Crocodile Skin Affecting Your Hands?

Q: I am 33 years old, but my hands look like they are aging faster than the rest of my body. What can I do to smooth the wrinkles and help with the areas of discoloration?

A: Many of us focus on protecting our face, arms and other areas of the body from the harmful effects of overexposure to sunlight, we often forget to apply these same protective measures to our hands. So, while our face may look 20 years younger, our hands will be telling a different story in that we are older, but not necessarily wiser.

While I can’t be sure without looking at your hands, the description of wrinkled, discolored and older looking skin suggests a type of damage known as photoaging. This commonly occurs on areas of our body (hands, face, top of the ears, etc.) that have a prolonged or chronic unprotected exposure to sunlight. This is not uncommon, but is concerning as it puts those areas of your body at a greater risk for skin cancer. Needless to say, you owe it to your hands—as well as yourself—to undergo a thorough evaluation by your family doctor or dermatologist.

Photoaging results from the damaging effects to the top layer of the skin (epidermis) due to ultraviolet B radiation, as well as to the middle layers (dermis) from ultraviolet A radiation. Even though these effects occur on a daily basis and appear at the cellular level during childhood, the true and obvious damage may not be seen on the visible skin until age 20, or even five to 10 years after that. And, if you are a smoker, the damage is further accelerated due to an additional process known as biochemical aging. However, either way you put it, the results are pretty apparent—the hands are left with thinner skin that is:

• Dry and flaky, often itchy
• Wrinkled due to the loss of elasticity and resiliency in the tissues of the skin
• Easily bruised and injured due to a significant loss of its padding of fat
• Discolored with "age" or "liver" spots that appear as flat, rounded brown areas (if these spots are irregular they could be warning signs for melanoma and should be checked by your physician)
• Bumpy with warty reddish growths known as actinic keratoses (concerning for the possible development of squamous cell carcinoma) or elevated black or brown spots known as seborrheic keratoses (non-cancerous)
• Dotted with red or pink areas that are created by enlarged blood vessels (cherry angiomas) or broken capillaries (telangiectasias)

Given that your hands are already wrinkled and discolored, it appears they have experienced a moderate to advanced degree of photoaging. But don’t throw them up in disgust just yet: There are measures you can take toward healthier and more youthful appearing hands. These include but aren’t limited to:

• A visit with a family doctor, dermatologist or plastic surgeon experienced in the rejuvenation and treatment of photoaged skin
• Use of a water-resistant sunscreen that offers a sun protection factor of 15 or more on a daily basis (especially during intense exposure times between 10 a.m. to 3 p.m.) according to the manufacturers directions
• Avoiding tanning beds
• Use of a mild soap flushed with warm (not hot) water
• Hydrating your skin with creams or lotions
• Alpha-hydroxy acids, lipoic acid or retinoid creams
• Wearing protective gloves when handling cleaning products and other harsh solutions
• Dermabrasion, chemical peels (some feel these may be too harsh on the hands), intense pulsed light, laser resurfacing or fractional laser treatment

For further information, please visit the New Zealand Dermatological Society at www.dermnetnz.org as well as the American Academy of Dermatology at www.aad.org

More Advice From Dr. Rob:

• Get Rid of Garlic Breath
• Perpetual Sniffles
• Natural Constipation Cures

Find all articles by Dr. Rob.

Do you have a health question you'd like to ask Dr. Rob? Send e-mail to experts@microsoft.com. Please include Ask Dr. Rob in the subject line.

Each of our experts responds to one question each week and the responses are posted on Mondays on MSN Health. We regret that we cannot provide a personalized response to every submission.

Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)