Ageing Hands

The main components of the ageing soft tissues of the hand are the Skin itself and the underlying supporting soft tissues. They need to be considered separately.

The skin is like the skin elsewhere on the body, except that it is exposed to rather more sunshine. It becomes thin and inelastic and develops brown patches and then rough patches (Actinic Keratoses), which may develop into tumours.

The dermis thins as elastin and collagen is not replaced. Fat and supporting collagen is lost at a deeper level exposing the tendons and blood vessels. Anyone trying to take blood from an older hand is aware that the now prominent veins on the back of the hand appear easy to obtain blood from. However, the vein is no longer fixed and has developed a tougher wall. Penetrating this vessel with a needle is none too easy as it squirms away from the needlepoint.

A course of IPL reverses the skin damage, perhaps with the help of extra cryotherapy of the brown patches and rough areas (Actinic Keratoses).

The soft tissues can be plumped up again with fillers. The more severe problems are treated with Fat Grafting (Lipofilling, Fat Transfer) possibly enhanced with extra stem cells. This will give a long-lasting improvement of the soft tissues, but also the skin, via the stem cell rejuvenating effect.

It is a good tip not to throw away the fat removed by liposuction but put it to good use elsewhere.

Those ugly veins will be disguised by fillers and fat, but the worst can be simply removed. You do not need them for function as there are plenty on the other side of the hand. Our Vascular Surgeons have special hand vessel lasers which work from the inside of the vessels to destroy them.

The bones and joints develop ugly bumps and deformity which can be improved by our hand surgeons. The commonest are the boney lumps (Osteophytes) appearing around the end finger joints, called Heberden’s Nodes.

Jelly filled cysts or ganglions appear across the back of the hand and wrist. They can be injected or less commonly surgically removed. If they appear on the ends of fingers (mucous cysts), they distort the nail growth.

Nail growth can be damaged by chronic infection, oftenfungus. This is now treatable by drugs and laser.