Skin Damage Control from Neck to Knees

Sun, smoking, yo-yo dieting — these sins take a toll on skin. We’re savvy about what to do from the chin up. Now, here are the best, newest fixes for everything else.

By Christine Fellingham

HandsWe, with the help of science — and an arsenal of tricks from anti-aging creams to eye-lifts — have figured out all the ways to keep time at bay on our faces. Problem (if we think it is a problem) nearly solved. Now dermatologists and cosmetic surgeons have rushed into the breach with an array of fixes for just about every other body part. How far will you go to repair the rest of you? The choice is yours, from simple, at-home fixes to more serious procedures performed by doctors. Your HandsTelltale signs: In your 40s, freckles and light splotches start darkening and spreading. Eventually, the already-thin skin on the backs of hands thins further, revealing veins and developing a dry, papery texture. "You’ll also notice more dramatic changes in winter — extreme dryness, cracking, or redness," says Bruce Katz, MD, clinical professor of dermatology at the Mount Sinai School of Medicine. At-Home SolutionsBlock further damage: Use a sunscreen or lotion (such as Lubriderm Skin Renewal Age Defying Hand Cream SPF 15) daily, whether or not you’ll be outdoors. Says New York University dermatologist Deborah Sarnoff, MD, "Sunscreen allows skin to recoup and fade damage that’s already surfaced."Fade brown spots: Lighten with an over-the-counter hydroquinone lotion or a cream designed to diminish pigment, such as Philosophy A Pigment of Your Imagination or Clinique Active White Lab Solutions Hand Cream. You’ll see results in about eight weeks. Avoid self-tanners: "You’d think they’d camouflage spots, but they don’t," says Deborah Sarnoff. "The tanner is absorbed and darkens them."A dermatologist can… Upgrade your lightener: A stronger hydroquinone cream such as EpiQuin Micro can lighten spots in eight weeks. (Cost: $95/tube.)Zap spots with a laser: Often, all it takes is one treatment. (Cost: $500-$700.) "We can typically do both hands in under an hour with a q-switched ruby, Alexandrite, or Nd YAG laser," says Sarnoff. "You get tiny scabs that last two weeks, but you can cover them with concealer." For difficult-to-treat splotches, check out the Sinon. "This laser vaporizes the pigment without harming skin," says Mitchel Goldman, MD, associate clinical professor of dermatology at University of California, San Diego. "It’s best for lighter skin tones." Pump up hand volume: Fillers such as Restylane or Hylaform are injected in a series of a few syringes, at $750 each. Your hands may look a bit swollen and bruised for a day or so, but you can go back to work that day. "These last four to six months and have no serious side effects," says Sarnoff. Neck and ChestTelltale signs: You’re likely to see (in order of appearance): dry texture, uneven pigmentation, sun spots (including precancerous lesions), broken blood vessels, crepiness, creases and banding in the neck. "The skin on your neck and chest is often unprotected in the sun. The skin is very thin and has few sebaceous oil glands and, consequently, little natural moisture, so signs of aging tend to appear," says dermatologist David E. Bank, MD, of Mount Kisco, New York. At-Home SolutionsEven out pigment: This area is sensitive; overtreatment can leave hypopigmented, or light spots and scars. Avoid hydroquinone creams, but try face or body creams with alpha-hydroxy acid (such as Vaseline Intensive Care Lotion, Healthy Body Complexion) or vitamin C (such as Neutrogena Visibly Even Exfoliating Body Wash). Protect, protect, protect: Apply sunscreen daily, making sure to cover the sides of your neck. Sun exposure is the cause of poikiloderma, a reddish/brownish discoloration from the bottom of the ears down the sides of the neck. "Most women mistake it for a rash, but it’s a mixture of broken blood vessels and pigment caused by sun damage that’s fairly common," says Bank. Sunscreens with zinc oxide or nanotitanium dioxide (such as DDF Matte Finish Photo Age Protection SPF 30 or Neutrogena Ultra Sheer Dry Touch SPF 45) offer complete protection with the sheerest finish.A dermatologist can…Prescribe a lightening cocktail: Tri-Luma Cream (a combo of retin-A, hydroquinone, and an anti-inflammatory; $90/tube) and Kinerase Lotion ($60/ tube) both work to lighten discolorations without irritation.

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