INTRODUCTION
With many advanced anti-aging creams developed and marketed for the face, attention is now turning
to other visible areas of the body. There is growing
interest in creams for aging skin on the hands, which receive
high UV and environmental exposure. UV damage and secondary signs of aging1, 2 on the hands make them one of the most obvious indicators of age outside the face. The past several years have seen a focus on and significant increase in the number of devices, procedures and injectables approved for the hands, yet
Photo-aging is characterized by UV-induced epidermal and dermal changes, including textural changes, lentigines, actinic keratosis (AK) and seborrheic keratosis (SK). Dermal changes also play into visual aging, including sagging and thinning of the skin, loss of elasticity, increased fine lines and wrinkles, and increased skin fragility. Finally, a loss of subcutaneous fat due to both UV exposure and intrinsic aging leads to a loss of volume
and increased visual prominence of vascular, tendon and bone structures.3
In-office procedures commonly used to help address the many visual manifestations of photo-aging include lasers (ablative and non-ablative), IPL, chemical peels, cryotherapy, electrodessication and photodynamic therapy (PDT). Options range from treating individual lesions to more comprehensive and aggressive full-surface treatments. For all in-office hand treatments, care needs to be taken when treating more aggressively due to longer recovery times and increased risk of scarring, hyperpigmentation or hypopigmentation
on the hands (as compared to the face). Further, it is important to mitigate the risk of a line of demarcation between treated areas and the remainder of the arm.3
The final primary indicator of aging on the hands is increased
visibility of vasculature, bone and tendon structures due to fat atrophy and thinning. Common office treatments for these issues include revolumizing through filler injections (especially with the newly approved Radiesse indication) and removal of vascularity via sclerosing or endovenous laser procedures.
With all treatment modalities, effective topical agents should be integrated to enhance and maintain procedure results. Marini
Luminate Hand Cream (Jan Marini Skin Research) contains multiple key ingredients designed to address the visible signs of UV damage and photo-aging, including: textural changes, increased hyperpigmentation and discoloration, increased fine lines and wrinkles and decreased elasticity. Primarily, these ingredients include Retinol, Alpha-Arbutin, Kojic Acid, Azelaic Acid, Hexylresorcinol, Licorice Root Extract, Dipotassium Glycyrrhizate, and Vitamin C, as well as multiple antioxidants and soothing agents to help hydrate the skin, reduce irritation and protect against further damage (Table 1).
Retinoids are vital to the maintenance of optimal skin health and are utilized extensively by dermatologists. They yield many benefits for the skin and are used to treat a variety of skin conditions,
yet prescription-strength tretinoin is often too harsh or irritating and results in poor compliance or discontinuation by the patient. Many studies have show that retinoids provide significant anti-aging benefits by increasing skin thickness and cellular turnover, promoting healthier skin.4
The two most well known retinoids are all-trans retinol (retinol) and all-trans-retinoic acid (tretinoin). In a study