Best treatment for prematurely aging arms and hands? (photos)

You are an excellent
candidate for BBL light-based treatments that target brown pigmentation from
prior sun exposure. It may take several treatments to clear the spots completely,
but most patients have great results.  If you do not want to use fillers, you might consider fat transplantation to your hands. I would suggest it be done by a board-certified plastic surgeon with years of experience. Because it is your own fat, after the transplantation surgery (or surgeries), you would not need to continue refilling your hands year after year, as with manufactured fillers.  

I find that lasers in combination with fillers work great to this area.  I use sculptra on the arms with fraxel and radiesse/belotero on the hands with lasers or microneedling.  Best, Dr. Emer.

 Aging changes in the hands include signs of  sun spots, pigment and brown spots, and a wasting appearance due to fat loss and muscle wasting  after the third decade.  For the most part, sun-damage  is due to unprotected skin from the environment.   The best preventative measures include all the same we would think of for the face-- sunscreen, Vitamin C, retinols and exfoliating cleansers.Although dermal fillers , such as Radiesse, are perfect solutions for hollowness and a  scrawny appearance caused from  fat loss and  muscle wasting , IPL laser treatments - such as Cutera's Limelight - are great solutions to improve tone, texture and eradicate sun spots.  Depending on how much correction is needed,1-3 treatments , once a month should be sufficient.  With protection and prevention of further damage, treating 1-2 times/ year will keep hands looking youthful.