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"Like most women, I fret about lines and blotches on my face, but I mostly ignore my hands. Sure, I get a manicure now and then, and I slather on cream when I remember to. But otherwise, I barely give them a second thought. Then one day, after a very stressful period in my life, I looked down and barely recognized them: When had my hands become so paper-dry, wrinkly, veiny, and splattered with spots? For all the TLC I give my face, I realized that my hands were a dead giveaway of my age \u2014 52. (In fact, research shows that most people can accurately guess how old a woman is just by looking at her hands.) I soon grew tired of wearing long sleeves as a disguise, so I resolved to give my hands a &amp;quot;lift.&amp;quot; Over six months, I tried a spectrum of at-home and in-office treatments. Here&amp;#039;s what I learned from the pros...and what really worked. THE TROUBLE DRY, RED SKIN Skin needs moisture to stay soft and supple. When water in the top layer escapes, the texture becomes flaky. The catch: Water is also skin&amp;#039;s potential enemy, because it can wash away the lipids that help hold on to moisture. Excessive hand-washing can strip away these natural oils and dry out hands, as can detergents, alcohol-based sanitizers, and abrasive scrubs. Redness and chapping often follow.  THE TREATMENT Switch to gentle, fragrance-free hand and dish soaps. To minimize your exposure to water, whenever possible use a non-soap cleanser like Cetaphil Gentle Skin Cleanser ($4.49, drugstores), which you can wipe off with tissue, and invest in a good pair of dish gloves. After washing your hands or having any other contact with water \u2014 shampooing your hair or rinsing vegetables, for example \u2014 think defensively, and apply moisturizer. Skip lotions, which are light, and go straight to heftier sealants \u2014 creams and ointments. In a cream, look for glycerin or petrolatum; Cur\u00E9l, Moisturel, and Eucerin all make good, thick ones. For an ointment, try Neutrogena Norwegian Formula Hand Cream ($4, drugstores). Too greasy? I rub my fingertips on a hand towel to get the residue off. If you&amp;#039;re battling redness, check ingredients for an anti-inflammatory like chamomile or aloe. And keep multiple tubes within arm&amp;#039;s reach \u2014 in a desk drawer, kitchen drawer, handbag, or car \u2014 so you actually use them. Sometimes hands get so chapped, normal creams won&amp;#039;t do the trick. Take mine: They had become chronically red, exacerbated by a prolonged period of constant hand-washing when I was caring for my husband, who was ill with cancer. My skin had become &amp;quot;compromised,&amp;quot; as Francesca Fusco, M.D., a New York City dermatologist, put it. I had scoured off its buffering lipids and needed stronger help \u2014 a barrier cream with fat molecules called ceramides (lipid-building blocks) and hyaluronic acid, a moisturizer. She recommended CeraVe Moisturizing Cream ($15, drugstores), and also gave me a prescription for a more potent hand cream, EpiCeram. They began to alleviate the chapping and redness within weeks.  For maximum absorption, Dr. Fusco recommends wearing cotton gloves overnight; I found it worked \u2014 in the mornings, my hands were less dry and less red. Even more effective: gel-lined gloves like Bliss Glamour Gloves ($48, Sephora), which moisturize continuously but are so thick, they make dialing a number or flipping a book&amp;#039;s pages a challenge. For more practical (if less spa-like) conditioning, she suggests cutting the fingers off a pair of your nighttime gloves. Wear them over moisturizer, and you can hydrate while you work.   THE TROUBLE AGE SPOTS AND WRINKLES Among the most obvious age giveaways are age spots \u2014 dark splotches that are bigger than freckles and not as cute. &amp;quot;We don&amp;#039;t know why pigment collects into spots, but we do know that the sun&amp;#039;s ultraviolet rays are the culprit,&amp;quot; says dermatologist Susan H. Weinkle, M.D., affiliate clinical professor at the University of South Florida in Tampa. Repeated UV exposure also leads to wrinkles, and hands are especially vulnerable to damage, thanks to their thin skin.  THE TREATMENT Just as bleach lifts stains out of clothes, hydroquinone helps fade pigment from age spots. A 4% concentration, available only by prescription, works best, but can be irritating. More gentle are over-the-counter creams with 1% to 2% hydroquinone, such as Porcelana Skin Lightening Cream ($8, cvs.com) or Ambi Fade Cream ($5, drugstores). Another alternative: creams that promise to inhibit pigment with nonirritating botanicals (see 5 Ways to Fade Age Spots for suggestions). However, the nonprescription options can take months to work, and while they may fade spots to a lighter shade of tan, they are unlikely to vanquish them altogether.  A more surefire way to obliterate sun damage is with a laser. Some types \u2014 Nd:YAG, DioLite, Ruby \u2014 target brown pigment, one spot at a time. The pigment absorbs the light, cells break down, a superficial scab forms, and in a week or so, the scab flakes off, leaving neutral-pigmented skin underneath. Prices vary widely depending on how many spots you zap and your zip code \u2014 anywhere from $250 to $650.  For diffuse spots, an all-over treatment is preferable. The plus: It will address spots and wrinkles in one go. Intense Pulsed Light (IPL) zeroes in on both brown and red pigment, and also stimulates wrinkle-fighting collagen. The light is beamed below the skin&amp;#039;s surface, so there&amp;#039;s no visible injury or downtime. But in contrast to the laser, you usually need three to five sessions \u2014 $300 to $600 apiece \u2014 each spaced a month apart. Another all-over approach is fractional laser, or Fraxel. I opted for the mid-strength version known as Re:store. It works under the surface, creating pinprick-size micro-wounds that form new, smoother skin as they heal. While Fraxel Re:store produces more dramatic results than IPL, it requires a day of downtime. You typically need three to five sessions, each about $700 to $1,200, spaced over three to five months. I found it worth the mild pain: The skin tone on the backs of my hands became impressively even.  No matter which option you choose, you have to be vigilant about protecting your hands with sunscreen after treatment, or those spots will reappear. Try Boots No7 Protect &amp;amp;amp; Perfect Hand Cream SPF 15 ($14, Target), a GH 2010 Anti-Aging Award Honorable Mention.  THE TROUBLE LOOSE, WRINKLY SKIN AND POPPING VEINS Hands are just like faces \u2014 they gradually lose fat, or volume, over time. Without that natural padding, hand skin becomes slack, creating even more wrinkling, and tendons, joints, and veins appear more prominent. In fact, veins may actually increase slightly in size. &amp;quot;They dilate as the connective tissue decreases with age,&amp;quot; says New York City dermatologist Macrene Alexiades-Armenakas, M.D., Ph.D. &amp;quot;And if your skin is pale, their bluish-purple color shows through that much more.&amp;quot;  THE TREATMENT You can increase skin thickness with retinoic acid: This anti-ager improves skin texture and decreases wrinkles by speeding up cell turnover and boosting collagen production. The prescription strength has a reputation for being irritating, but don&amp;#039;t dismiss it if you&amp;#039;ve had a bad experience. &amp;quot;I&amp;#039;ve found retinoids like Renova [$150 plus] are much easier on the hands than on the face,&amp;quot; says Dr. Alexiades-Armenakas. Over-the-counter creams with the less powerful retinol or retinyl palmitate, like Yes to Blueberries Seed Fund Gardener&amp;#039;s Hand Cream ($9, yestocarrots.com), are even gentler. Still, you may or may not see an improvement. Exfoliating also encourages new skin, but most body scrubs are too rough for hand skin; instead, look for a sloughing cream, like Philosophy Time on Your Hands ($18.50, Sephora), with glycolic acid. Chemical peels are a stronger route to cell renewal and offer a quick skin perk-up. If you go the at-home route, one option is Dr. Dennis Gross Skincare Alpha Beta Daily Body Peel ($78, amazon.com). A dermatologist&amp;#039;s glycolic peel will cost more (about $200) and requires multiple sessions for maximum results, but the concentration can be tailored for fragile hand skin.  Only an in-office procedure can address protruding veins. Consider a laser like DioLite, which heats and shrinks vessels in one or two sessions, at $600 each. Or, for immediate gratification, try a synthetic filler, injected into the space between the tendons. The most popular these days is a gel called Radiesse, which is used off-label for hands (it starts at about $2,000). Once injected, it stays soft and melds with surrounding tissues, lasting a year or more. On top of instant plumping, it prods skin into producing more collagen. A 2011 study at Sadick Dermatology in New York City deemed it safe, with very minor side effects and impressive results. At nine months, 80% of the patients&amp;#039; hands were improved. A call to Dr. Fusco confirmed this: &amp;quot;I&amp;#039;ve never had a bad result with Radiesse.&amp;quot;  I decided to give it a try. The process was relatively quick and painless, but right afterward, my hands puffed up like mittens. A week later \u2014 the swelling down and bruises gone \u2014 I found myself staring at my smooth, filled-out hands with admiration. There is still some redness across my knuckles, and I will continue to pamper and protect. Meanwhile, I&amp;#039;ve pushed up my sleeves and started wearing bracelets and rings again. Finally, after six months of treatments, my hands are ready for their close-up. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.goodhousekeeping.com/beauty/anti-aging/tips/a19169/younger-looking-hands/>