Between frequent hand washing, exposure to the elements like the sun and the cold, and nightly dish washing, hands are often the true revealers of age – even more so than the face. In one study published in Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), participants were able to pinpoint a woman’s age simply by looking at photos of her hands.

According to Lance H. Brown, MD, a private practitioner in New York City and assistant clinical professor of dermatology at NYU School of Medicine, there are three telltale signs of aging hands: texture, color and contour. The participants in the ASPS study cited obvious veins as the No. 1 hand ager. Crepe-y or bony hands or hands that are covered in age spots are also big indicators of aging hands.

Fortunately, there are many ways you can rejuvenate your hands in order to achieve a youthful appearance that matches your face and the rest of your body.

Lasers for Hand Rejuvenation

A variety of lasers can be used to improve both the texture and the color of hands. Dr. Brown prefers the Fraxel laser, which can also be used on the face and décolletage areas. The laser shoots microscopic beams into the skin in a pixilated fashion, meaning some areas of the skin are left untouched. “In between the laser dots, the untreated skin serves as a healing base,” explains Brown. The treatment helps promote collagen growth to improve the skin’s texture and also removes brown spots and unwanted color. One or two treatments may be required.

Another laser that is commonly used on hands is the Cutera Excel Laser V, says Grant Stevens, MD, a board-certified plastic surgeon in Los Angeles and the medical director of Marina Plastic Surgery Associates. It uses radial frequency and is excellent for zapping away veins and brown spots.

Intense Pulse Light (IPL) Therapy for Hand Rejuvenation

If the skin on your hands is still taut and not overly crepe-y, but it is discolored, you may want to consider Intense Pulse Light Therapy. (A good test is to pinch the skin on your hands to see how quickly it snaps back into place. The skin on youthful hands is more resilient.) IPL is similar to a laser, but it works with high-intensity pulses of light. While it does stimulate collagen growth, it’s not at the same rate as a Fraxel or other lasers. On the plus side, it is effective at removing brown spots and broken capillaries and there is little-to-no downtime. Generally one or two treatments are required.

Fillers for Hand Rejuvenation

To erase the boniness of hands, doctors agree that fillers are the way to go, though there is some disagreement as to which one is best. Brown prefers Radiesse, a calcium-based filler that can last from 12 to 16 months. “The area between the tendons is very delicate with lots of blood vessels, so you have to be careful injecting in the area,” he says. “Radiesse gives a nice fullness to the skin, and if you combine it with a laser, you’ll get beautifully rejuvenated hands.”

Fat transfers, where fat is harvested from a patient’s buttocks and injected into the hands, is another option, but Brown warns that the results can be inconsistent. “The fat must be handled correctly after it has been harvested, otherwise, it will die quickly,” he says.

Another option is Sculptra, which is a favorite of Jeffrey Spiegel, MD, chief of the division of Facial Plastic and Reconstructive Surgery and a professor at the Boston University School of Medicine. “Sculptra is a biocompatible, biodegradable synthetic material,” he explains. “With three injections over the course of 12 weeks, the results last up to two years.” On the downside, if your injector is inexperienced, you may end up with nodules or bumps of the filler in your hands. “The better the quality of your skin to start with, the better the filler is going to work at restoring volume back to your hands,” he says.

An Ounce of Prevention

Though hands can certainly be treated effectively and years erased, know that these treatments are not a permanent cure-all. “When my patients ask what can be done about their hands, I tell them it involves a commitment,” says Dr. Stevens. After a laser and/or injectable filler use, Stevens encourages his patients to wear sunscreen on their hands and even consider wearing gloves when driving or out in the cold. “If they do, they can stave off additional discoloration and loss of texture for several more years.”