Dr. H. Christopher Coley, board-certified and fellowship-trained in both hand and cosmetic surgery, is owner and chief surgeon of Coley Cosmetic & Hand Surgery Center in Greensboro.
Hand rejuvenation is a term used to describe improvement in the appearance of the hands so that they don’t give away your age. It involves many of the same procedures as facial rejuvenation, including chemical peels, laser therapy, dermabrasion, skin care products and fillers.
Most sun and age spots can be removed with lasers and chemical peels, which also tighten loose skin to make hands appear healthier. For visible veins and tendons, fillers such as Radiesse or a small amount of fat are injected into the back of the hand to restore a youthful look.
Aside from aesthetics, there are several common hand conditions that can creep up as we age. Here’s a quick guide on what these conditions are and how to treat them.
Carpal tunnel syndrome is a condition in which the median nerve is compressed as it travels from the forearm to the hand. The carpal tunnel is formed from wrist bones and a thick ligament that houses the nerve, as well as several flexor tendons.
Symptoms include loss of or altered sensation in the thumb, index, long, and ring fingers. Some patients experience burning, tingling, weakness and even pain in the hand. Treatment should begin with an Healthy hands examination and diagnosis by a hand surgeon. If the signs and symptoms are vague, then a nerve conduction study can be performed to confirm the diagnosis. The surgeon then should discuss treatment options, which can be anything from modifying your work environment to splinting, medications and injections, and surgery.
Cubital tunnel syndrome is a condition in which the ulnar nerve, which supplies sensation to the ring and small fingers, is compressed at the elbow. Symptoms can include numbness and tingling in these two fingers, and pain in the elbow and forearm.
Treatment includes a thorough examination by a hand surgeon, X-rays and a nerve conduction study to rule out other causes. Treatment can include splinting, modification of activity, and occasional local injections or surgery to release nerve compression.
Arthritis and tendonitis in the thumb have similar presentations. With arthritis, the cartilage at the base of the thumb becomes worn out. With tendonitis, the tendon or tendon sheath becomes inflamed.
Treatment of thumb arthritis and tendonitis is similar. Rest, immobilization and anti-inflammatory medications are first-line treatment options, while other treatment modalities include splinting and local injections. Surgery is performed to restore function when these modalities fail to relieve pain.
Trigger finger is a condition caused by inflammation on or around the tendon. Symptoms can include pain, locking of the finger when it’s flexed and a popping sensation when the finger is extended.
Treatment involves a local injection to reduce inflammation. If this does not relieve the symptoms, then surgery might be necessary.
Ganglion cysts — No mass should be taken lightly. Fortunately, most masses on the back of the hand or on the wrist are ganglion cysts, which are benign.
Commonly, ganglion cysts come from the joint space or tendon, and can be a sign of arthritis or tendonitis. If they are symptomatic, then surgical removal rather than aspiration or drainage offers a more permanent solution.
Animal bites to the hand and fingers can be serious. An animal’s fanged teeth often can penetrate deep into the tissue, causing a deeper infection. A thorough evaluation of these bites should be conducted by a doctor.
To prevent infection, cleanse wounds thoroughly and use antibiotics as needed. At the first sign of an infection, have the bite evaluated to avoid the spread of infection and help determine whether surgical exploration or drainage is required.