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Hands Up

By Janet McCormick May 2008 issue of Skin Inc. magazine

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Estheticians receive extensive training in offering services and treatments for the face, but when it comes to treatments for the hands, that type of knowledge is more elusive. The wise esthetician seeks training for these kinds of treatments, especially now, and this old adage could sum up the ever-growing popularity of the trend: If you want to know a woman’s real age, look at her hands. Lately, more and more clients are asking for hand treatments to coincide with the services they are having done to match their younger-looking faces.
      Aging of the hands results from the same intrinsic and extrinsic processes as aging on the face. Intrinsic aging, from heredity and oxidation, results in loss of collagen and subcutaneous fat on the back of the hands, as well as a decreased barrier function of the stratum corneum. Extrinsic aging results from exposure to the sun and elements, and includes epidermal atrophy, or skin thinning; solar elastosis, or loss of elasticity on sun-exposed skin; pigmentary irregularities; and the development of actinic keratoses, which are scaly or crusty elevations on the skin.
      Many believe aging on the hands is ultimately more disfiguring than on the face, and it also can be more obvious and more difficult to address. Not wearing sunscreen on the hands is one of the key factors in their skin problems, and such problems may seem more obvious because the hands are seldom covered with makeup. Another trying factor in the treatment of hands is the possibility of constant hand-washing, as well as a lack of developed protocols.

Tracking hand-aging
      Hand aging is progressive, with spots usually beginning to appear after age 40. In fact, it’s estimated 90% of women 60 or older have one or more of these spots.
      When first starting to age, the hands will show dehydration through tiny fine lines, then wrinkles begin to develop, becoming more and more apparent. Next, the veins seemingly increase in size and stand out from the surface of the hands more and more as time passes, as do the tendons. The reality of the latter symptom is that the subcutaneous fat on the hands is resorbed with age, and the epidermis and dermis thin, allowing these veins to stand out. Then sun spots, often in the form of solar lentigines and hyperpigmentation, develop initially as small, light brown discolorations, later enlarging and darkening to brown—and sometimes even black—spots. Finally, the back surface of the hands and arms becomes drier and more dull, leading to an aged appearance that ultimately shouts, “I’m old!”
      Spa owners know well how much clients willingly pay to repair or enhance the appearance of aging on their faces, so why not move into treating the hands for such conditions, as well? The truth is, many people are becoming more and more self-conscious about the aging of their hands. Are you ignoring this opportunity with your clients, allowing their hands to shout their age and belie the benefits they’ve paid for on their faces? Do you treat your clients’ hands beyond hydration or relaxation?
      If not, you should begin offering these types of services now. Treatments options should involve not only hydrating the skin on the hands, but also improving their appearance through reducing fine lines, wrinkles and hyperpigmentation.

A hand evaluation
      Just as with the face, the hands, including the arms, should be analyzed to define their correct needs. “Our estheticians are trained to perform the same evaluation on the clients’ hands as on their faces, then to make recommendations,” says Pat Dobson, co-owner of the spa Changes of Cherry Creek in Denver, Colorado.
      Estheticians at her spa perform a high number of hand treatments, Dobson says, and they focus not only on the face, but on the entire body. “Every initial client analysis includes the hands,” she explains.

The hand plan
      After the evaluation, it is time to initiate the actual service, and most hand skin care treatments are performed during facial services. “They are simple, easy to perform for the esthetician and inexpensive for the client when performed during the facial as an add-on,” says Dobson.
       A variety of treatment plans can be created and recommended for these types of services, and the results can be as long-lasting for the hands as they are for the face. Protocols should include both home and professional care as well, because leaving out either one will discourage achievement of the goal.

      Home care. The home care regimen for the hands must be simple and focus on results-oriented products. The products also must enhance the recommended professional treatments, and maintain the results—youthful, beautiful hands—after they are finished.
Important ingredients are included in each of the home care program products, and the number of products can actually be limited to just three: a daytime moisturizer lotion, a nighttime treatment moisturizer and a scrub. These products shouldn’t just soften and smell gorgeous; they also are great products that provide important nourishment to the skin on the hands.

      Daytime moisturizing lotion—The options recommended for an anti-aging regimen here need to have superior hydration and softening ingredients, as they are much more results-oriented than the usual hand lotions. Other ingredients can be included in this lotion to addresses specific problems, as well: Lighteners are included to resolve hyperpigmentation, antioxidants are important to prevent further aging, peptides and other dermal stimulators are added to encourage the development of collagen and elastin in the dermis for minimizing fine lines and wrinkles, and of particular importance is an SPF, or sun protection factor, included in the formulation.
      Selling SPF products for the hands and arms only and achieving the important behavioral use can be tough, so prepare to offer some intense education concerning the causes of aging on the hands. The product should be luxurious enough to have clients using it after showers or baths as well as after every time they wash their hands. This reapplication after every daytime washing is important, as it works to protect the skin from the sun, so a purse size lotion is beneficial in encouraging use.
      Nighttime treatment moisturizer—The nighttime treatment should contain all of the above ingredients but also include 8–15% alpha hydroxy acids or possibly a retinol. Regular use can enhance epidermal thickness, stimulate development of the dermal matrix—which counters skin thinning through time—lighten the hyperpigmentation on the back of the hands, and bring a more youthful look to the skin. Optimal results do take time, though some improvements should visible within 10–14 days. Continued use is required to maintain these effects.
     Scrub—A gentle, manual exfoliator is also recommended for use two to four times per week and should usually be done in the evening before applying the nighttime treatment product. The regular use of the scrub enhances the products’ results and speeds up the anti-aging process.

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