How can I improve the texture of the skin on my hands? Last year my hands suddenly appeared very crepey on the surface. (photo)

Hello and thank you for your question and photos.  The good new is, there are many options to enhance the youth of your hands!  I would recommend a consultation with a board certified provider.  After your consultation, the provider will be best able to give you a treatment plan that will give your hands the rejuvenation that you desire. We offer a variety of options including IPL, skin pen with PRP, euro threads and Radiesse~ this all would be assessed at the consultation.  I hope this information helps you and best of luck!

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

With regards to your specific question, aging of the hands like all other aging is a function of a number of factors including genetics and lifestyle (weight changes, sun exposure, occupational exposure). While there is no definitive answer for "why," there are options.Aging of the hands manifest (aesthetically speaking) in skin changes and volume loss. Skin changes may take the form of pigment variations, fine lines etc. Volume loss leads to prominence of the tendons and veins on the dorsum of the hand.
I typically treat the skin with Fraxel laser therapy.
The mainstays of volume loss correction are fillers. HA's (Juvederm and Restylane) and Radiesse (hydroxyapatite) are the most commonly employed. I prefer HA's for a smoother contour relative to hydroxyapatite, however, compared Radiesse, the effect is shorter lived.
I will typically dilute my HA in 1 cc of local anesthetic for a total of 2 cc per hand.
Both should be infiltrated superficially. I prefer blunt cannulas to avoid bruising and disruption of dorsal veins. After injection, the product should be aggressively massaged to a smooth contour.As always, discuss your concerns with a board certified plastic surgeon (ABPS)

From your picture your hands have enough volume so that any type of volume increase is not a good idea. Besides keeping your hands out of the sun, moisturizing, not smoking etc. the best options are micro needling with PRP several times with weeks apart from each treatment. An expensive way of dealing with this would be stem cell isolation from fat and placing the stem cells evenly under the skin. Different lasers can also help. Good luck

Though there are many treatments that would help including filler or fat grafting, if you are mostly worried about the texture of the skin which is due to a loss of elasticity, a resurfacing treatment with PRP or micro needling with RF and PRP would produce the best outcomes. All the best,Carlos Mata, MD, MBA, FACSBoard-Certified Plastic Surgeon

You can treat texture on your hands using chemical peels and lasers. We also encourage medical grade topical products to supplement your treatments. See a medical spa near you to learn more.

Several treatments can improve the appearance of the skin on your hands. Start with moisturizers and hand protection with housework, tretinoin cream and sun protection. Treatments such as microneedling and fractional lasers can stimulate collagen. Fillers can add volume and plump the skin.

There are a few good ways to rejuvenate the hand:
1. Fillers or fat (addressed volume loss)
2. 3 Step peel (addresses surface damage)
3. Comprehensive skincare program (maintains the above)

As we age, we lose elasticity and thickness of the skin on the back of the hands. Radiesse is the FDA approved filler for the back of the hand. It can restore "plumpness" and hide veins and tendons. It is a very good choice. However, results typically last 6 months to a year. 

Fat transfer with PRP works very well and it has a long term outcome. It will restore the volume and it will increase the collagen procuction. This technique is usually combined  with a chemical peel. Best LM