What if you could turn back the hands of the clock … on your own hands? Erase those age spots? Shrink those lumpy veins? “A lot of people are now aware of all the things they can do with their faces,” says Dr. Robert Weiss, an associate professor of dermatology at Johns Hopkins Hospital and a practicing dermatologist at the Maryland Laser, Skin and Vein Institute in Hunt Valley. “Then they look down at their hands and think, ‘That doesn’t match.’”

Weiss has been performing age-erasing hand treatments for more than 15 years, but his rolls have sharply increased in the past few years. In 2005, he performed about 2,000 procedures to remove age or sun spots, and he did roughly 40 treatments to collapse veins, called sclerotherapy, up from only five to 10 in recent years. He expects that number to reach 200 in 2006.

Weiss attributes the recent popularity of hand treatments to procedures that are quicker and less painful than in the past. He used to use chemical peels to remove age spots, which required as many as five treatments. When the technology progressed, he used lasers, but even then he could only zap a few at a time. Now, with intense pulsed light called photorejuvenation, he is able to “refinish” the whole back of the hand in two minutes, and 90 percent of patients only need one treatment. (The cost is between $275 and $600 per treatment, depending how far up the arm clients want to treat.)

To treat prominent veins on the backs of hands (also typically caused by sun exposure, which damages the vein walls and causes the breakdown of soft tissue around the veins), Weiss injects a solution recently approved by the FDA, called Sotradecol (sodium tetradecyl sulfate). As it enters the vein, the solution temporarily displaces the blood and causes a gentle irritation to the vein’s inner lining. When the blood returns, it’s trapped in the treated veins, and then the body gradually absorbs the trapped blood, shrinking the veins in the process. As opposed to older solutions, Sotradecol foams up to almost shaving-cream consistency, which allows for very precise distribution when injected into the vein. (The cost is $250 to $350, depending on number of veins.)

Jody of Bel Air, recently underwent both the sclerotherapy and the photorejuvenation on her hands. “I work with the public, at a desk, and my hands are very visible,” she says. “I think they look 20 years older than the rest of my body and my face. … Gardening and everything has really aged them through the years. So I wanted to make them look more in sync with the rest of my body.” She says the pain was “very tolerable;” the needle for the sclerotherapy felt like “nothing more than a pin prick.”

Dr. Debra Bailey and her colleagues at the Annapolis Dermatology Center also use photorejuvenation to treat spots on hands. The day after treatment, the spots scab over, and in seven to 10 days, fall off, leaving skin smoother and spots less noticeable. Since the procedure stimulates collagen, in about four to six months the patient will “see the skin thickening and the texture and quality will be smoother, with less wrinkling,” says Bailey. (Cost: $510 for three treatments, or $200 for one.) Bailey says there is minimal discomfort at the time of treatment, best described as a “rubber band snap.”

Annapolis Dermatology Center also offers cryotherapy, in which spots are frozen off with liquid nitrogen (cost: $125). Bailey recommends this for patients who want to remove a few spots, but aren’t worried about wrinkles, vessels or veins.

An additional vein-shrinking option available from many dermatologists is a laser fiber method, but Weiss recommends this only for very large varicose veins, most often occurring in the legs, that need a good deal of heat inside the veins to shrink them. “Sclerotherapy injections are more gentle and painless for the size of the ropy veins on the backs of the hands,” he says. For patients who do choose the laser fiber, he recommends using a “cooler” wavelength called CoolTouch, which targets water and not blood like the other laser fiber methods, and generates less heat inside the vein.

Dr. Barbara Honig of Owings Mills, another local dermatologist seeing the recent upswing in demand for hand procedures, says she saw about 200 patients last year who wanted spot removal on their hands, which she treats with cryotherapy. (Cost varies depending on number of lesions, but starts at $100.) She treats veins with Cool- Glide lasers, which deliver pulses of light energy into the vein, destroying it and redirecting the blood flow to veins that are deeper below the surface.

Overall, the feedback Weiss has received has been very positive. “Most patients appreciate looking down at their hands and seeing tiny, normal veins instead of ropylooking ones,” he says. “Baby boomers are continuing to work and the average age of workers is increasing.” So the desire to look good for the workplace and feel confident when shaking hands is a concern of many older professionals. “I feel less self-conscious now,” confirms Jody.

With all of these choices, the new agedefying procedures are the best thing to happen to hands since the manicure.

Beth Plambeck is a free-lance writer and editor living in Baltimore.

Robert A. Weiss, M.D. Dermatology Associates/ Maryland Laser, Skin and Vein Institute, 54 Scott Adam Road, Hunt Valley, 410-666-3960, http://www.dabaltimore.com

Debra Bailey, M.D. Annapolis Dermatology Center, 71 Old Mill Bottom Road North, Suite 300, Annapolis, 410-268-3887

Barbara Honig, M.D. 21 Crossroads Drive, Owings Mills, 410-356-0171 American Academy of Dermatology http://www.aad.org.

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