The Ultimate Guide to Hand Care for Aging Hands

But no, like why do I have these old lady hands, these praying hands, these troubled water hands, civil rights activist hands, telling them the mountain hands, watching pray hands, grandma's hands. If your hands look like this, or this, then you're like most of my patients who come in, they have a great skincare routine for their face. Maybe they're even getting some procedures done on the face, but they've completely neglected their hands, and then they're asking, "What can they do for my hands? " And so, in this video, we're going to be talking about hand care. My name is Dr. Sha, Dr. Maxfield, — and welcome back to our channel where we talk about all things skin care and dermatology. Aging hands is one of the most common concerns that we see in the office, and it happens to all of us. And in this video, we're going to be talking about what causes this, how to treat it, what ingredients to look for, what procedures to look for, and everything that you need to know to treat and prevent this. Yeah. So, these are definitely one of the most neglected areas that we see patients regret not taking care of. So, we'll tell you all things how to take care of aging hands. Here we go. So, let's talk about what causes this. There's really three main reasons that our hands start to look older than our face. First, it's simply just time. And you can't really stop the biological clock. We're all losing collagen. We're all losing fat. We're all losing muscle. And this can cause our hands to look older. The second reason is sun exposure. And sun exposure without sun protection, at least not the same diligent sun protection that we have on the face. And then the third reason would be simply washing your hands a lot more and coming in contact with chemicals and irritants that can dry out your hands and also make them look older. Right? So this combination of time, sun and environmental exposure does a lot of things on the cellular level. Not only does it thin out the skin, that thinness also translate to a crepey looking appearance. Also where the collagen is damaged, lost, disorganized, the elastic fibers of your skin are lost, damaged, disorganized. Also, you get increased melanin production, which translates to these dark spots on the back of the hands. We used to hear these called being called liver spots, but that's certainly not the case. It's just from sun and time. And then additionally you get loss of the fat and this can lead to very thin appearing hands that exaggerate the presence of both the vascule and also the tendons making them look older. Exactly. So your hands can almost become so thin from loss of collagen and elastin and loss of fat that your skin almost starts to appear translucent, transparent and you can start to see your tendons, your bone and those blood vessels showing very prominently through the skin. And it gets to the point where your skin actually starts to tear really easily. And so we have a lot of patients that come in with what we call solar perpa which is bruising basically from just easy like little a little bump on the skin and you'll bruise a huge bruise or your skin will tear and this is an exaggerated version of what's happening to the skin and if you don't continue to take care of your skin this will eventually happen to all of us with time. — Right. Exactly. And so one thing that's extremely important to realize especially when it comes to body care and I would say hand care almost disproportionately is prevention is so much better than anything reactive. So proactive prevention severely outweighs anything you can do reactively for treatment. Absolutely. And if you really think about it from like a sun exposure standpoint, there's really no area that gets more sun exposure than your hands and your face. And most people do a good job protecting their face, at least most people that watch this channel, but they completely neglect their hands. And the rest of the areas, right, are covered by clothing, especially if you're wearing long sleeves and you're wearing shoes, your feet are covered really. So the only areas that you really get consistent sun exposure through your entire life without sun protection is the back of your hand. So let's talk about exactly how to treat this first starting with prevention. So one of the first things you should think of is sunscreen. Most of us or many of us are already doing this for our face. And this translates to pretty much everything else in the treatment phase. Whatever you do here, you can also do here, here, wherever. But the back of the hands is so easy. You have your sunscreen, apply to your face, apply it to the back of the hands. It can help protect and prevent damage throughout the day. Now, there also are some things you'll see other people talk about driving gloves. You spend so much time in your car, quantified, it's probably years of your life you spend in your car, and that sun does get through the window. Maybe not necessarily UVB, which primary chromophor is your DNA, causes skin cancer, it causes a lot of burns, but UVA, which penetrates deeper, is primarily responsible for a lot of aging in the skin. That does get through many windows and can age your hands significantly. Absolutely. So, you'll see people using these driving gloves. They basically are gloves that usually have little finger cutouts for the fingers. And I think the reality of this is not very practical for most people, right? I mean, you can use them in the car. And I know some people who are very diligent about sun protection that do actually do this. They're also the same people that use visors to cover their face. I think the reality is most people aren't going to do that. One simple hack that you could do is get some tinted windows or some UV glass that covers both UVB and UVA on your windows. It's a onetime treatment. might be a little bit pricier, but it will protect you every single time that you're driving, right? Because we do try to uh weigh heavily the practicality of these things into your daily life. And

so, for me personally, because I'm not the driving gloves type of person, I did go and get my windows tinted to block the UVA rays. And then another side of prevention is addressing the environmental exposure. So, if you're someone who washes your hands a lot or you're coming in contact with chemicals and you need to wash your hands a lot or you're working healthcare and you have to wash your hands a lot, one of the best things you can do is to use a moisturizer immediately after washing. Make it a part of your regular routine. It protects the skin barrier. It gives you an immediate benefit in terms of hydration and plump, but then longterm as well. It'll probably help prevent some of the tired deterioration of your skin. So, if you have to wash your hands frequently, you should probably wash your hands frequently. We have to all the time. You can also wear gloves. This can get a little bit complicated, but if you wear gloves more frequently, then you don't come in contact with potentially like harmful chemicals. If you're using like bleach to clean things, this can also be useful. Now, the other thing that you can consider is what you're washing your hands with, right? So, if you're using fragrance-free soaps, this is going to be less irritating to the skin. The other thing that you can consider is if you're somebody who's frequently using hand sanitizer, which are usually alcohol- based, in my opinion, even though some of the studies are a little bit mixed on this, hand sanitizer tends to be a lot more drying than something like a hypocchlorous acid. So you could consider instead of using hand sanitizer all the time using hypocchloric acid on the hands which tends to be a lot more gentle in my opinion. — Perfect. Yeah, totally agree with that hack. If he didn't say it, I was also going to go there. That's perfect and something you'll use every single day. Now beyond that, then you're going to get into some of the reactive treatments. So these are the active ingredients, the skin care products that you're going to use on your skin to try to help those changes. Dark spots, crepey skin, fine lines, collagen, salowess, bruising, all of this is going to fall into this stage, right? And so the three I think groups of ingredients that I would look for is number one your retinoids. So this is going to include your retinol, your retinaldahhide, your tininoan, your peptides and these are specifically your anti-aging peptides like something like a metatricxel would be very useful in this scenario. And then finally exfoliating acids can also be useful here. URA being a really great ingredient especially at concentrations over 10%. You can get an improvement in the crepiness of your hands. Right? So how are you going to implement this? Well just like you were doing for the morning with the sunscreen, now you're going to do it in the evening. So whatever active ingredients you're using here, tininoan, peptides, whatever it is, apply it here and also apply it to the back of your hands. Right? So you can just simply do that. I for some reason, whatever reason, like I always give this tip to people, but then I completely forget to do it myself, but it is a really good hack to bring it down from your face to your neck also. Don't neglect your neck as we've said in the past and then bring it to the back of your hands. And then you can also find body care ingredients that have these ingredients in them, right? So body retinols can be very useful here. So if you're using a body retinol, apply it to the back of your hands. of using a body ura. Apply it to the back of your hands and you'll get those anti-aging benefits. — Right. Correct. Now, again, practically, I always try to think of how this falls into your everyday life. I love products you can bring on the go. Hypogloric acid being one you can use at home. You can use it in the car. I pack it everywhere. Another product that I've seen is actually from Dr. Shaw and remedy that I absolutely love. This is remedy for the hands. Hand remedy. And here it is. This is our hand and cuticle repairing buttercream with retinol. I have a vendetta against long names and so I go with the abbreviated version especially for this one. But can I tell you a story really quick? Sorry, this is a sidebar. But I also was very against long names and we started to introduce longer names that are still very practical names like they describe what the product is a little bit more distinctly than in the past. But the problem was we launched a product initial launch of products many of you remember for dry lips. The problem is when people are searching for remedy for dry lips online, they can't find the product because that is a commonly searched term, right? So, the problem is when you don't know the name, sometimes people can't find the product. And so, for searchability, we've tried to add more descriptive terms for people to find the products. Okay. Uh, that actually makes a lot of sense. I'm still probably not going to say the whole product name. If you followed us along, you know that I actually rarely say the entire product name, but this is hand remedy. Says right there. Now, the reason I like this one so much though is the packaging is extremely unique. Um, I'll show you. I'm actually wearing scrub pants today. You can actually put it in the pocket, take it with you wherever you go, and then also, as I've had to learn, um, you open it like this. But the reason I like it so much is you just take it with you. You reapply throughout the day because you do want to apply your hand moisturizer throughout the day, especially if you're someone who works with your hands. It's a thick moisturizer. Like, it grips, but it's so hydrating. It's really easy to work in. And then the retinol in it has some nuance. It's encapsulated. One of the questions I've seen actually already even though this product just launched is like well can't you why what about retinol you can't use it in the daytime right that's not a hard rule this is encapsulated it's more stable so it will still be active and functional throughout the day and then additionally with the photosensitive you're like well you can't use it in the sunshine it doesn't quite work like that cuz we've also diligently talked about how you need to use sunscreen to protect your skin so that combination of moisture retinol and then that step of sunscreen in the morning is really going to not only treat but also help maintain healthy hands for the course of your life right so this is really similar to remedy products. It's really your all-in-one. It's 20% shea butter. It lasts through multiple washes. It has your camides and glycerin in it. It also has your encapsulated retinol. So, it's going to do more than moisturize. It's also going to repair at the same time. And you can take it on the go. And honestly, I wasn't really a hand cream wearer, but I do get dry hands. And

since this actually has added benefits, I'm more encouraged to use hand cream than ever before cuz I know it's actually going to do something for my hands. And in our study, people actually showed an improvement in their cuticle and their nail quality as well. So, it's something that can do a lot more, especially if you're somebody who's noticed more brittle nails with time. That retinol can help to speed up your skin cell turnover and also make your nails be healthier. We've been listening very closely to your feedback on our hand cream. So, let's talk about how to open this product. But first, I want to thank you all so much for supporting remedy. This would not be possible without all of you. We have heard a lot of positive feedback about the formula of this product, but we know that people are having difficulty opening it. So, first mistake we made, this opening is not intuitive. It looks like it would open on this side, or at the very least, this would be a button. It's not. This is actually the hinge and you have to open it from this side. And so you put your finger in there and then you open it. Now as you use it more it's a bit easier to open but that hinge can be quite difficult for people especially if you have nails. The other issue is that some people are having difficulty squeezing it and this can be an issue in very cold areas if you keep the product in a cold space. Now we are working actively to make this hole slightly larger to make it easier to dispense. And the other thing in the next production run which is going to take a few months to fix is adding a lip to this product so it's easier to grab without having to use your nail. Now, if you have this version of the packaging, don't throw it out. Definitely try to make use of it. But what you can do here is a quick hack is you can actually twist the lid off simply, just like any other product that you have that has a twist off cap. And then you simply dispense the product. Now, because the product is thick, you won't overdispense the product if you're gentle when you squeeze it. And you can just simply take as much as you need and you can close the product back. Again, thank you all so much for the support. We actively listen to all feedback to improve the products and hopefully in the future we can make a better version of this product for you. Now, let's talk about different types of procedures that you could potentially do. And we actually do have patients pursue procedures for their hands because it's something that does really bother them, right? And so, we can organize these kind of by least invasive to most invasive. Really, it is a big cost investment though. And that's why I said it's easier to be proactive than reactive here like with most things because all of these procedures have a pretty significant cost. And although they can provide tremendously good benefits, they will not outshine good daily habits. So, the first one we'll start with is filler. Filler is where you inject something into the skin. In this case, you'll either see hyaluronic acid or something called radius used. Hyaluronic acid is in our bodies. It's gelatinous. You fill it and it fills space. So, if you're someone who's lost a lot of fat there, this can actually refill the volume, make it appear more youthful, make all the tendons and structures more subtle. Now, radius or calcium hydroxy appatite, this actually is a bone type of derivative and it will help stimulate the growth of new collagen around that structural thing itself. And it's actually more of a permanent fix or at least has a longer lasting presence in the skin than the hyaluronic acid filler. — Right? So filler can help with this volume loss that's occurring with that see-throughness that you're starting to see where you can see your bones. It can give your skin more plumpness. Now there there's a lot of blood vessels in the hands as you've noticed especially if you lost a lot of volume in your hands. And so you have to be very careful because you can never inject a blood vessel with hyaluronic acid or calcium hydroxy appatite because it can cause severe issues. Right? So you have to definitely go to a skilled injector to do this. and you want them to inject a bit more superficially into the skin to have that type of result. Now, you can also get auttogus fat transfer. Now, this is not something that we do. At least I don't do in my office. I don't think Dr. Maxwell does in his office either. This is where they take some of your own fat and inject it back into their hands. It's a little bit safer when you do this. You still have to be careful of what you're injecting, but this can give you maybe a little bit more of a natural look to replace some of that lost volume. Then when you think about some of the surface changes that are occurring to the skin, you could also think about some of the other procedures that we do for surface changes like dark spots, fine lines, and wrinkles. And so these are going to be your chemical peels and your lasers. And so you could get a chemical peel on your hands that could make a big difference. There are some people that will even do chemical peels on both their hands and their arms for people who have things like superficial actctinic keratossis, which are precancerous lesions that occur on the skin. There's also something else that you can do, which is you can get your laser procedures on your hands, which this is something I actually just thought of because I was thinking about this. It would be pretty cost prohibitive to go and say, "Hey, I want to get micro needling on my hands or I want to get laser on my hands. " Because a lot of times the cost to the office is a disposable needle head and sometimes a disposable tip if you're getting something like radio frequency micro needling or a card for the session. It cost the office a certain amount of money. What you could ask for, which I would actually be open to as a practitioner if you came to see me, is to say, "Hey, when you're done doing my face, can you also do the micro needling on the back of my hand, or can you do the RF micro needling on the back of my hands, or could you potentially uh bring the laser to the back of my hands? " And I think I'd be pretty open to it. So, I think that's something that you could ask for if you're already getting procedures on the face, just similarly like we're saying, bring your skin care from your face down to your body, you could simply just ask them to do the hands if it's something that does bother you. — Yep. Definitely. And I think that's one thing that we communicate often but not often enough is you just have to be really candid with what concerns you, what's important to you when you're speaking to your doctor in the office because when you look at the health care system, it's still just an efficiency model, a volume game, a machine that everyone's kind of a part of. I'm actually getting very frustrated with the healthare system in general for your sake. But you just need to take the time, try to be very clear and just tell your provider, hey, you know, yeah, I want to treat this, but you know, this really bothers me too. And then like Dr. Shaw said, expand the treatments from here to here and you'll see great results. And yes, it'll be the most

efficient use of your time and also cost in terms of what you need to put down. — Absolutely. So, most of the people that do come into my office for cosmetic treatments, they usually tell me, "Hey, I have this issue I'm trying to treat. " And then I'll guide them through them. Like, here are your options. Here's what you can do. Here's what I do in the office and here are what some other practitioners would do. I try to give my full education on what's happening here. But I'm never going to point out things that maybe that you haven't brought up to me. And I'll give you classic examples of this, right? So if you get cherry angiomas, which are those little red dots on the skin, we've done a video on in the past, or you get seereay keratossis, or you even get skin tags, even though they're on the skin, and they might bother you if you don't bring them up to me, they're so common, just like dark spots on the back of the hands are, that unless you tell me that you want to do something about them, I'm usually not going to point them out or treat them. And so I can educate on any issues that you have, and I'll tell you whether I would treat them or I wouldn't treat them. And I'll be fully honest whether it's worth it or whether it's not worth it. But a lot of times if you do have something that's bothering you, if you simply bring it up, there is usually a treatment for it. But we'll only bring it up if you ask us. — Yeah, exactly. And then the last category, let's just call it supplemental because there actually are a lot of supplements that I have patients ask me about when it comes to the changes in the skin on their hands and on their forearms. So specifically, we'll start with solar pera. This is that bruising on the back of the hands comes from the thinning of the skin, fragility of the blood vessels, loss of supporting structures like the fat. And I would say of all the supplements and options, the things you could do at home, oral bromelain, which is often found in like pineapple rind, pineapple fruit, but primarily in the rind. This supplement taken by mouth has been shown to help bruising. And if I was going to do one thing for this, I would do that. Otherwise, arnica topically would be probably a distant second. Yeah, arnica doesn't have nearly as much successful data as Brolin does. So, Bromelin tends to actually have more data, even though arnica is more widely prescribed for these issues, honestly. And so, those are kind of more targeted things that you can do. You can also think about if you're somebody who's really prone to discoloration, hyperpigmentation, taking a supplement called polypodium lucatomis. So this is something that has some added sun protection benefits. And so in addition to your sunscreen, using something like this, especially if you're someone who's prone to melasma, it could have benefit on the back of the hands. And then finally, there's collagen supplements, which again, you know, I think initially I was very against them. I think now that there's a little bit more promising data and there's a mechanism that makes a little bit more sense to me than previously had been presented in the past, I'm willing to study it a bit more, but I still to this day don't have a recommendation for you that I'd say, "Hey, I I'd recommend this to my patients or family members. " So, more data to come there. I don't think it would necessarily be harmful, but it's just not something that I have enough data or I know which form of oral collagen I would recommend for my patients yet. — Yeah. Similarly, I think oral collagen has a lot of paper data. I think phys pathophysiologically if you eat a well balanced diet you do get those building blocks inherently. So rolling that all together you have supplements for bruising sun protection you potentially have supplements that provide building blocks for your skin that's all supporting those primary treatments that we talked about previously. So this is pretty much the comprehensive guide to taking care of aging hands. I truly believe that prevention is so important in this category. That means applying the same ingredients that you would apply to the face, applying them to the back of the hands. really taking care of your hands with sun protection that's going to go such a far way. The corrective procedures, they're expensive, they're cumbersome, you don't always get the result from them. And by the time the skin is so fragile, it gets even harder to work on. And so, this is something where I'd say be proactive and really start taking care of them sooner rather than later. Right? So, let us know if this was helpful for you. If there's another part of your body you want us to talk about, whether it's your feet, whether it's dark elbows, whether it's your hair, whatever it is, just let us know and we'll try to direct our attention to it. But thank you for being a part of this with us and we'll see you next time. And last, for those of you who have already bought our hand cream, I do apologize for having the difficulty opening the product. We have gotten a lot of positive feedback on the performance of the product and people who love the packaging. I tend to hyperfocus on critical feedback because I'm always trying to improve. So, I've definitely heard you. With time, it does get easier to open as that hinge starts to get looser. But I do apologize. It's it wasn't as easy to open. We are going to be working with our manufacturers to improve the packaging. So, we really value your feedback. Thank you so much for taking a chance on remedy and thank you for so much for trusting our videos and trusting us with your care. — Yeah. We'll see you next time.