Wednesday, July 30, 2014

Treating Aging Hands With Dermal Fillers

Aside from being asked to treat wrinkles on the face and neck, you may also be asked to address aging issues that occur on the hands using dermal fillers. Before this can happen you need to examine your patient’s hands for signs of both intrinsic and extrinsic aging.

Intrinsic and Extrinsic Aging

There are two types of aging that affects the hands of older person. 

Extrinsic aging effects are more outward in appearance.  It affects the epidermal and dermal layers of the skin due to an overexposure to the sun, smoking and chemicals.  This can result in aging spots known as sunspots such as solar lentigines, punctate hypopigmentation and solar purpura.

By contrast, intrinsic aging comes from within the softer deeper tissue planes creating a condition of decreased skin elasticity, soft and atrophied tissue. This can manifest as translucent, waxy looking thinner skin and more prominent veins joints and tendons.[1]

There are a number of methods for restoring the appearance of aging hands using injections that are taught in the Pinewood Institute for the Advancement of Natural Medicine Dermal Fillers course.

Hyaluronic Acid for Aging Hands

All aging is due to the depletion of endogenous hyaluronic acid that plays and important role in the hydration of tissues and joints, maintaining the biomechanical integrity of the body and preventing it from oxidative stress. Intradermal injections of HA increases the dermal thickness and elasticity of the skin.

Hand fillers treated with hyaluronic acid may need further treatments as it is a temporary solution.

Calcium Hydroxylyapatite

Calcium hydroxylyapatitie is an inert filler with a lot of applications in dentistry and bone repair. It has been used as a filler for hands. It is sold by the commercial name of Radiesse.  The color and viscosity of CaHa makes it a good option for concealing unsightly veins.

Other Dermal Filler Options for the Hands

Bovine Collagen has been used as a dermal filler in cosmetic surgery fro years even though it is not currently on the market.  The results are a bit iffy with this treatment but there have been reports of more success using porcine bovine fillers. In both the case of bovine and porcine collagen injections, the results only last a year.

 Poly-L-Lactic acid (PLLA) has been used for over thirty years in surgical implants. However treatment with this acid requires multiple injections and is expensive. Granuloma and visible bumps under the skin could also develop with injected Poly-L_Lactic acid.

Injection Techniques for the Hands

Injection technique is taught in full as part of the Pinewood Institute’s Dermal Fillers course. You will learn techniques for volume restoration including:

Tenting – injections through pinched skin
Serial punctures – injecting small amounts of filler along a line
Microdrooplets- injecting tiny amounts of filler across a large number of points
Tunnelling- injecting the dermal filler while withdrawing a needle at the same time
Fanning- injecting dermal filler radially without withdrawing the needle

There are many other techniques to learn as well that apply to individual cases.
Learning how to inject dermal fillers without damage to the hands is another important issue.

For more information about The Pinewood Institute for the Advancement of Natural Medicine courses including course outlines, detailed descriptions of courses and information about upcoming training sessions, please go  You can also send us an email using our email form at or call us at 416-656-8100. If you prefer to fax the number is 416-656-8107.

[1]  Ulrich Kuhne and Matthias Imhof, Treatment of the Aging Hands With Dermal Fillers, Journal of Cutanaeous and Aesthetic Surgery, Medknow Pubulfication, 2012 5(3): 163-189.

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