthful appearance. Laser resurfacing can also be performed on this area to improve the texture and tone of the skin. A combination of Fraxel Dual and an Alexandrite laser often produce the best results for my patients. Make sure the doctor you work with is both board certified and an expert in skin rejuvenation to ensure your treatment is tailored to your precise needs for the best possible results.

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 you provided. I am sorry one treatment did not show you the improvement you were hoping for. Unfortunately, years of sun damage can cause skin to look like this. I would recommend Morpheus microneedling to build collagen and elastin in the skin of your hands to help with the crepe-y appearance. Make sure you consult with a board certified plastic surgeon.

Burke Robinson, MD, FACS · Answer

Hand Rejuvenation Options are:  Lasers, topicals and injectables

I would suggest a TCA Peel or a light Erbium laser treatment. Multiple treatments may be needed.  Adding Revisions Lumiquin hand cream daily will help improve the hands also.   Revision Skincare Lumiquin is an advanced product that is specifically formulated to treat skin on the hands and restore a youthful look. You may also consult about cosmetic fillers in the hands.

Gabriele C. Miotto, MD · Answer

Thank you for your question. From your pictures I can see that your hands have severe skin photo damage and thinning. There is no single treatment that can treat all the wrinkles and thinning of the skin, but a combination of a treatment plan with skin resurfacing (chemical peels, topical home products) and volume replacement (fat grafting, fillers) can help improve the overall skin quality and look you desire. An in person consultation is very important to define the treatment plan for you. Hope this helps. Best, Dr Miotto

Jason Emer, MD · Answer

As we age the skin sags there is nothign you can do that but try preventative treatments or get a neck/facelift earlier in the aging process.  There are numerous options and some can be used in combination to get best outcomes but you need a consultation with an expert. you will need long term peels, microneedling, lasers and sunptection for this type of creepe skin.
Options include for skin tightening :
thermage radiofrequency to heat skin and tighten it over time and prevent the aging process
ultherapy highintensity ultrasound to contract muscle and tighten the face and neck and prevent the aging process
PDO nova threads or instalift threads for immediate lifting without surgery and long term collagen production
sculptra injections for collagen production to areas of the face and neck with crepe skin or early sagging
btl exilis ultra, venus legacy, and thermi250 for constant collagen stimulation monthly with facials
facelift/necklift with fat grafting/fillers if you need a big improvement
ThermiRF or J plasma or Inmodebodytite  internal heating and tightening to long term internal heating and tighting with or without surgery
Platysmaplasty to tighten the muscles of the neck long term and create contour
Facial implants or fillers to contour the jawline and chin to improve the apperance of the nec
Best, Dr. Emer.

Michelle Copeland, MD, DMD · Answer

Thank you for your question! I would need to examine you to best answer your question; however, there are several non-surgical treatments that can be very effective for hand rejuvenation. Fat or filler can be injected to improve the fullness of your hands and give a more youthful appearance. For loose or lax skin, I often recommend using Thermage,® which is a non-invasive procedure that uses radiofrequency (RF) to stimulate collagen and help smoothen, tighten and contour the skin with no downtime. I often combine these treatments with a combination of laser skin treatments to improve the overall quality of the skin. You may have some redness after these treatments, but unlike other treatments, there is no downtime. You could even do this on your lunch break and go back to work after. I take an individualized and hands-on approach to develop the best treatment plan for my patients. I recommend you speak with a board-certified plastic surgeon who is comfortable performing these procedures to further discuss your options.

Grant Stevens, MD · Answer

Consider fillers to your back of your hands to address the volume depletion.  After that, consider a laser resurfacing like Halo by Sciton.  This will give you a more youthful appearance in your hands.  Also, do not forget to apply sunscreen on the backs or your hands where you are out. Hope this helps.

Heidi A. Waldorf, MD · Answer

In 2018, we have many options to improve the appearance of the hands noninvasively.  1) SUNSCREEN: Be sure that you wear sunscreen on your hands daily and re-apply regularly.  (If you are going to be outdoor for a long period of time, you can even get sun protective lightweight gloves.).   2) COSMECEUTICALS: Be sure to use your facial anti-aging products on your hands (in addition to your neck and décolletage).  Antioxidants, aha's, retinoids, peptides can all help your hand skin just as they can help your facial skin.  3) LASER: the texture and color of your skin can be improved with treatments using fractionated resurfacing (Fraxel Dual) - a series of 3 or 4 these treatments can produce a marked improvement in the hand skin. 4) FILLER: Radiesse was the first filler and now Restylane Lyft is the second with the FDA indication to improve the dorsal hand contour.  Injection makes hands look younger by reducing the appearance of veins and tendons on the hands and giving more support for the skin.  Radiesse has been shown to have a secondary biostimulatory effect -- as it goes away, it acts to stimulate new collagen and elastin to improve the skin's appearance further.I hope this answer was helpful. Best wishes.

Aurora DeJuliis, MD · Answer

The best way to rejuvenate your hands is using fillers in order to replace lost volume. Radiesse is FDA approved for hand rejuvenation. The treatment is very effective and delivers results immediately. Restoring lost volume will make the skin look better. For age spots you can consider a series of IPL.
Love your skin.

Are there any effective lasers to effectively treat extremely crepey/wrinkled/loose skin on my hands? (Photos)

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