As skin ages, it becomes thinner and less elastic.  Collagen and elastin, the tissues that keep the skin firm, become weaker. These changes lead to fine lines, sagging skin and other noticeable signs of aging. Global rejuvenation is the use of non-invasive skin procedures to improve the appearance of areas of the body beyond the face, such as the hands, neck or chest. 

• The goal of global rejuvenation is to give the patient a more youthful look by diminishing the signs of aging and the damage caused by years of sun exposure in both facial and non-facial areas.
• Rejuvenation can effectively reduce wrinkles, treat sun spots, tighten loose skin, improve skin tone and color, remove blotchiness, and eliminate damaged blood vessels.
• Global rejuvenation eliminates uneven pigmentation that can occur in the skin when one area receives more sun exposure than other areas.
• The most commonly requested non-facial areas for rejuvenation are the neck, chest, arms and legs. 
• In addition, patients request tissue tightening of loose skin and improvement of stretch marks.

Rejuvenation of the neck

• Excessive sun exposure on the neck can result in blotchy pigmentation and erythema, or redness. 
• The use of a potassium-titanyl-phosphate laser or pulse dye laser can target the erythema and reduce the uneven pigmentation. This treatment may require five to six treatments to achieve lightening.
• The use of botulinum toxin can soften horizontal lines on the neck, providing a smoother appearance.  These results are temporary and often require three to four treatments per year to maintain the appearance.
• Non-ablative laser technologies such as fractional laser treatments are non-invasive laser procedures that penetrate deep into the skin, leaving the surrounding skin unaffected and intact, thereby allowing for the surrounding, healthy skin cells to assist in the healing of the damaged cells.  Generally four to six treatments are required to obtain the desired improvement. These procedures can reduce persistent wrinkles on the neck and provide tissue tightening for a more youthful appearance, they do not replace the need for the more invasive neck lift procedure in patients with prominent neck sagging or jowl formation.

Rejuvenation of the chest

• Intermittent sun exposure to the chest, especially during the warm summer months when the sun is most intense, can lead to lentigines, or brown spots.
• Isolated brown spots respond to treatment with Q-switched lasers, which specifically target pigmentation. 
• More extensive pigmentation can be treated with several sessions from a non-ablative laser such as a fractional laser. 
• Extensive pigmentation also responds to medium-depth chemical peels performed over several weeks. 
• Wrinkles on the chest due to sun exposure or aging can be treated using botulinum toxin, which can smooth mid-chest wrinkles, or those wrinkles above or between the breasts.  

Rejuvenation of the hands

• Daily sun exposure on the hands can lead to lentigines, or brown spots. 
• Q-switched laser treatments and fractional lasers can reduce these signs of aging.
• Aging causes veins on the hands to become more prominent due to thinning skin.  
• Sclerotherapy is a successful treatment for veins of the hands. This is an injection treatment designed to collapse the vein so it is absorbed into the body and disappears.
• The loss of fat on the hands, called hand lipoatrophy, also can denote aging.
• Soft tissue augmentation, using the patient’s own fat, or calcium hydroxyapatite, a semipermanent filler, can provide effective temporary replacement of this lost fat.  These fillers can provide up to 12 months of augmentation. 

Rejuvenation of the legs

• Leg veins are a common condition that can be caused by genetics, hormones or sun exposure.
• Varicose veins can be treated with endovenous laser treatment, a non-invasive laser treatment in which a laser fiber is inserted into the vein and heat activated to destroy the varicose vein. 
• Ambulatory phlebectomy, a treatment involving the removal of veins through an incision in the skin, also can successfully treat varicose veins.
• Spider veins can be treated with a series of sclerotherapy sessions.  Laser treatment for spider veins is generally reserved for persistent veins, telangiectatic matting, which is a large grouping of small spider veins, or ankle veins.

Rejuvenation of the abdomen and thighs

• Aging, genetics and hormones all can contribute to excess fat in the lower part of the body, particularly in women.  Also, the loss of fat, through diet or exercise, or the stretching of the skin during pregnancy can cause stretch marks across the abdomen. 
• Liposuction is currently the most effective option for removal of unwanted fat that does not respond to diet and exercise. 
• There are currently no successful clinical treatments for the elimination of stretch marks.  When stretch marks are new and red, the pulse dye laser can reduce the redness and may soften uneven skin layers.  Fractional lasers have been successful in reducing white stretch marks, or those that have been on the body for a longer period of time. 
• To assist patients who are concerned about cellulite or excess skin, radiofrequency devices have shown to be effective in providing some tissue tightening. 

Protect your skin

Speaking at the American Academy of Dermatology’s (Academy) 66th Annual Meeting in San Antonio, dermatologist Sandy S. Tsao, MD, FAAD, Associate Program Director for Procedural Dermatology, Harvard Medical School in Boston recommended basic tips to protect facial and non-facial skin from photodamage:

• Generously apply sunscreen to all exposed skin using a Sun Protection Factor (SPF) of at least 30 that provides broad-spectrum protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays.  Re-apply every two hours, even on cloudy days, and after swimming or sweating.
• Wear a tightly-woven, wide-brimmed hat.  A good rule to remember is that if you can see through the hat, then sunlight is able to get through as well.   A baseball hat does not provide ample coverage for your neck. 
• Apply sunscreen on your entire body even if you are wearing clothing.  White t-shirts provide only minimal sun protection, an SPF of between 4 and 8.
• Look for clothing with built-in UV protection. 
• Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 2 p.m.
• Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling.  If you want to look like you’ve been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.

See your dermatologist for successful diagnosis and treatment of skin, hair and nail conditions.