I recently had the privilege of lecturing on hand rejuvenation at the 72nd Annual Meeting of the American Academy of Dermatology in Denver, Colorado. During my session, other speakers from around the world shared their experiences. I was particularly interested in pearls of wisdom and techniques for off-the-face rejuvenation. Overall my Miami dermatology patients are pretty good about protecting their facial skin, from strong broad-spectrum sunscreens to wide-brimmed hats and topical retinoids to reverse sun damage. However on a daily basis in our clinic I hear, “I only get sun on my body, not my face.”
Up until their 30s, most men and women can do this without noticing any sequelae, however brown spots, broken blood vessels, and fine wrinkling can start to appear. Dr. Kaufman and I learned about this personally when developing the settings for a device called the Palomar/Cynosure Skintel™ Melanin Reader™. It measures the amount of pigment in the skin to suggest safe settings for IPL and hair removal treatments. Some of our patients had dramatically different levels of pigment in the skin of their faces compared with their chests — for laser purposes they were like two completely different people. Of course it would be best to prevent this from happening, but it’s never too late to rejuvenate the skin off the face.
I would start by applying sunscreen daily. If you’re on the road a lot, consider tinting your car windows, or if you’re not a fan of that look have a clear film installed that blocks the sun’s harmful UV rays. Apply topical retinoids nightly. The prescription strength tretinoin products are great, but they can get a bit pricey to apply on a large surface area. Consider an over-the-counter retinol product like Overnight Resurfacing Serum.
We also have a multitude of injectable and device treatments available in the office. The Ulthera® device works well for neck tightening, but it is also quite effective for vertical lines on the mid-chest — telltale signs of sun damage in women. Lasers such as the Q-switched alexandrite and ruby can remove individual brown spots from the back of the hands to the chest and neck. The Fraxel® Dual 1927 nm Thulium laser can treat brown spots and has the added benefit of improving texture and actinic keratoses, or pre cancers. The Excel V™ by Cutera KTP laser can improve poikiloderma, the red and brown mottled sun damage on the neck. Lastly injectable fillers can safely and comfortably work wonders on hands that appear bony from lost volume.
These are just a few of the options for off-the-face rejuvenation. I or any of my colleagues would be happy to guide you through them and formulate a plan best suited to you.