Age 41. What can I do to improve the look of my hands? (photo)

Question

I am 41, and have worked with my hands my whole life. It’s really showing now and I’m embarrassed about it. Aside from sclerotherapy for the huge veins, is there anything else I can do?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

There are several treatments that can help rejuvenate the appearance of your hands by addressing volume loss, prominent veins, wrinkles, and skin discoloration:

Dermal Fillers: Hyaluronic acid fillers (e.g., Restylane Lyft) or Radiesse can restore lost volume, making veins and tendons less visible while improving overall smoothness.
Laser Treatments & IPL: Fractional laser resurfacing or intense pulsed light (IPL) can improve skin texture, reduce pigmentation, and boost collagen production.
Chemical Peels: Mild to medium-depth peels can help fade age spots and improve skin tone.
Microneedling with PRP: Stimulates collagen and improves skin quality, helping with fine lines and texture.
Topical Treatments: Retinoids, vitamin C, and moisturizers with hyaluronic acid or ceramides can help improve skin elasticity and hydration over time.
Fat Transfer: If you’re looking for a more natural filler option, fat grafting can restore lost volume while providing longer-lasting results.
Wearing sunscreen daily is essential to prevent further sun damage and maintain any improvements. A dermatologist or aesthetic specialist can help tailor a treatment plan based on your specific concerns.

Monika Kiripolsky, MD · Answer

Hi RF,
 There are several great options for your hands! We all lose volume in the backs of our hands as we get older. It’s a great way to determine someone’s true age (unless they’ve been fixed!).  I would do a fat transfer to them to restore lost volume (disguise the tendons & veins), or injections of calcium hydroxylapetite/hyaluronic acid to add volume as well as stimulate production of more collagen & elastin. Fat is more permanent than the other 2 options, but, each has its own advantages & disadvantages. Regardless, I wouldn’t jump right to sclerotherapy until you’ve restored the lost volume first. 
I love fixing hands! Hope this helps!
- Dr. Kiripolsky

Nelson Lee Novick, MD · Answer

The reason the blood vessels are so prominent is largely because their is loss of volume in the backs of the hands. So, if loss of volume is the culprit, the quick and easy answer is to revolumize the hands with a robust HA volumizing filler. Not only will the backs of the hands look more full and youthful, but you will not only find that your hands look more youthful, but you will also find that the blood vessels are no longer prominent. 
On the other hand, scerotherapy would not only be permanently close off the blood vessels (which, would preclude their use if ever needed for IV medication treatments in the future), but would do nothing to restore the volume necessary for reestablishing more youthful-looking hands. 
You would be wise to consult with a board certified cosmetic dermatologist filler expert and best of luck.

Eric M. Joseph, MD · Answer

In our practice, we utilize microdroplet Silikon-1000, a permanent soft tissue filler, to camouflage veins and tendons on the back of somebody's hands, to achieve a more youthful hand appearance. I hope this helps! Sincerely, Dr Joseph

David Hansen, MD · Answer

I don't recommend sclero for hand veins since those veins are needed.  Injecting fat or radiesse under local will make the hands look amazing and is easy to undergo.

Steven Mehta, MD · Answer

I would suspect that you are lean, based upon the relative amount of fat on the back of your hands? This would also contribute to the prominence if the veins. Yes, sclerotherapy of the prominent veins would likely be the first step, but I would pause for a few months after that to see what change you might see in the skin turgor. If you were still dissatisfied with the appearance, at that point you could consider treatment to increase tissue volume - either fat transfer or filler (pros/cons to both). Again, like any medical procedures, be sure to be evaluated by an experienced physician who can determine the best types and sequence of treatments to achieve your goals.

Camille Cash, MD · Answer

Renuva is a great option for hand rejuvenation.  This product is unique in that it initially works like a filler to add volume to the area.  But it is different in that over time the product is replaced by your body's own fat to provide longer lasting results.  See my website or a provider near you to learn more.