Hand
Rejuvenation
For visible veins and tendons, sun spots and crepey skin on the backs of the hands.
With Dr. Juliya Fisher and Dr. Shereene Idriss.
In Brief
Hand rejuvenation treats what age does to the backs of the hands, from lost volume that lets veins and tendons show to sun spots and thin, crepey skin. We restore volume with hyaluronic acid filler or Radiesse, fade defined spots with the Alexandrite laser and treat the whole hand with Fraxel, after a daily routine of sunscreen and a retinoid.
Diagnosis First
“Nothing gives away your age faster than your hands,” says Dr. Idriss. The skin on the backs of the hands is thin and meets sun and washing every day, so lost volume, veins, tendons and crepey texture show early.
- Volume. As the backs of the hands lose volume, the veins and tendons beneath the skin show more. Volume is restored with an injectable; no cream or laser replaces it.
- Sun spots. Brown spots from years of sun, a few defined ones or many scattered across the hand. Every spot is examined before it is treated.
- Skin quality. Thin, crepey, wrinkled skin from sun and time. A retinoid and sunscreen help it at home; a fractional laser treats it in the office.
Most hands show more than one of these, so most plans combine them, with volume for the veins and tendons and a laser for the spots. For sun damage on the face, neck and chest as well, see dark spots and sun damage.
Most brown spots on the hands are sun damage. Knowing which ones aren’t is why a dermatologist examines every spot before it is treated.
“I look at every brown spot on a hand before anyone treats it. That is the Mohs surgeon in me. Most are sun damage, and a spot that is new or changing gets checked instead of lasered.”
What We’d Skip
The most useful thing for your hands costs very little, and some of the costliest treatments miss the cause.
Don’t stop your sunscreen at your face
Sunscreen goes on your face, neck, chest and the backs of your hands every day, especially if you drive a lot. Without it, treated spots come back.
Don’t put a retinoid straight onto dry hands
Apply moisturizer first and the retinoid on top, at night, to buffer it so your hands don’t get irritated, then sunscreen in the morning. Used this way, it helps keep the skin from turning thin and crepey.
Don’t expect a laser to hide veins and tendons
A laser evens out spots and texture; it doesn’t replace lost volume. For hands, “this is where filler actually makes a big difference,” says Dr. Idriss.
Don’t laser a spot no one has examined
A brown spot on the hand is usually sun damage, but your doctor examines every spot before treating it, and one that is new or changing is checked, not lasered.
Don’t buy a set of sessions before your first
If you’re told how many sessions you need before anyone has treated you, pause. Your doctor treats you, sees how your skin responds, and then decides.
How Are Aging Hands Treated?
Volume, sun spots or both decide the treatment, and a daily routine comes before any of it.
- Every hand, before anything else. Sunscreen on the backs of your hands every morning, and a retinoid such as tretinoin at night, over a moisturizer. Dr. Idriss uses tretinoin on the backs of her own hands and fingers.
- Visible veins and tendons from volume loss. With Dermal Fillers, hyaluronic acid filler restores volume in the backs of the hands, visible right away, and can be dissolved. Restylane Lyft is FDA approved for age related volume loss in the back of the hands in adults over 21.
- Volume loss with thin, crepey skin. Of the two Sculptra & Radiesse biostimulators, Radiesse is FDA approved to correct volume loss in the backs of the hands. It gives structure right away and builds collagen over months.
- A few defined sun spots. The Alexandrite laser aims very short pulses at each spot, so individual spots on the backs of the hands can be treated without resurfacing the skin around them.
- Many sun spots, with crepey texture. Fraxel Dual Laser treats the whole hand. Its 1927 nm setting treats discoloration and its 1550 nm setting smooths texture, while the surface of the skin stays intact.
For tone across the whole hand, IPL is another option.
The Treatments
Two injectables restore volume in the backs of the hands, and two lasers treat sun spots and texture.
- Results visible right away
Dermal FillersHyaluronic acid filler for volume, visible right away 
Sculptra & RadiesseRadiesse for volume and structure, then collagen over months
AlexandriteA Q switched laser for individual, defined sun spots
Fraxel Dual LaserA fractional laser for spots and crepey texture across the hand
Side by Side
Filler and Radiesse restore volume, while the Alexandrite laser and Fraxel treat spots and texture. Your doctor often combines one of each.
| Treatment | How it works | Suited to | Downtime | Results | Lasts |
|---|---|---|---|---|---|
| Dermal FillersHyaluronic acid fillers and Skinvive | A hyaluronic acid gel placed under the skin of the back of the hand to restore volume; it can be dissolved | Veins and tendons that show through as the hand loses volume | Little; possible swelling or bruising | Right away | Months to years, by filler and area |
| Sculptra & RadiesseCollagen building biostimulators | Radiesse, a calcium based gel, gives structure right away and prompts your own collagen over months | Volume loss with thin, crepey skin on the backs of the hands | Little; possible swelling or bruising | Radiesse right away; Sculptra over months | Often longer than hyaluronic acid filler |
| AlexandriteQ-switched laser (Alex TriVantage) | Very short pulses of a single wavelength that brown pigment absorbs, aimed at each spot | A few individual sun spots with clear borders | Depends on the area and the number of spots | As treated spots fade, over the following weeks | As long as you protect your skin; pigment can return |
| Fraxel Dual LaserNon-ablative fractional laser, 1550 nm and 1927 nm | A fractional laser treats microscopic columns of skin; 1927 nm for discoloration, 1550 nm for texture | Many sun spots and crepey, uneven texture across the whole hand | Shorter than ablative lasers; a few days of redness and peeling | After the first session, improving over time | With sunscreen and skincare; pigment may need upkeep |
“Hands get the same sun as your face and far less care. I start with sunscreen and a retinoid on the backs of the hands, then decide what the office can add.”
In Their Words
“
I highly recommend Dr. Fisher. I followed her from her previous practice and I continue to be happy with my results. I’ve gotten fillers and laser. Whenever I’ve wanted to do more, she was always honest with me. If I didn’t need it, I could count on her to tell me
Lillian J.
“
Dr. Idriss takes her time to listen to your concerns. She works with you to develop a treatment plan you are comfortable with, without ever being pushy. Her work is subtle and her expertise is evident. …
Sydney S.
“
I’ve always had a great experience here. Dr. Fisher is great, I’ve seen her many times for a variety of different conditions. I never feel rushed and her advice on treatments, products, and care have always been highly effective. The results are great. …
August R.
“
I would recommend Dr Idriss a thousand times over and over. She is extremely knowledgeable, knows what will work and what won’t and will always give you an honest recommendations. You will never feel pushed into moving forward with any injections or procedures.
Hiva F.
Bryant Park, New York
Your Dermatologists
Founder
Dr. Shereene Idriss
Candid advice, subtle results.
Board-certified, Practicing since 2013
Dermatologic Surgeon
Dr. Juliya Fisher
A Mohs surgeon’s eye for every spot on the hand.
Double Board-certified, Columbia Mohs fellowship
Both doctors share one philosophy, so either is a good place to start. Book online with Dr. Fisher, or call (212) 612-1520 for Dr. Idriss.