Already popular in volume replacement for the face and neck, researchers investigate the use of small particle hyaluronic acid (SPHA) fillers to address the appearance of aging hands.
Aging can be seen in the appearance of one’s hands. As we age, our skin thins out because of the progressive loss of moisture, collagen, and fat. Our skin also becomes more susceptible to the effect of ultra-violet light, which is the phenomenon called photo-aging. These changes can be more apparent on the backs of our hands, where the skin is already relatively thin. The underlying structures like veins and tendons can become more prominent and the result is aging hands with the wrinkly and spotty hands we associate with old age.
Replacing the lost soft tissue volume can mask these changes in aging hands. Taking patients’ own fat from somewhere else and injecting it into these areas is one of the most popular methods used by physicians. However, this method, called autologous fat injection, has its drawbacks. The amount of fat is limited by the patient’s supply or the amount of available donor areas, usually the abdominal areas. Some patients may also find the extraction process painful. Indeed, a series of injections are required to take out the fat, and another series is required to place it into the hands. Moreover, the injected fat has been found to shrink in volume over time, which makes the final results less predictable.
Fillers like small particle hyaluronic acid (SPHA) are popular choices for volume replacement because they shrink much less than injected fat. Using SPHA also precludes the need for any donor site, which addresses the other concern of too many injections. To investigate the potential of fillers for hand rejuvenation, dermatologists from New Jersey conducted a trial on selected patients using SPHA gel. Their results were recently published in the journal Dermatologic Surgery.
In this study, the dermatologists selected 25 female volunteers between the ages of 40 to 70 years. Prior to the procedure, their hands were graded using a scale that accounted for the amount of soft tissue volume and corresponding visibility of veins and tendons. A patient’s one hand was then serially injected with SPHA gel, and both hands were compared over one, three, and six months.
The study reports that there was a marked improvement of the appearance of the treated hand using their evaluation criteria, with no reported adverse effects. More importantly, this improvement persisted even after the six-month period. This long-lasting effect further bolsters SPHA’s potential in replacing the lost volumes in the hand.
The development of a definitive treatment protocol means that further studies are required to determine ideal injection volumes and treatment durations. Nevertheless, this initial study demonstrates the safety, efficacy, and durability of SPHA fillers for use in aging hands. In the days to come, there may indeed be a much better alternative to fat injections.
Written by Jay Martin, M.D.
Source: Wilkerson, EC and Goldberg, DJ. “Small-Particle Hyaluronic Acid Gel Treatment of Photoaged Hands”. Dermatologic Surgery. 2017 (0):1-7. DOI: 10.1097/DS.S.00000000000001251.