Hand skin care

In recent years, modern cosmetology has increasingly turned to the correction of age-related changes in the skin of the hands. Indeed, this area often "gives away" a person's age, despite a thorough and comprehensive approach to the correction of age-related changes in the skin of the face. Hands are especially susceptible to age-related changes and a number of dermatoses both due to the constant impact of external aggressive environmental factors on them and due to certain anatomical and physiological features of the skin structure.

Dermatocosmetological approach to the skin of the hands

The anatomical and physiological features of the hands include the structural features of the epidermis, dermis, subcutaneous fat, and underlying tissues. The structure of the skin on the dorsal and palmar surfaces is fundamentally different.

The back of the hands is covered with the so-called "thin" skin, the features of which are the thickness of 1-2 mm, as well as the presence of hair and sebaceous glands. The epidermis is characterized by a small number of cell rows. Thus, the number of rows of cells in the spinous layer is 3-4, while in other areas of the skin - from 3 to 8-15. A small thickness of the stratum corneum is also noted. There are vellus hairs and small lobular sebaceous glands. The specified structural features cause a noticeable thinning of the skin of the hands in the process of evolution of age-related changes, as well as a high tendency of the skin to dryness when exposed to exogenous irritants. Dry skin of the hands, cracked rashes, along with drug-induced cheilitis, are also possible against the background of acne therapy with isotretinoin. Xerosis of the skin is associated with delipidization of the skin surface and a sharp violation of its barrier properties. In connection with the above, it is very important to constantly use moisturizing and nourishing products as basic care, including, first of all, film-forming substances (petroleum jelly, paraffin, silicones, natural oils rich in polyunsaturated fatty acids, wax, lanolin, some fatty alcohols, etc.).

Melanocytes in the epidermis are few in number and are located in people with light skin only in the basal layer. That is why the consequences of even second-degree burns can be persistent foci of depigmentation associated with the destruction of pigment cells. This fact should always be taken into account when performing peelings on the skin of the hands (medium and deep).

The dermis and subcutaneous fat tissue in the area of the back of the hands are poorly developed. Studies have been conducted confirming significant changes in the volume, quality and distribution of fat tissue with aging. It is known that age-related changes in fat tissue include its physiological atrophy, and this process is most pronounced in the area of the face and hands. This is why superficial skin veins and muscle tendons on the back of the hands become more noticeable with age. Such changes are especially pronounced in women during perimenopause.

The small thickness of the dermis and subcutaneous fat dictates the importance of extreme caution when performing mesotherapy techniques in the indicated localization: there is a high risk of damage to the synovial sheaths of the dorsal surface of the hands.

The skin of the palmar surface of the hands is classified as "thick", has a thickness of more than 5 mm; the same skin covers the soles of the feet. It is characterized by a thicker epidermis and its stratum corneum than on other parts of the body, the absence of hair and sebaceous glands, and a relatively thin dermis and hypodermis. The epidermis also has a shiny layer (stratus iucidum). The large thickness of the stratum corneum and the absence of sebaceous glands cause stereotypical clinical manifestations of many dermatoses in this localization: they can be accompanied by keratosis, the appearance of cracks due to a violation of the elasticity of the skin. This is possible with chronic eczema, atopic dermatitis, allergic dermatitis, palmoplantar psoriasis, climacteric palmoplantar keratoderma (Haxthausen syndrome) and other diseases. In some cases, the diagnosis is confirmed not only by detecting characteristic primary rashes on other areas of the skin, but also by histological examination. The papillary layer of the dermis determines the pattern of ridges and grooves on the skin surface, which is most pronounced on the palms and soles. The pattern of the skin is strictly individual and genetically determined; on this basis, the fingerprinting method was developed in forensic science. In medicine, both traditional and non-traditional, the dermatoglyphics method is popular (for example, the characteristic skin pattern on the palms of Down syndrome is known). In dermatological practice, doctors may encounter very pronounced grooves on the palmar surface of the hands in patients with atopic dermatitis, chronic allergic dermatitis, chronic eczema and other dermatoses.

There are a large number of eccrine sweat glands on the palms, which participate in thermoregulation. This area is relevant in clinical practice due to localized hyperhidrosis and dyshidrosis.

External aggressive environmental factors include meteorological influences. Thus, in severe frost, xerosis of the skin is detected on the hands, and cracked or xerotic eczema may also develop. These changes are typical both in childhood and in adults (the so-called "chicken skin"). One of the significant external factors is insolation. At the same time, on the skin of the hands, as on any open area of the skin, the symptom complex of photoaging is clearly visible: a rough emphasized skin pattern, a combination of superficial and deep wrinkles, dryness and lentigo. With excessive ultraviolet irradiation, the action of ionizing and non-ionizing radiation sources (usually, occupational hazards), various neoplasms can be detected on the skin of the hands: actinic keratosis, basalioma, squamous cell carcinoma, melanoma. The hands may be involved in the process in cutaneous forms of lupus erythematosus, late cutaneous porphyria, photoreactions - dermatoses induced by ultraviolet radiation.

An important role is played by contact of the skin of the hands with various chemical substances in everyday life and at work, both obligatory and optional.

Peculiarities of hand skin care at home and in a cosmetology institution

Taking into account the constant impact of aggressive environmental factors and the anatomical and physiological characteristics of the hands, a gentle regime and careful care are recommended. It is necessary to wear gloves at low ambient temperatures and insolation. In the presence of allergic skin diseases, the glove material should be taken into account: cotton fabrics and viscose are preferable, and wool and synthetic fibers are not recommended. Hand protection at home and at work is important. When choosing protective gloves, it should also be taken into account that the most popular material - latex can act as an allergen.

Gentle care includes washing with products that do not change the pH of the skin surface (synthetics), as well as active moisturizing and nutrition. In a beauty salon, moisturizing and nourishing masks, massage, paraffin applications, and mesotherapy are recommended. To improve microcirculation in the distal parts of the hands, for example, with onychodystrophies, supravascular laser irradiation is prescribed, as well as Darsonval, UHF on the paravertebral areas in the cervicothoracic spine.

Various methods of surgical correction, constantly developing and improving at present (for example, lipofilling), are aimed at changing the appearance of the back of the hands by replenishing the deficiency of subcutaneous fat.

In summer, effective photoprotection is indicated. For solar lentigines, external agents containing hydroxy acids, azelaic acid, and retinoids can be used. They can be used at home in the form of creams and solutions, as well as in cosmetology institutions (peelings). Microdermabrasion and LHE therapy are used among hardware methods.

Thus, modern knowledge of the peculiarities of the structure of the skin of the hands can help a cosmetologist in choosing certain methods of prevention and correction of age-related skin changes in this anatomical localization. It is necessary to emphasize once again the importance of correct diagnostics of the analytical approach to the identified changes and complex correction