November 30 2010
A few years ago, while I was interviewing Dr Nick Lowe, the London-based dermatologist, he rather suddenly asked my golf handicap. As small talk, the conversation was destined to run dry quickly, since the only golf I’m remotely familiar with comes prefixed with the word “crazy”. When I said as much, he responded, “It’s just that your right hand is quite pigmented, and the left one isn’t, so I assumed you were a keen golfer.”
Thus the conversation turned to my “beauty” hand – the result of almost daily testing of skincare products on the back of my left hand for 20 years (I use my right hand to apply cream to the left). Surprised, he took a closer look. The left hand was relatively unlined, slightly plumper and with fewer noticeable veins and sinews than the right. “Yes, definitely a golfer,” said Lowe. “Or a long-distance lorry driver – they also have this kind of asymmetry.” Ah, yes; my secret trucking past…
Cut to today and there are still differences between my two hands, despite my playing match up/catch up by lavishing the right one with every cream that’s landed on my desk in the intervening years.
But although assiduous application – even with one of the most sophisticated creams on the market, Deborah Lippmann Rich Girl SPF25 Cosmeceutical Anti-Aging Hand and Cuticle Cream with Fade Botanicals (£24 for 85g) – has slowed the decline, it has been impossible to rewrite the history of my right hand.
So, years after that first conversation, I find myself in Dr Lowe’s office once again, backs of hands presented for inspection like a begging puppy. “As far as anti-ageing treatments go, hands are the new face,” he announces. “It’s the hands that give away the true age,” he adds, commenting that increasingly, there’s a noticeable difference between the apparent age of a woman’s face and that of her hands, “especially if she takes care of her facial skin.”
“On the hands, you get solar lentigines [age spots caused by UV exposure], slackened skin, a papery texture,” he explains. “Excessive exercise and a low body fat ratio make it worse, or if you play sport,” he adds. “The veins appear prominent, the tendons more pronounced.”
Lowe ticks off a list of available products and procedures: they include prescription and topical drugs such as hydroquinone to lighten pigmentation, peels to resurface the skin, lasers to remove age spots, light treatments to stimulate collagen production and fillers to replace lost fat. Even the prosaic hand cream, especially those with advanced formulae – including his own Double Duty Hand Cream SPF15 (£12.99 for 100ml), the first to include UVA as well as UVB protection – are part of his arsenal in the war against time-ravaged hands.
No matter how rigorous my home care regime – a weekly hand spa, which involves working a glycolic peeling pad over the back of each hand then smothering them in Bamford Organic Hand Cream (£15 for 75ml), and sleeping in Bliss Glamour Gloves, polymer gel-lined mitts containing nourishing mineral oil (£36) – it will never match the results of any of Dr Lowe’s super-charged treatments. And although I had even started wearing gloves for gardening and housework, I was never quite prepared to make the same sartorial sacrifice as Cornelia Zicu, worldwide chief creative officer of Elizabeth Arden Red Door spas, whose hands are like a girl’s. Unblemished, youthful and attractively plump, they’re very pretty – very likely because she wears gloves whenever she’s out, especially in the summer.
“Part of the problem is that we don’t wear gloves any more,” says Dr Mark Whiteley, “so the hands are constantly exposed to the elements – and they’re visible.” Whiteley is a consultant vascular surgeon who generally treats leg veins but sees at least one client a week with hand “concerns”.
“The common complaint is big veins and a bony look, but the problem is actually thin skin, which makes the tendons and veins appear more prominent,” he says. Whiteley prescribes a course of three Restylane Vital treatments, one month apart (£588). This hyaluronic acid-based filler is especially viscous, and was developed expressly for the hands. Administered via microdot injections, it works to improve hydration as well as elasticity and smoothness. “Patients may experience some superficial bruising initially, but after the third treatment, there is a major visible improvement – and we don’t need to treat the veins,” he says. The results last for 12 to 18 months, with occasional top-ups recommended, depending on the individual.
With more immediately visible benefits, CACI’s hand treatment (from £30 for 30 minutes) combines the same skin-brightening and lifting effects of the company’s microdermabrasion and microcurrent muscle-toning facials. “Most clients book in after their holiday to treat dehydration, lines and coarse skin texture caused by spending time in the sun,” said my therapist. She worked a small electronic wand back and forth over the hands and fingers, first blasting away dull, dry skin, then plumping up the tissues with a cocktail of vitamins, oxygen and moisturisers. After just one treatment the results were still apparent two weeks later, but 10 sessions give a longer-lasting effect (up to a year), with a reassessment/top-up recommended every two months.
However, CACI’s hand treatment can’t get rid of age spots completely. A 2006 study by behavioural biologists Dr Karl Grammer and Dr Bernhard Fink confirmed that uneven pigmentation on the face can add as much as 20 years to a woman’s perceived age. If the same is true of the hands, then it’s time to up the ante.
“I can’t leave the hands looking like 50 when the face is nearer 40,” says Dr Marko Lens, a Harley Street plastic and reconstructive surgeon who also performs non-invasive treatments on a clientele that increasingly wants the apparent age of their hands to match that of their faces. Lens prefers to use a CO2 ablative laser (from £250 per treatment) to remove age spots permanently, especially the darker pigmented ones, and tends to follow up with a series of chemical peels to improve skin texture and thicken the epidermis. “You could have Fraxel,” he offers (from £750; normally one session is enough, and once treatment is completed the results should last a few years). Fraxel treats a larger surface area by delivering pixellated bursts of energy. “But it involves significant down time,” he warns, with redness and scabs, “like sunburn”.
Work commitments mean I can’t afford for my hands to be out of action, so I opt to have a couple of my most noticeable age spots treated for now. I don a pair of goggles and Dr Lens zaps away. Pain-wise, on a scale of zero to 10 for waxing, it’s probably a seven – but I imagine that if the backs of both hands were treated, it would be quite uncomfortable, and I would certainly opt for the topical anaesthetic cream that Dr Lens had offered. I’m left with two miniature craters where the pigmented layers of skin have been vaporised by the CO2 laser. A day later, they’re slightly red and starting to scab over. One week on, the pale pink scars have begun to fade and certainly look no worse than the aftermath of pruning a thorny rose bush a few weeks earlier.
In fact, the laser treatment was so uncomplicated that I wish I’d embarked on a course of hand improvement years ago. It seems I’m not alone. “Many of my patients are women in their 50s, 60s, 70s,” says Dr Diana Piana-Mariton of the French Cosmetic Medical Company, a busy laser practitioner. She tells me about one patient, an MP who had decided she didn’t like the appearance of her hands on the lectern and eventually chose to do something about it. Piana-Mariton examines my hands and, like Lens, recommends Fraxel (from £500) to remove the superficial and textural aspects of pigmentation, but, also like Lens, warns me of the recovery time. “However, after a few months, you’ll get this tightening and plumping effect as well, due to its collagen-stimulating activity,” she says, adding that, depending on my skin cells, the effects should last for up to 18 months, while any scars will be permanently removed.
Fraxel works by raising the skin temperature to the point where cells respond to the thermal “injury” by producing more collagen. Piana-Mariton recommends Retin-A as a follow-up treatment, to re-texturise the skin. I question her about sun exposure as I know that Retin-A makes skin UV-sensitive. “Protection from UV is vital, but it’s not realistic for me to say, ‘Don’t go in the sun.’ Many of my patients use Fraxel as a licence to extend their time in the sun because it leaves your skin higher up the collagen ladder – essentially, you’re growing new skin.”
All roads seem to lead to Fraxel, but in the meantime, with a hectic work schedule, a manicure is about as much as I can commit to. My usual habit is to paint the nails a neutral shade of pinky-beige so as not to draw attention to my hands. But then I find myself at a Revlon event, with free manicures to promote the relaunch of “matching lips and tips” – lipstick and nail polish, a concept that Revlon launched in the 1950s. The colour on offer is a vivid shade of red – very Mad Men, very appealing. As I have the glossy scarlet painted on, a shadow falls across the table and a deep, American voice announces over my shoulder: “Wow, they look like candy apples.” I turn to see the actor Jeff Goldblum, who has wandered in from his gym class next door. I play it cool and hold my hands up for inspection. “I love the colour. I could almost eat them!” he enthuses. Perhaps the Fraxel can wait after all.