Monday, 21 October 2013

Ageing Hands

So we’ve lavished meticulous anti-ageing and beautifying attention to our faces, and have conquered the effects of ageing on most parts of the body. Our now fresh youthful looks keep even the most discerning guessing.  Those in pursuit of the perfect body can either work at it themselves, or be on the receiving end of the knife or needle.  However, while our stomachs are tucked, our breasts lifted, face and neck too, and saddlebags sucked out, we might unknowingly be giving away our age at the first glimpse of withered shrivelled hands.
Our skin-care routine is religiously adhered to and we have endless supplies of make-up to cover blemishes and enhance our features.  While we can achieve success in holding back the years on our faces, our hands often bare the truth of our age.  In fact all it takes to gauge a person’s true age is a cursory glance at the backs of someone’s hand (think Madonna – her hands are a dead give-away).
Daily wear and tear takes its toll on our hands as we expose them to environmental factors.  Our hands are constantly being used (if not abused) as we move through our daily lives. Thankfully with a little basic care and some expert help, we can avoid letting our hands give the game away!!
Ageing signs on the hands, typically include the formation of wrinkles, sun spots (very similar to those on the face), thinning skin, loss of volume and guttering (the appearance of longitudinal hollow  “gutter” running down the back of the hand starting in between the knuckles), enlarged veins and a bony appearance.
At least 80% of the ageing signs on hands can be attributed to UV exposure.  So, whip out the sun cream, and remember your hands need it as well as your face does.  Cumulative exposure to UVA and UVB accelerate the the breakdown in collagen and elastin – the essential proteins which render the skin elastic and young.  We stop producing elastin and collagen when we about 25 years old.  This starts to become apparent at the age of 28.  As the body’s stores become depleted, signs of ageing in the form of wrinkles and thinner papery skin begin to appear.  This process is accelerated by exposure to the sun’s harmful rays and other factors such as smoking and chronic dehydration.   As the skin loses volume, the hands can appear thinner and more boney with hollowing out between the londitudinal long bones.
Chronic sun exposure also predisposes to sunspots, blemishes of pigmentation, ageing spots and possibly to more sinister lesions such as skin cancers. While most pigmented spots are benign, any sudden change or suspicious features (irregular borders or pigmentation) should be promptly investigated.
Even with seemingly innocent activities such as washing our hands, wringing clothes or doing the dishes, the skin on our hands is exposed to a whole plethora of insults.  Constant hand washing and the use of various astringents in soaps and detergents leads to a leaching out of intrinsic moisturisers, normally present in the epidermis.  This is the skin’s outer ‘dead’ layer, which provides barrier protection against irritants and infection.  Dry and chapped hands never look good, so have a moisturizing hand cream (preferably with a decent sun protection factor too) at the ready, and when cleaning, a pair of rubber gloves can go a long way in preventing this premature ageing.
So what if the damage is done ie you’re looking at a pair of crinkly, furrowed and spotty hands? Despair not, help is at hand (pardon the pun!).
The skin on the hand is amenableto the same treatments used on the face.  Chemical peels (such as TCA, AHA, or the Obagi Radiance Peel) are instrumental in reducing uneven pigment and reducing fine lines and wrinkles.  Before undertaking any chemical peel, the skin must be primed with products to reduce the potential of adverse reactions and to ensure uniform results.  Many of these treatments involve prescription only medications in the form of ointments including hydroquinone and/or tretinoin as a preparation for the peel.  Chemical peels are very safe treatments, yielding beautiful results, both on face as well on the hands.
The thickness of skin can berestored by injecting hyaluronic acid directly into the dermis (the middle layer responsible for all the activity).  Hyaluronic acid is a naturally occurring substance found naturally in the skin which maintains moisture and volume.  Alas, as with collagen and elastin the skin’s sources of hylauronic acid become depleted as we grow older. The injected hyaluronic acid absorbs moisture and rehydrates the skin restoring volume.   Hyaluronic acid is capable of absorbing up to 1000 times its weight in water.  This treatment would need to be repeated every 6 to 9 months, as it is gradually re-absorbed by the body.  This procedure is a relatively painless one, and some bruising may occur.  This is temporary. 
Another dermal filler which canbe used similarly for longer lasting effects (up to 18 months) and is alsouseful in filling out the guttering appearance is calcium hydroxyl appatite.  Guttering occurs due to loss of fat in the subcutaneous tissues.  A recent trend pioneered by American plastic surgeons is the replacement of the patient’s own fat harvested from elsewhere in the body.
Veins tend to become more apparent with the loss of volume and the thinning of the skin.  Some centres offer ligation of the veins on the back of the hand to reduce this appearance.  Dermal fillers could reduce the appearance of these veins by restoring volume.
The above medical treatments should only be carried out by qualified and experienced medical professionals for optimal results.  While these treatments are extremely safe, there might be some contra-indications such as pregnancy, breast-feeding, blood-thinning medications and infection at the site to be treated.  As with any other medical or surgical intervention, no procedure is without its risks (however minimal) and it is imperative to be aware of the potential adverse effects, hence the importance of taking an educated decision and having the opportunity to ask questions when choosing to undergo any treatment
As always prevention is better than cure.  So slather on the hand cream, carry your SPF with you everywhere, handbag sized versions are very convenient, drink your daily 2 litres of fluid – no, alcohol does not count – stop smoking (nicotine stains are so unsightly), and use rubber gloves when going about your chores!

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