Thin skin with brown spots, less elasticity, and loss of underlying fat are characteristic features seen with the passage of time. Causative factors include long-term ultraviolet exposure from the sun, aging, and, in some cases, medications such as chronic use of topical and/or systemic steroids. Fortunately, the appearance of the hands can be improved. Brown spots fade with photo rejuvenation using intense pulsed light or lasers.
The volume loss of the back of the hands can be replenished with fillers such as Radiesse, Juvederm, or Restylane Lyft. This also helps to diminish the prominence of underlying veins and tendons. Finally, the skin can be nourished with emollients and sunscreens to moisturize and protect the skin from further sun damage.