title: Hand rejuvenation: a review and our experience.
abstract: BACKGROUND
  The aged hand is characterized by cutaneous and dermal atrophy, with deep intermetacarpal spaces, prominent bones and tendons, and bulging reticular veins. Epidermal changes include solar lentigines, seborrheic keratoses, actinic keratoses, skin laxity, rhytides, tactile roughness, and telangiectasia.
  
  
  METHODS
  A Medline search was performed on hand rejuvenation from 1989 to 2011, and results are summarized. Practical applications of these procedures are also discussed.
  
  
  RESULTS
  Reports of injectable hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, autologous fat transfer, vein treatment, and chemical peels, along with lasers and light sources such as Q-switched laser, intense pulsed light, photodynamic therapy, nonablative resurfacing lasers, and ablative resurfacing lasers, in the rejuvenation of hands were found.
  
  
  CONCLUSIONS
  Review of the literature revealed options for minimally invasive treatment for rejuvenation of the skin and volume restoration of the dorsal hand. These treatments include injectables and fat transfer for volume restoration; sclerotherapy or vein ablation for dorsal hand vein treatment; and chemical peels, lasers, light, and energies for the treatment of epidermal and dermal changes.
authors.affiliation: Goldman, Butterwick, Fitzpatrick, and Groff Cosmetic Laser Dermatology, San Diego, CA 92121, USA. sgfabi@gmail.com
authors.forename: Sabrina G
authors.initials: SG
authors.lastname: Fabi
authors.forename: Mitchel P
authors.initials: MP
authors.lastname: Goldman
mesh_terms: D000273:Adipose Tissue / Q000473:pathology / Q000637:transplantation; D001284:Atrophy; D001672:Biocompatible Materials / Q000008:administration & dosage; D003357:Cosmetic Techniques; D017886:Durapatite / Q000008:administration & dosage; D006225:Hand / Q000473:pathology / Q000502:physiology / Q000601:surgery; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D007267:Injections; D019344:Lactic Acid / Q000627:therapeutic use; D053685:Laser Therapy; D010778:Photochemotherapy; D000077423:Polidocanol; D011091:Polyesters; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011108:Polymers / Q000627:therapeutic use; D012060:Rejuvenation / Q000502:physiology; D015911:Sclerotherapy; D015595:Skin Aging / Q000502:physiology; D014014:Tissue Adhesives / Q000008:administration & dosage
chemical_list: D001672:Biocompatible Materials; D011091:Polyesters; D011108:Polymers; D014014:Tissue Adhesives; D000077423:Polidocanol; D019344:Lactic Acid; D011092:Polyethylene Glycols; C033616:poly(lactide); D006820:Hyaluronic Acid; D017886:Durapatite; C445361:Restylane