By area

Polynucleotides for Hands

Hands age in two separate ways at once, and only one of them is a skin problem, so the useful question is which of the two is bothering you when you look down.

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The short answer

What this treatment is

The backs of the hands are second only to the face for lifetime sun exposure and they are almost never protected. They also sit on very little: a thin layer of fat over tendon, vein and bone, with skin that thins steadily from middle age.

That produces two distinct changes. The skin itself becomes fine, crepey and marked with pigmentation. Separately, the fat pad between the tendons wastes, so the tendons and veins stand proud. People describe both as their hands looking old, and they need different answers. Polynucleotides address the first and do nothing for the second, which is worth establishing before anybody books a course.

Hands at a glance during and after your session

Session timeAbout 20 minutes
CourseUsually three sessions
IntervalTwo to three weeks apart
First changeTexture, from session two
DowntimeMild swelling for a day
Result judgedAt about eight weeks

Areas treated

What's included

Improves fine crepey texture on the backs of the hands
Hydrates skin that has thinned and lost its suppleness
Softens the fine lines that show across the knuckles
Treats an area that carries heavy lifetime sun exposure
No downtime that interferes with using your hands
Can precede volume treatment where both are needed

Boundaries of practice

What's not treated

Good practice means saying no when indicated:

Known allergy to fish, since the source material is salmon or trout
Pregnancy or breastfeeding, where no safety data exists for this treatment
Active skin infection, inflammation or an open wound in the area
Active autoimmune disease affecting the skin, without clinical advice first
Anticoagulant or antiplatelet therapy, which needs assessment before treating
A course of isotretinoin taken within the last six months

Patient journey

What to expect

Consultation & preparation

Stop fish oil, high-dose vitamin E and anti-inflammatory painkillers for a few days beforehand if your own doctor is content for you to, because each of them makes bruising more likely. Come with a list of what you have already had done and when, and the medicines you take. Describe what you dislike in your own words rather than naming a treatment, so the assessment starts from the problem.

During treatment

Telling skin quality apart from volume loss

There is a simple test. Look at the back of your hand with the fingers relaxed. If the complaint is that the skin looks fine, dry and finely creased, and it stays creased for a moment when you pinch and release it, that is a skin quality problem and this treatment addresses it.

If what you notice is the tendons standing out as ridges and the veins sitting proud between them, that is volume loss. The fat that used to sit over those structures has gone. No treatment that improves skin quality will hide them, because they are not being hidden by skin, they are being hidden by fat that is no longer there. That needs volume replacing.

Most people over about fifty have some of both, and the sequence is usually skin first, since thin crepey skin over freshly placed volume tends to show every contour.

What a session on the hands involves

Shorter than the face, usually around 20 minutes. The product goes into the skin across the back of the hand in a series of small deposits, avoiding the tendon lines. Numbing cream is offered but many people do not bother, as the area is less sensitive than the under-eye.

Expect mild swelling for a day, which is more noticeable on hands than elsewhere simply because you are looking at them constantly and using them. Bruising is possible around the visible veins. You can use your hands normally straight away, though it is worth avoiding heavy gripping for the rest of the day.

Sunscreen on the backs of the hands is the single thing that most determines how long the result holds, and it is the thing almost nobody does.

Why results on the hands are the shortest-lived

Hands get a harder life than any other area treated with this. They are washed and dried many times a day, which strips the barrier repeatedly. They are exposed to ultraviolet light year round, because unlike the face they are almost never covered and almost never protected. And they are in constant mechanical use.

The practical consequence is that a result which holds twelve months on a face will often hold nearer six on hands. That is not a failure of the treatment, it is the environment the tissue lives in.

It also means the single highest-value thing you can do alongside a course costs about eight pounds. Sunscreen on the backs of the hands, reapplied, makes more difference to how long the improvement holds than any decision about product or practitioner. Almost nobody does it, including people who are meticulous about their face.

Aftercare

Leave holding a written plan that names the area, the number of sessions, the intervals between them and the total cost including any review. Read it somewhere other than the clinic. A fortnight between assessment and first treatment is the interval commonly recommended for elective cosmetic procedures, and nothing about this treatment is urgent enough to shorten it.

FAQ

Common
questions

Will this hide the veins and tendons on my hands?

No. Prominent veins and tendons are the result of lost fat between them, not of skin quality, so improving the skin will not conceal them. That needs volume replaced. Polynucleotides treat the fine crepey texture and dryness of the skin lying over those structures.

Will it fade the brown marks on my hands?

Not meaningfully. Age spots on the backs of the hands are accumulated pigmentation from sun exposure and need a pigment-directed treatment such as a laser or a peel. Texture and hydration will improve while the marks stay, so plan for both if the marks are what bother you.

Does treating the hands hurt?

Less than the under-eye area, and many people skip the numbing cream entirely. The injections are shallow and the session runs about 20 minutes. Expect mild swelling for a day, which feels more noticeable on hands simply because you are looking at them and using them constantly.

How long do results on the hands last?

Typically six to twelve months, though hands tend to sit at the shorter end because they are washed constantly and exposed to sun year round. Wearing sunscreen on the backs of your hands makes more difference to how long the result holds than anything else you can do.

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Describe what you want changed.
We come back with a registered practitioner.

Polynucleotides Marylebone • UNTIL Marylebone, 1 Orchard Street, London W1H 6HJ

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