Episode 13: Hand Rejuvenation

Hands are one of the most exposed areas of the body.  We remember to wear sunscreen on our faces/neck area, but we often forget the hands.  Over time we begin to see the changes of aging on the hands.

This episode will cover:
1.  Signs of hand aging
2.  Home care tips to help minimize 
3.   In office procedures to help with volume loss of the hands, pigmentation and laxity.

Enjoy!

Thank you for your listenership!

Transcript

Dr. Minni Saluja 0:07

Hi everyone. I hope you're well. Thank you so much for joining us in another podcast. I've just laser it and all things cosmetic back up here again with Link and Cane on our third day of spring. Is that right?

Kane Rogers 0:21

It doesn't feel like it, but yeah.

Dr. Minni Saluja 0:22

it's starting to feel like it. Little

Kane Rogers 0:24

tomorrow it's gonna be like 80.

Dr. Minni Saluja 0:26

Tomorrow we're gonna start peeling off layers of our coats and everything else, so I just can't wait. But Kane, before we launch into this, I've got a question for you, and I know you don't speak for the entire male population, but I'm curious, when you see aging, what, whether it's the face, the body, et cetera, what are some of the first areas that you start to see aging and, and what would you describe as aging?

Kane Rogers 0:51

You're right, I don't speak for everybody. I let me. Speak to myself. So the first thing I noticed was

Dr. Minni Saluja 0:58

you wanna get through

Kane Rogers 0:59

My hair started going great. I like to call it platinum, but my hair started going platinum, so that's a sign I'm aging. I would say my face, especially my jowls, I can start to see a little sagginess there. And the biggest thing is my belly. I just seems to

Dr. Minni Saluja 1:12

Okay, I wanna go. We're go. I should've prefaced this a little bit more. We're going in a way different direction than, so what about the skin? Okay. I hear what you're saying. Yes, we get gray hair. Thank goodness that's what Laura's for my hairdresser to take care of me with that. but, and also certainly our, our body changes shapes, whether it's the change of hormones, et cetera. We get that. But when you think about the skin, let me, let me give you a little kind of guidance here. When you think about areas of the skin and whether it's the face, et cetera, where do you see aging on the skin? Like what

Kane Rogers 1:45

Well, I mean, you, you, I think you kind of. A lot of places, the face and neck, I think certainly.

Dr. Minni Saluja 1:51

We're in the face. Would you.

Kane Rogers 1:54

Well, I mean, everywhere. I mean, signs of aging, you start to lose volume. In my case, you know, like I said, my jowls are kind of, you know, you start to sag a little bit. I think you start to get thinning and volume loss and sun spots or liver spots or whatever we call'em nowadays, so, okay. All those

Dr. Minni Saluja 2:10

well, well, what I'm trying to get at

Kane Rogers 2:12

are you going at? You just really putting me on the spot

Dr. Minni Saluja 2:14

well, I'm sorry, sorry, sorry. But you're exactly right. Those are things, but one of the first areas that we see it on the face, around the eye area, we start to see lack of volume. We start to see crepiness around the eyes. Oftentimes patients will come in and they might even be in their early thirties, and they're starting to see these signs. And certainly we could do a little filler in the midface area. You know, my patients know that I don't like too much filler under the eye area, but as far as the crepiness, we'll do a whole episode on periocular rejuvenation, meaning around the eyes. But I think that that's one of the first areas we see it. You're exactly right that the neck. That skin is another area. And, and back to the eyes, that skin is so much thinner than around the face area. So that's why we start to see the crepe, same with the neck area, that that skin is so much thinner. So we start to see kind of that laxity, especially centrally. But one area that I'm trying to get at that we don't really talk about. Are the hands. We start to see a lot of aging on the hands. And when you see, you know, our face, our neck, these are sun exposed areas.

Kane Rogers 3:22

Okay. I just have to say that was a really long wind up to get to the hands.

Dr. Minni Saluja 3:26

Well, that's what we're gonna talk about today is we're gonna talk about the hands, because again, we'll talk about the eyes the neck on a separate episode. But today we're gonna talk about hand rejuvenation and what we can do. On our own at home and what we would do in the office for it.

Kane Rogers 3:42

That is actually a good point now that I think about it. I mean, the hands, you do see a lot of thinning and you do see a lot of sun spots on the hands.

Dr. Minni Saluja 3:50

Absolutely. So when you're getting at that thinning, there are certain things that you can do at home. Like even Retin A on the hands can help. You know, you always hear we're talking about Tretinoin because it increases cell turnover. It's a vitamin A rettino acid is a vitamin A derivative. it's also an antioxidant. It also prevents degradation of collagen builds collagen. There's a lot of attributes of Tretinoin, so that's something that you can do on the hands at home. You can also make sure that you sun protect with sunscreen. I mean,

Kane Rogers 4:19

I'm not, I don't want to dive too much into this, but I'm not really familiar with Tretinoin. like, what is it briefly, what is it and how would you apply it?

Dr. Minni Saluja 4:28

Okay, that's a fair question. So Retin a Tretinoin is a retinoic acid, which comes from vitamin A. It's a vitamin A derivative. And the reason why we like this trans retinoic acid, the, the Tino for the face is that again, our skin goes through a cell cycle of about about 30 days, 28 to 30 days, and as we get older it becomes slower and slower, and so Retin A increases that cell cycle back to where we want it to be around that 28 day mark. And so it helps to slough off some dead cells as well. But more importantly, It is an antioxidant. We know that vitamin C is an antioxidant, vitamin A is an antioxidant as well. So it helps to just to protect the skin and it, it increases collagen in the skin, which is always something that we wanna see. And it's really, it's dirt cheap. It's not expensive. I tell patients that whenever they start on to always start minimally, like maybe. Twice a week at nighttime after, after they wash their face, they put a little pea size amount on their face and rub it in with the same concept. We can also use it on our hands and over time you can build it up to either every other night or possibly even nightly.

Kane Rogers 5:42

So it just helps with the cell turnover and basically it just helps you have new skin. and

Dr. Minni Saluja 5:48

stimulate and elastin in

Kane Rogers 5:49

has some protective properties as well.

Dr. Minni Saluja 5:51

Absolutely, and very easy. Now, don't expect, you know, when you put on your skin, don't expect to look five years younger over a month's time period. No, it doesn't work like that, but it does improve the skin quality over time. And again, it's inexpensive to utilize. And one of the most studied products in dermatology from a cosmetic perspective is, is Tretinoin.

Kane Rogers 6:11

It's just a, a long term at home regimen.

Dr. Minni Saluja 6:14

Correct? Correct. So that's something you can do for the hands, but we have to always remember, gotta wear your sunscreen. I mean, we're, I think most of our patients are, are pretty darn good about applying it to their face. I'd say they're getting better with their neck. Sometimes we neglect the neck. But the hands, we might apply it and then we wash our hands during the day and we don't really think about it. I'll tell you the time that I think about my

Kane Rogers 6:37

I raise my hand for that. I put it, I put it on my face and neck. I don't put it on

Dr. Minni Saluja 6:41

Hey, don't put it on your hands, Rogers, you gotta do that. So and so the other thing is I always think about my hands when I'm driving home because I can feel that sun coming through my window and I'd almost feel it searing my hands. So I put this actually on Instagram. I got a pair of Cooley Bar, U P F gloves. U P F is Ultraviolet Protective Fabric. And I got it off of Amazon. There was like, it was$31 or something. I love them. I just put'em in my glove compartment and I take'em out when I drive home, and that way my hands are protected. So these are little things that you can do on your own to help protect your hands. Now, one of the other things, so patients often will say, gosh, my hands are starting to look very veiny or very tenderness, and they're, and they're right. Over time we lose fat in our hands. So we start to initially see the veins in our hands. And then over time as we start to lose more and more, we actually get to see tendons. Have you seen that cane

Kane Rogers 7:39

Yeah. No, it's, the words that's coming to my mind is it's very spindly.

Dr. Minni Saluja 7:43

It's very spindly. Exactly. And so the other day I was telling a patient, yeah, we, you know, we can just put filler there. And she was dumbstruck. She said, you could put filler in the hands. And I said, absolutely. We do that quite often. I mean, I wouldn't say that's the number one area that we do for sure. Lips and cheeks and whatnot. But the hands are really a popular area and there are different type of products you can use in the hands. You know, sculptor has been used in the hands. I don't, I love it in the face all day long. I, I love sculptor there in the hands. I don't like it as much because the hands are thinner. So I prefer either hyaluronic acid, whether it's Restyline Lift or the R H A products. or even hyper dilute radi es, which is something that could be used in the hands. The only thing about radius is it does swell more in the hands, so that's why I often, you'll, you'll see me doing more hyaluronic acid in the hands.

Kane Rogers 8:39

this. But overall, I mean, there. A treatment option when you start to get those real veiny, spindly looking hands that there is an option for you to, to use some sort of filler product. And, and it, I mean, it really does

Dr. Minni Saluja 8:53

work. It makes, and it's, it's an immediate benefit that you see. And the way that we do it is we do it with cannula. I mean, the idea, some people might think, oh my gosh, a needle in my hands, that's too much. But it's with a cannula, which is a blunt tipped cannula, and we just go in either from where the wrist is and we go right through there into the hands and we just put a little filler in and you. immediately see the benefit right then and there. It just gives that kind of, that that youthful, youthful kind of volume back to the hands. So something to think about. And and the other thing that you had touched upon is that,

Kane Rogers 9:28

well, let me, let me ask you a question. So would it, would it, does it typically last as long as, as filler that you would inject in the face?

Dr. Minni Saluja 9:36

It does and sometimes maybe even a little bit longer because, so I think you get a good year out of, out of filler, and again, depending on which products, some products are 15 month products. But because think about it, I'd say filler dissipates the quickest around the mouth because you're constantly moving that area. Filler does very well In the midface or the temple area, but filler in the hands and the dorsum of the hands does really well there's some movement there, but it, it still just stays put. So you could really get some nice

Kane Rogers 10:03

So it's typically your fingers that are moving, it's not necessarily your hand,

Dr. Minni Saluja 10:07

That's exactly right. And usually, so typically it's one syringe per each hand will really give you a nice volume. But oftentimes I will start with half a syringe if patients are just wanna see what it's like half a syringe in each of the hands. So one syringe total, but I think you're really gonna get your most benefit. And again, this also depends on how much volume is lost with one syringe because per hand, because remember, each syringe is 20% of a teaspoon, which is not a lot.

Kane Rogers 10:35

No, that's not a lot at all.

Dr. Minni Saluja 10:36

and you have to cover the entire dorsum. So that's a very

Kane Rogers 10:39

does it take? Is it a similar time for, for, for the injection process as if you were doing lips or is it faster?

Dr. Minni Saluja 10:47

much faster. It's probably about 10 minutes per hand. I mean, I'm a slow injector, you wanna go slow to try to minimize discomfort and whatnot. So maybe 10, 15 minutes per hand doesn't take long at all

Kane Rogers 10:58

no downtime, nothing to to

Dr. Minni Saluja 11:00

there could be a bruise. There could, especially in the entry point there possibly could, but typically patients aren't as concerned as if they have a bruise on their face. But that is, you know, a really popular treatment. And oftentimes we will do it with I P L. now, as I travel into the summer months, I don't do ipls. I stop doing ipls and I resume again in October, but I p l can target the pigmentation. And we did an episode on I P l, I think it's episode three on our podcast that goes into it in full detail, but that can target the pigmentation of the hands to kind of give just a more rejuvenated appearance

Kane Rogers 11:39

so it can help clear out the, the sunspots or the, the browns that kind of develop on the hand,

Dr. Minni Saluja 11:44

Correct. The benign pigmentation that's there. And then other lasers can be done. I mean, even RF microneedling. There's a RF microneedling device called sifu, which has a pulsed wave mode, and you can go pretty superficial with it as well. So you can even do that on the hands, or sometimes we use Lacey D, which is a fractional non-ablative laser, just to help with the, the crepiness in the hands.

Kane Rogers 12:04

so you, so you can address the volume very quickly with a very. Common filler that a lot of people are used to. It doesn't take very long. And there's very little downside. Maybe a, maybe a small bruise or something like that. And then you can also, so you can address the volume and then you can also address the, the color with lasers.

Dr. Minni Saluja 12:25

With the color, with lasers. You

Kane Rogers 12:26

And can you do that all in one treatment? Could you do filler and lasers at the same time?

Dr. Minni Saluja 12:32

You can. Absolutely. Because remember the laser that we're selecting and even PicoSure is another great laser to utilize with it because that's just, that's not gonna affect it's not gonna go subdural. Now, I probably would not do RF microneedling at the same time as filler. I would either do a fractional non-ablative laser like Las m d or PicoSure focus lens, or an I P L at the same time. Otherwise, I would just split it.

Kane Rogers 12:56

Okay. But it's important for people to know that there are options. Out there to address both the volume loss that, that, that spindly look and the colorization.

Dr. Minni Saluja 13:06

Absolutely. And you know what, what I'm gonna do here, hang on one second. Let's see if I can get it. Did I do it

Kane Rogers 13:16

kind of, there we go. That's better.

Dr. Minni Saluja 13:18

Okay, so let's do something. We have not done this for a long time now, but I will qualify this. So someone who listens to this podcast six months from now, this is not going to exist. I'm gonna qualify this and say that for our next 10 patients that call. That need the two syringes of filler for their hands, we will take a hundred dollars off and we're gonna, all you have to let us know is turn back the hands of time and we will take a hundred dollars off of the two syringes for the hands. This is not two syringes for the face, but this is really specifically looking at the hands. And what I'll try to do is I'll try to gather some photos where I can place them on Instagram so patients can see what I mean about how it rejuvenate.

Kane Rogers 14:03

Okay, turn back the hands of time. I almost wanna sing it like there's a song,

Dr. Minni Saluja 14:07

Yeah. If I could, yeah. Okay.

Kane Rogers 14:10

but turn back the hands of time and you get a hundred dollars off,

Dr. Minni Saluja 14:13

you get a hundred dollars off of two syringes.

Kane Rogers 14:15

the next 10 patients,

Dr. Minni Saluja 14:16

So not one syringe, not the half. But if you're doing one syringe per each, we'll give you a total cumulative of a hundred dollars off of that procedure. And and that's it. That's all I got.

Kane Rogers 14:27

I think that's all the questions I have as well. I do want to thank everybody again for listening. This, this podcast has taken a life of its own and it has surpassed our expectations, and that's due to everybody listening and then giving us feedback. So thank you very much.

Dr. Minni Saluja 14:40

Thank you so much. Have a great night. Bye.