And it’s meant that more patients are seeking out the kinds of in-office treatments they’d normally do for their face—lasers, peels, even injectables—for their hands. In her San Diego practice, Sabrina Fabi, MD, a board-certified dermatologist, says she’s definitely doing more in-office treatments on hands now than she was 10 years ago. She sees it as a natural progression for patients who have already tried various treatments on their face, neck, and chest: “I think it’s just an evolution of being on an aesthetic journey and having already treated other parts of the face and body for years.”
Ahead, experts share all the ways that patients are extending their filler and laser routines to their hands, in order to target concerns like wrinkles, discoloration, loss of volume, and more.
In this story:
Sun spots are a top concern among patients, but lasers can help.
When a patient comes in asking what they can do for their hands, they’re usually looking to treat sun spots, says Dr. Garshick. “People often forget to apply sunscreen to their hands,” she explains, so the discoloration is typically caused by “cumulative UV exposure over the years.”
In-office laser treatments are dermatologists’ go-tos for targeting sun spots on the hands. Margarita Lolis, MD, a board-certified dermatologist in Hackensack, New Jersey, believes picosecond lasers are the most effective option for erasing areas of discoloration. They deliver energy in short pulses, within the pico-second range (or the equivalent of one trillionth of a second), and can selectively target pigment like melanin or tattoo ink.
“The laser essentially breaks down the pigment into small particles the size of sand, which are eliminated by the body,” she explains. “It’s fast—it requires a few treatments depending on the degree of discoloration, and can fully remove sun spots.” The Q-switched laser functions similarly to picosecond lasers, targeting melanin using a specific wavelength of light. Dr. Garshick uses both to treat individual and well-defined brown spots.
When a patient has more diffuse discoloration or wants to treat both sun spots and redness caused by sun damage, doctors might reach for Intense Impulsed Light (IPL). After an IPL treatment, some patients may experience some redness and temporary darkening or scabbing of brown spots, but overall Dr. Garshick says it has relatively little downtime.
A more intensive, but very effective choice, fractional CO2 lasers reduce both pigmentation and fine lines by resurfacing the skin, adds Dr. Rabach. “These treatments are particularly effective because they can address both the surface pigmentation and deeper layers of the skin, improving both tone and texture,” she explains.
Fractional CO2 lasers are ablative lasers, which create injury to the skin in order to stimulate the production of new collagen and address fine lines, wrinkles, crepiness, and discoloration. “Since the CO2 [laser] is also creating controlled injury to the surrounding skin, there can be more downtime associated with it compared to some of the other treatments,” she adds. Redness, some swelling, and skin texture changes may occur post-treatment. “In general, there is a grittiness to the skin that feels like sandpaper,” she explains. The worst of the redness and swelling is typically experienced within the first 24 to 48 hours, but the scabbing and rough, sandpaper-like texture can continue for around seven to 10 days. Dark spots treated with the laser may also appear darker before lightening or going away.
