| chemicaL peeLs | aRTicLe
recently reviewed the use of hyaluronic fillers for body sculptuing and volume restoration elsewhere6
The ageing hand has become a matter of increasing .
appropriate dermal filler use must be individualised. Filler substance, stiffness of the gel, longevity of the effect, and safety profile are all important issues. Fillers used for deep facial lines are also often appropriate for the volumisation of ageing hands. These hyaluronic acid fillers can be injected either using a feathering technique with tunnelling or tenting, or — particularly for monophasic fillers — as a single bolus with immediate massage to evenly distribute the material. The microdroplet technique has also been used for treating aged hands. another option is the use of biostimulatory fillers
such as calcium hydroxylapatite (caha). This particular filler offers the advantage of small volume injections (microbolus) with a nice volumising effect and a longevity of stimulating collagen neoformation. in this case, small deposits of 0.1 mL are evenly distributed over the application area. subsequent massage is then carried out. These procedures are minimally invasive, but do carry some risks, such as granuloma formation, infection or allergy. Lasers and other light devices can also produce a degree of downtime for the patient. chemical peels are widely used for skin rejuvenation.
peels can be classified into a number of categories according to the depth of the effect they have, whether this is superficial, medium, or deep. medium and deep peels generally have a longer downtime for
interest in aesthetic medicine. Thinning of the skin, loss of volume, pigmentation spots, deformities of joints and nails, wrinkling and prominent veins are regarded as the main hallmarks of the aged hand.
patients. Deep peels also have the potential adverse effects of scarring and permanent depigmentation7
.
examples of superficial peels include alpha-hydroxy acid and salicylic acid; a typical medium-depth agent is trichloric acid (Tca) of less than 50%; and deep peels are realised by Tca of more than 50% or phenol-based agents. combined peeling procedures were first
recommended for hand rejuvenation in the early 1990s. swinehart8
used tretinoin and 20% trichloroacetic acid
(Tca) peels followed by 50% salicylic acid ointment peeling for the removal of lentigines and actinic keratoses from the dorsum of the hand8
. in this article,
the author reports on the use of a new superficial peel to restore the ageing hand in a non-invasive manner, but with significant and long-lasting results.
Material and methods Ten patients (seven females and three males) with an age range from 33–76 years were included in this uncontrolled study. successive patients asking for
prime-journal.com | September 2011
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