Characteristics of Aged Hands and Causes

Hands that are not beautiful and aged have the following characteristics:


Many people forget that in addition to the face, another area that screams out one’s age is the back of the hand. This is because the back of the hand is usually not covered. In addition it is common for people to look at the back of the hand to notice the diamond ring or watch worn by the individual. It would be such a waste if these expensive accessories were worn on aged hands. The back of the hand is a good indicator of age because a firm face with aged hands is a dead giveaway of the person’s actual age.

The marking for filler injection

1.   The skin is wrinkled with no elasticity. There may be black or white blotches on the skin, which are indicators of damage to the epidermis. This may be due to UV exposure because the back of the hand is a sun-exposed area. Aging and UV rays cause the skin to become thinner losing collagen and moisture. This causes the appearance of wrinkles and lack of elasticity.

2.   The shrinking of the skin on the back of the hand revealing blood vessels under the skin. The color of the blood vessels may appear or even protrude from the skin. This is because the fat layer has disappeared resulting in volume loss, which is a consequence of aging. This is comparable to effects seen under the eyes, wrinkle on the cheeks, and temples. As a consequence the blood vessels become more pronounced. This is partly due to the accumulation of calcium and fat in the blood vessels resulting in a narrowing of the vessels. Thus, higher blood pressure is needed for circulation as a the blood vessels become bigger protruding from the skin as described by Pascal’s law.

P=F/A where P is pressure, F is the force on the blood vessel and A is the area or diameter of the blood vessel.

As the blood vessel becomes constricted the pressure mounts this causes the blood vessel to expand to cope with the increased pressure. The result is a bulging blood vessel that has less elasticity because it is clogged with calcium and fat (this is the same type of problem that may happen in the heart or brain). As the layer of fat disappears, the fingers become thinner and the joints protrude more visibly.  

Treatment Options

The optimal treatment is to inject a material to help fill the layer of sunken skin to reduce the visibility of the bulging blood vessels. To stimulate the skin layer, stem cell serum can be injected to stimulate the growth of new skin cells. Lasers can be used but it must be done carefully because the skin in this area has fewer pores thus it cannot fix itself well. Thus the treatment using laser or chemical peel is not very effective often resulting in negative side effects such as black marks on the skin and scarring. Another problem is oftentimes these treatments are not effective. 

There are two options for injecting substances into the skin –fat or HA fillers. In the past using the person’s fat to inject into the back of the hand was a preferred option. Part of it was because at that time the HA fillers were not yet well developed and the effects did not last very long. The newer type of fillers are better than fat. This is because the new fillers are softer, making it easy to inject. In addition it has volumizing properties. Also the treatment lasts longer. There is no bruising or swelling like the injection of fat that takes two weeks to recover and cannot be injected in small areas of the hand. The only disadvantage of HA filler treatment is the higher price because a large amount of filler is needed.

illustrating filler injection on the back of the hand and between the fingers

Technique and Procedures

  1. Apply anesthetics for 30 minutes then inject another anesthetic to ensure that the skin is totally numb.
  2. Puncture small holes and use blunt tipped needles to penetrate the skin in order to inject the HA filler. The position for the injection of the HA filler is over the extensor tendon and between the inter-osseous muscle. This will help to volumize the back of the hand.  
  3. Inject the HA filler into the subcutaneous fat layer and the web spaces in order to create the smooth appearance and help to lift the skin in the area.

Expected Results

The results of the HA filler injection are visible immediately in solving aging signs on the back of the hand. The prominent blood vessels will disappear and the skin would have a smooth youthful appearance. The HA filler would help to refill the moisture in the skin making it soft and supple.

Words of Warning

There are many blood vessels and nerve endings on the back of the hand therefore it is safer to use the blunt tipped needle compared to the sharp tipped needle. In addition it is important to be treated by a doctor who has advanced knowledge in using blunt tipped needle injection technique. It is recommended to use needle sized 25G and bigger. Even when using the blunt tipped needle some bruising may be seen. However, most of these will disappear within a week. One of the dangers is infection. But if patients choose a quality service provider, this should not be a concern. In addition it is important to choose the right type of HA filler. The new type of soft HA fillers with hydro-balance property that are easily diffused should be selected for its volumizing and rejuvenating effect. The effects are also quite enduring. The only drawback is the price. This is because each hand requires 2 – 3 cc of the fillers. However, it is a very convenient treatment because there is no need for recovery time and the patients can always come back for additional treatment until the desired effect is achieved.

Diagram showing the tendons and muscles between the bones of the hand