AgingSkinNet Article
Non-Facial Aging Skin: Treatments

Our faces aren’t the only parts of our body that succumb to lifelong sun exposure and collagen breakdown. The good news is that just as there are treatments to rejuvenate aging skin on the face, there are treatments that can make the neck, décolleté, hands and legs more youthful.

When we look for the reasons for our aging skin, we need to look no further than the sun. The sun causes 90 percent to 95 percent of the wrinkles; lines; brown, red and white discolorations; and more on our bodies. That’s why the sun-exposed areas, including the backs of the hands, are most prone to the imperfections.

Rejuvenating Neck and Chest Skin
With age, many experience more and more pronounced skin blotchiness and spider veins, called telangiectasias, on the sides of the neck and chest. The condition, called poikiloderma, is a result of sun damage. Areas of atrophy, which are white areas, are related to loss of elasticity. The neck and the chest are particularly prone to these white indentations because of the thinning skin in the region.

Chemical peels and bleaching agents applied directly to the skin help with the pigmentation problems, including white and brown spots. Laser and light treatments, including pulsed light lasers, reduce redness.

A problem that often occurs is the mismatched coloration on the neck after a person has laser rejuvenation on the face. Laser procedures and chemical peels can lighten the skin. As a result, dermatologists can also lighten those areas, such as the neck, which can contrast the face, with a trichloracetic acid (TCA) peel. This helps to blend in the areas so that the face doesn’t look strikingly lighter than the neck and chest.

Nonablative lasers are tools dermatologists use to treat sun damage on the neck and chest area. While lasers work by heating and removing the top skin layers, nonablative lasers work beneath the skin’s surface by targeting cells that absorb the light’s energy. The underlying sources of the skin discoloration break apart from the laser’s light and become absorbed in the body.

After a series of nonablative laser treatments, dermatologists can reduce the signs of aging and sun damage, including fine wrinkles, freckles and irregular pigmentation—especially on the face, neck and chest (though it can also be used on the hands). Patients who have these procedures can return immediately to activities because nonablative laser therapy causes no downtime.

Photo rejuvenation is yet another approach that uses intense pulsed light technology to correct imperfections on the hands, neck, chest and face. The light penetrates the outer layer of skin without causing damage and goes directly to the dilated vessels or pigment. Patients have no downtime from the procedure but typically they require a series of treatments for optimal results.

Botulinum toxin can be used on the chest for diminishing wrinkles. Ask your dermatologist about its use in décolleté smoothing to relax the muscles underneath.

Younger Looking Hands
Many focus on rejuvenating the skin on their faces but forget about their aging hands. Among the most common problems associated with aging hands are lentigines, or brown spots, which respond to a number of treatments.

For those who don’t want to undergo any procedures, there is the option of dermatologist-prescribed bleaching creams, which patients rub on their hands on a regular basis for the long-term. These work subtly to reduce the discoloration of dark pigmented spots.

Approaches that lead to more dramatic, faster results include the use of chemical peels, from the superficial glycolic acid to the medium TCA peels, which work to remove dead skin cells and stimulate the production of new skin cells. Dermatologists use these peels on different parts of the sun-exposed body, including the hands, to diminish age spots and lighten the skin. Cryosurgery with liquid nitrogen can peel local areas.

Some dermatologists also use lasers, such as the Q-switched Nd: YAG laser, to change the hands’ skin color and remove spots. Unlike the face, hands are much easier to treat. Typically, laser treatments correcting discolorations on the hands might take about 10 minutes in a dermatologist’s office.

The skin on the hands also tends to be thin. Dermatologists have the option of using fat transplantation from other areas of the body to give the hands a more youthful plumpness. This can be done in conjunction with other procedures to lighten the hyperpigmented (or dark) areas on the hands.

Diminishing Leg Veins: Options in the Dermatology Office
Varicose and spider veins on the legs can worsen with age. Here, too, dermatologists have an arsenal of treatments to bring youthfulness back to the skin on the legs.

Varicose veins are abnormally swollen or enlarged blood vessels caused by a weakening of the vein’s walls. Dermatologists can treat the condition with a procedure called radio frequency closure. This involves the dermatologist inserting a small tube, or catheter, into the varicose vein through a small puncture. The catheter delivers radio frequency energy to the vein wall, causing it to shrink and seal shut. Patients generally do not feel pain during the procedure and often can return immediately afterwards to activities.

Though not as common, the endovascular laser procedure is another technique used to treat varicose veins. The technique involves inserting a diode laser wire or fiber directly into the vein. The laser fiber penetrates the skin to deliver laser energy into the vein, which heats and destroys the vein.

Dermatologists today treat leg spider veins, which are red or bluish appearing dilated small blood vessels located close to the skin’s surface, with lasers, which were traditionally reserved for the face. Newer versions of laser technology, including the Nd: YAG 1064nm, use wavelengths to penetrate the skin of the legs without heating the pigment. This reduces the risk of burning or injury to the skin. Typically, two to five treatments, which last about 15 minutes each, are required to remove spider veins.

The mainstay of leg vein treatments continues to be injection with sclerosing solutions or sclerotherapy, a method in which the solution is injected with a very fine needle directly into the blood vessel. All of the above procedures work in conjunction with or in addition to its benefit.