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Old Hands Can Look Younger

ANNA JANE GROSSMAN The New York Times
A patients shows how hands age after a thousand tiny injections of fat cells.

On a recent flight from New York to Los Angeles, Chris Salgardo noticed an attractive woman sitting a few rows ahead of him. "She looked like she was in her 40s," he said. "She was beautiful with great skin. She had an overall very supple complexion."

This is a significant compliment coming from Salgardo, the president of Kiehl's USA, a skin- and hair-care company. But then he looked down and saw the woman's hands hammering away on her laptop. "They were veiny, crepey and had brown spots all over them," Salgardo said.

Suddenly, his estimation of her age jumped at least a decade. "The hands were a dead giveaway," he said.

Once upon a time, people became older and it showed. Thanks to dermatologists and plastic surgeons who made it their mission to tackle visible age, future generations - at least those who will be able to afford it - may never have to endure sagging jowls or droopy eyelids. But the war being waged against dark spots, ropey veins and the various other symptoms of the no-longer-youthful hand is a relatively recent battle, one that can be more challenging than combating facial wrinkles.

The skin on the hands is generally thinner than facial skin. It has the consistency of an eyelid and may be more sensitive to the indignities of time.

For some people, the battle is being fought at night, with moisturizing gloves and thick coats of specially formulated hand creams - a skin care sector that has grown more than 60 percent globally in the last four years, according to a July report from the Nielsen Co., a marketing research company in Illinois.

Others, like Salgardo, never leave the house without applying sunscreen to their hands. Many people resort to options found only in doctors' offices: plumping fillers and other injections, along with age-erasing lasers.

Whatever the method, hands are clearly in the spotlight these days.

"The anti-aging movement has picked up a lot of steam and people are starting to focus on parts of their body other than their faces," said Dr. David Colbert, a Manhattan dermatologist who has worked on the hands of, among others, Dara Tomanovich, the face (and hands) of the Olay Regenerist skin care line. "Hands are in. In terms of dermatology, they're hot."

Marilyn Mehaffy, a 63-year-old retired professor in Chevy Chase, Md., said, "I never thought about my hands other than something that I did things with." Now, she doesn't go to bed without donning moisture-sealing gloves called Moisture Jamzz.

"Every day I have patients asking what they can do to make the back of their hands look better," said Dr. Michael Salzhauer, a plastic surgeon in Bal Harbour. "It's like you fix up your bathroom and then you want to do your kitchen, but then you realize you have to do your living room. You want it all to match."

Dr. Robert Weiss, a dermatologist in Baltimore, theorizes that the recent increased interest in hand care has something to do with the state of the economy. "People need to be working longer so they don't want to look like they could be considered retirement age," he said.

In the last two years, he noted, the American Society of Dermatologic Surgery, of which he is president-elect, has been offering its members a variety of information sessions relating to hand care. "We'd never done that before, but there was a demand for it," he said.

In Washington, hand-primping procedures have become increasingly popular among female politicians and lobbyists, said Dr. Elizabeth Tanzi, a dermatologist at the Washington Institute of Dermatologic Laser Surgery. "Lobbyists understand the importance of appearance," she said. One of the most visible signs of aging in the hands is a loss of volume, which creates hands that look bony, with pronounced veins. Weiss often uses sclerotherapy: injecting veins with a solution that shrinks them.

Some doctors inject the hands with fillers such as Restylane to add volume and render veins and visible tendons less noticeable. Restylane injections, which are approved by the Food and Drug Administration for use on the face, generally cost around $3,000 and usually takes just one visit. Results may last up to a year.Still, patients are lining up for the procedures.

Nonsynthetic injections are also an option. Dr. Sydney Coleman, a plastic surgeon in New York, has developed a procedure over the last 10 years that involves putting up to a thousand tiny injections of a person's own fat into their hands; the procedure, which costs at least $12,000, is done in-office and the results last over a decade, he says. The patient is likely to endure about three weeks of puffiness and redness, he said.

Injections are only one of a medley of available techniques.

"If someone has a lot of brown spots and sun spots, I'll use a laser," Tanzi said. One nonmedical expert, the hand model Ellen Sirot, says that hands that have sustained the normal wear and tear can be "de-aged" without injections or lasers. Over the years, Sirot, who is in her 40s, has been the flawless television hands of countless women, including Cheryl Tiegs, in ads for Light n' Lively yogurt, and Sarah Jessica Parker, in commercials for Garnier.

Sirot is working on a product line called Ellen Sirot Hand Perfection, which she hopes to introduce next spring. "What I'm doing is pairing the baseline botanicals I use - avocado oils, omega 3s, etc. - with the breakthrough technology that the beauty industry has found for our faces," she said.

But if you want to have hands like Sirot's veinless-poreless-hairless-looking appendages, it will be a full-time commitment. She said she hasn't cooked, cleaned or held her husband's hand in a decade. The latter activity would mean keeping her hands below her waist, which would increase blood flow and make veins more apparent.