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Helping Hands With Medical Esthetic Techniques

Elaine Linker March 2013 issue of Skin Inc. magazine
professional skin care for hands

Your clients’ hands tell a story. Although they are often taken for granted, the hands reveal significant details. Women and men spend so much time and money today trying to “de-age” their faces, but according to Howard Sobel, MD, “The hands can reveal true age quicker than any of the fillers can plump up sagging skin.” You need only to see all the pigmented spots on a woman’s hands that come from sun exposure to know that no matter how smooth the face, this person is way older then she claims to be.

In addition to environmental damage, hands lose fat and connective tissue, and start to look thin and transparent over time. Veins also become more prominent and the skin becomes thinner and drier; a dead give-away to a person’s age.

Like any other part of the body, prevention is the key. Wearing protective gloves when doing household chores is the mantra of any hand model, but what applies for the face and décolleté might be even more important for the hands: sunscreen. The face is actually slightly more protected with makeup and multifaceted face creams that contain sunscreen, whereas most people do not pay attention to their hands during their morning routine. Educate clients about their options for hand care, and provide the services and techniques that will transform their skin, giving them a more youthful appearance.

Dry hand helpers

The first line of defense is a good offense. There are many good hand creams on the market, but using an emollient sunscreen during the day provides double bang for your client’s buck. Encourage clients to apply moisturizing sunscreen to the hands as part of an everyday routine, right after applying sunscreen on the face. Sunscreen needs to be applied 30 minutes before exposure for maximum protection. Ideally, applying sunscreen right after a shower and before morning coffee will give it time to absorb. Remind clients to care for their hands by displaying and visibly promoting professional preventive treatment hand creams in your retail area.

Age spots and sun spots

Spots on the hands can appear as early as age 30, especially for those who live in a year-round sunny climate. Every skin care facility menu should have a hand treatment that appears in both the section for body treatments, as well as manicures and pedicures. This should include a 15-minute hand-lightening treatment, consisting of a light peel, skin-lightening hand mask and hand massage with a skin-lightening hand cream with SPF for day or one without for evening. The menu also should feature a five-minute add-on hand care service with a light peel, to be performed during a facial.

To treat lighter spots, a combination of prescription-strength hydroquinone and retinoid is the dermatologic standard use during a three-month period. Hydroquinone blocks the production of tyrosinase, the enzyme needed to produce melanin, and the retinoid increases cell turnover to remove visible pigmentation. This protocol can be very irritating to the skin. Light peels featuring both lactic and glycolic acids can be used by skin care professionals as an in-spa treatment to increase the exfoliation of visible pigmentation. Many professional skin care brands now make a skin-lightening formulation using herbal and botanical lighteners, such as arbutin, bearberry and kojic acid. Used in combination with light peels, these formulations provide cumulative lightening results. Expect the backs of hands to be dry, but with less peeling than results on the face. Diligent follow-up is needed to maximize results; therefore, recommend home-care formulations from your retail area that use arbutin, bearberry and vitamin C as their active ingredients.

For stubborn spots, many lasers on the market can target sun damage. Hand revitalization units look like nail dryers, but claim delivery of pulses of high-energy LED, causing acceleration in the turnover of visible pigment. Six to eight treatments are recommended for 10 minutes each with results starting to show at the fourth treatment. Dermatologists also offer IPL lasers or a fractional resurfacing laser. These lasers emit a short pulse of intense red light, which absorbs the skin’s melanocytes—cells that produce the dark spots. The light breaks up the pigmentation into smaller particles that the body’s immune system can then remove. Dramatic results can be achieved, but sun spots will return without diligent use of sunscreen.

Pronounced hand veins

As fat is lost, the veins in the hands become much more visible. In some cases, the veins actually look bulging and quite unsightly. The fashion to be thin also exaggerates the prominence of veins.

Sclerotherapy, the same physician-administered treatment used to treat leg veins, can be used on the hands. A saline solution is most commonly used. It works by irritating the walls of the vein, causing them to collapse. Some stinging and burning is experienced, and hands will be bruised and swollen post treatment. One to three sessions are needed, depending on the thickness of the vein. A more natural solution might be to keep the hands deeply hydrated so that the skin looks plumper.

Loose skin

As part of the aging process, not only does the face lose collagen and elastin, but all the skin on the body gets less tight. Choices for improving appearance range from laser treatments to fillers. Often, both treatments are used in combination for best results. Fractional lasers tighten lax skin and fillers add back lost volume. The fat can be harvested from an area of the body—often saved during a liposuction treatment—or commercial fillers, such as Restylane or Juvederm, are used. These are hyaluronic-based dermal fillers that have semipermanent results.

Nails

Healthy nails also are an often-neglected part of youthful hands. Pay attention to signs of fungus, yellowing or any dark spots on the nail, and resist covering up these symptoms with polish, because some can be a sign of health concerns. If clients wear a lot of dark-colored polish, nails are often discolored, but this can also be a sign of diabetes, psoriasis or even liver damage that requires medical attention. Cuticles are dry in most people and can be addressed by an overnight application of petroleum jelly. Breakage and ridges can be signs of poor nutrition, or just the lack of treating hands with the same respect as the face. Don’t neglect to provide anti-aging nail care options on your professional in-spa menu

An integral part of skin care

The hands are one of the most expressive parts of the body. Left untreated, hands not only reveal a person’s age and can become unattractive, they also can impact daily life, making it harder to perform simple, everyday tasks.

Encourage clients to take care of their whole self by evaluating needs and the techniques to address the hands. Some of the most exciting new anti-aging advances in face and neck care are turning out to be amazing treatments for the hands, as well. Treat hands with respect and hold hands with loved ones as much as you can for the ultimate anti-aging experience.

Elaine Linker is director of corporate communications and education for Christina Skincare USA. She has more than 20 years of industry experience, with research and development experience in product and ingredients as well as marketing, sales and training.

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