Dr. Busso’s Dermal Disconnect Correct #1: Face and Hands

Dr. Busso’s Dermal Disconnect  Correct #1: Face and Hands

Miami and Beverly Hills-based dermatologist Mariano Busso, MD shares his insights for making sure the skin on the hands matches up with the skin on the face.


Dermal Disconnect Correct #1: This is the first of a 3-part series with advice from our expert, top dermatologist Mariano Busso, MD on how the dermal disconnect between face, neck, hands and chest happens, why it happens and how to even things up.


We all know dermal disconnect when we see it. Envision a woman whose face looks youthful and radiant but with hands that look a decade or two more speckled, weathered and worn, and you get the picture. Says dermatologist Mariano Busso, MD, “Sometimes the eye is smarter than the brain. When the perceived age of the hands doesn’t sync with the perceived age of the face, the eye can tell that something is ‘off’ even if we’re not consciously aware of it. More often than not, this disconnect makes the viewer uneasy. The last impression anyone wants to make is, ‘She looks great but . . .’”


In the 1990’s, when cosmetic dermatology first made headway into the culture, it emphasized the face. These technological breakthroughs–that are still with us today albeit in ever more sophisticated variations–were laser/light source resurfacing, filler and neuromodulator injectables, and advanced topical product formulations.


Says Dr. Busso, “Of course we introduced technologies for the face first because the face is the seat of the identity and emotions. But then it became clear that harmony between the features, and between face and body, is the true signifier of beauty. Consequently, cosmetic dermatology treatments and procedures for the hands and body are catching up.”


Tissue Issue

Dr. Busso explains, “The skin on the face and the skin on the hands appear to age at different speeds because the tissues themselves differ in three significant ways,


1. Facial skin has to deal with the effects of gravity and fat depletion that change the shape of the face whereas the hands do not. Fat depletion, aka volume loss, on the hands manifests in a bony or scrawny look.

2. Facial skin is thicker with a whole network of tissues–sebaceous glands, ample blood supply–that the thinner skin on hands does not. These enable facial skin to heal more quickly and respond to more aggressive rejuvenation treatments and topical product strength.

3. Other than (on some people) blue vessels at the temples, facial skin rarely involves the blue ropey veins so common on aging hands.”


Sunscreen Protection

“One of the big differences between the face in the hands,” notes Dr. Busso, “is that most people who care about the health and beauty of their skin know the importance of daily SPF application on the face. But they’re less aware how essential sunscreen is on the hands too. So for years, their hand skin has gone unprotected out of doors, in the car and in life in general. The leathery texture, blotchy age spots and matrix of line are UV-triggered photodamage, not intrinsic aging. When it comes to preventive care, though the formula strengths may vary depending on the site, whatever you do on the face you should be doing on the hands. This means both skincare and sunscreen (and even makeup).”


Hands on

Dr. Busso himself has been deeply immersed in hand rejuvenation for over a decade. To this end, as part of a clinical trial of Radiesse in hands in 2009, he developed the Busso Hand Volume Severity Scale.* The first validated and FDA approved scale to measure volume gain or loss on the dorsum (tops) of the hands, it is an objective and reproducible system of measurement useful to dermatologists, plastic surgeons and hand surgeons.


Renewed and improved

Cosmetic dermatology’s arsenal of hand rejuvenation tools and technologies is impressive. Every doctor has her or his favorites that deliver superb results. For example, to erase age spots and smooth leathery texture, Dr. Busso likes NeoGen Plasma Skin Regeneration (PSR) as an alternative to lasers or light-based devices. To replace lost volume, his injectable of choice today is Juvéderm Ultra Plus XC which is an hyaluronic acid gel.


Mineral Air in the Picture

Because the Four-in-One Foundation drapes so lightly while still covering flaws, Mineral Air is an excellent and efficient tool for making the hands look even with the face, even if you’re undergoing rejuvenation treatment. Dr. Busso concludes, “I’m all for patients applying a light coat of foundation (over sunscreen, of course) on the backs of their hands. It just means that they’re paying attention.”


What’s the difference?

Mineral Air offers two device-plus-formula categories, one for makeup, the other for skincare.
Mineral Air original (MA) includes its AirMist Device, an easy to use, everyday consumer tool that rivals professional airbrushing in its cosmetic application of our eponymous foundation, blush, or bronzer.
Mineral Air Skin (MAS) features the Renewal Serum System with its ElixerMist Device for lightweight vaporized delivery.

“When it comes to preventive care, though the formula strengths may vary depending on the site, whatever you do on the face you should be doing on the hands. This means both skincare and sunscreen (and yes, even makeup).”


Mariano Busso, MD
Miami, FL and Beverly Hills, CA

W drbusso.com
IG @drbusso

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