Words: J.P. Faber

Of the many signs of aging, the appearance of your hands is a dead giveaway. Here is one solution.

I am not obsessed with my hands, any more than the next person. I don’t constantly pour over them, examining them for signs of aging. Nonetheless, instead of the unblemished appearance of youth, they eventually carry the imprint of time; in my case, brown blotches.

I used to see these on my grandmother. Those clusters of brown stains, like tiny islands on a map of something warm and familiar. It was fine for her, because she was old. But when they appeared on me I felt like I was looking at the hands of a stranger. I would look at them whenever I reached for something, and I would think, my god, whose old things are these?

There are certain clues that give away our age, marks that brand us as surely as the rings on a tree trunk. One of those is the appearance of our hands. As we grow older, our hands are aged by the sun, exposure to the elements and by time itself; they lose volume, the skin grows thinner and the cells weaken and develop unsightly “age spots.”

Fortunately, a well-trained cosmetic surgeon or dermatologist can reverse a great deal of this deterioration. And, as a victim of age spots, that’s what I needed: some reverse engineering.

I went to see Dr. Deborah Longwill, a highly skilled dermatologist and one of Miami’s best. A master of both needle and intensified light, she uses a high-tech laser to ‘ablate’ the surface of my skin. Like chemical peels, lasers burn away a superficial layer of the epidermis, or outer layer of the skin, which is where the pigment lies. In the past, CO2 lasers were used to ablate the whole layer of epidermis, exposing the dermis where collagen, nerve endings, blood vessels and glands are located, thus leaving the patient’s face or hands looking like a lobster for weeks. Today, we use something called ‘fractionated’ lasers, which only burn a faction of the skin surface away.

In Dr. Longwill’s Miami Center for Dermatology, she uses the Fraxel brand of fractionated laser. She no longer uses the old CO2 type because of her concerns with possible scarring and the long recovery time.

“The Fraxel is only going to hit 60 percent of your hand at one time,” she explained. “It’s a fractionated laser beam, and that is the beauty of it, and why your skin heals so quickly. It’s like the pixels in a newspaper picture, with space in between the dots, which are the beams—and I can control that.”

Dr. Longwill also treats the other symptoms of hand aging, mainly the loss of volume that reveals the blood vessels and bones. For that she uses a dermal filler called Radiesse, which she injects between the knuckles so that sunken skin plumps up and becomes smooth.

But for my case—the case of the spotted hands—the solution was a handheld laser the size of a cell phone, with a red, glowing head on one end. Sort of like an electric razor but with laser lights instead of blades. Her assistant had already applied numbing cream to my hands, a topical anesthetic that eliminated most of the pain—but not all of it.

Okay, call me squeamish, but I don’t like pain—though I can take it if I know it’s temporary. Fortunately, the discomfort was just that. Dr. Longwill moved the head of her laser gun over the surface of my hands and fingers, like a tiny lawnmower making its rounds. On either side of the hot laser head were intense streams of cold air. So, even though it stung at the point of contact, the sting was momentary and did not linger.

The process took about 20 minutes for both hands. When Dr. Longwill was finished my hands were covered with tiny spots, just like the newspaper photos she had described. And, yes, they felt like they were both badly sunburned, but nothing more than that.

In the coming days and weeks I coddled my hands. I was told to keep them out of the sun while they recovered, so I bought an inexpensive pair of smooth, goat-skinned gloves from the hardware store. I wore these when I drove to work, and whenever I was in the sun.

The metamorphosis—for that is what it was—took about two weeks. At first there was little change, just a red pallor and those tiny dots. I remember on the fourth day that my hands ached painfully when I held them by my side, but not when I lifted them up. And then they started to slough off the spotted layer of epidermis, like snakes shedding their skin. Patches of new pink skin appeared between the shredded sheaves.

And then it was over. The dead skin was gone, and my hands were smooth, and a little pinkish (since then they have become a ‘normal’ flesh tone). A couple of freckles seemed to appear, but they were pale and hardly noticeable. The original age spots, so hard for me to look at, were gone!

As for the ‘freckles,’ no problem. “Remember, we only hit about 60 percent of the surface,” said Dr. Longwill. “You need to come in for another treatment, maybe two, so we can get the rest.”