The 850 'fruit and veg' jab that could wipe ten years off those Madonna hands



22:22 GMT, 21 April 2012

It will come as disappointing – yet perhaps not unexpected – news to women of a certain age who hoped they were getting away with it. People are able to more or less correctly guess a woman’s age simply by being shown pictures of their hands rather than their faces.

The phenomenon, highlighted in a study in the Journal Of Plastic, Reconstructive & Aesthetic Surgery, has been dubbed ‘the Madonna problem’. It is often unkindly pointed out that the singer’s hands look every one of her 53 years – unlike her face.

Now a new 850 jab that combines a chemical found in fruit and vegetables with an existing filler promises to banish Madonna hands, at least temporarily.

Palm reading: Michelle Gilder says her hands shown before and after, below, now look better than those of a younger friend

Palm reading: Michelle Gilder says her hands shown before and after, below, now look better than those of a younger friend

So why do these parts of the body, perhaps more than any other, show the visible signs of ageing so early

‘Hands naturally lose volume from the age of 40, making veins and bones more prominent,’ says cosmetic doctor Dr George Roman, who has clinics in Paris and London. ‘Hands are also more or less constantly exposed to the elements.

‘Many women use a facial moisturiser with a sun protection factor but similar care isn’t usually taken for hands. Environmental stresses combine to speed up the natural depletion of the proteins collagen and elastin, an abundance of which gives youthful skin its firm plumpness and elasticity. Being a low body weight can make this process more obvious.’

Before and after

Dr Roman says many clients have youthful faces but feel their hands ‘make them look older than they are’.

Previously the best-known hand-rejuvenation treatment involved filler gel injections containing Restylane hyaluronic acid, which is found naturally in the skin and helps it to retain moisture. It was administered in three painful sessions, several weeks apart, with no results showing until the third treatment. Not only was this time-consuming and with a high ‘ouch factor’, but patients would leave clinics with hands covered in visible lumps of filler each topped with a small scab – ‘like a crocodile’, as one patient put it. This unpleasant appearance could last up to three days after the treatment.

‘My patients have busy lives,’ says Dr Roman. ‘They didn’t want to keep coming into the clinic and have any giveaway signs of treatment. I wanted to offer instantly natural results in just one treatment.’

The key to the new treatment, developed by Dr Roman, is a filler from France called Stylage. It combines mannitol, the chemical found in fruit and vegetables, with hyaluronic acid, and dissolves gently in the body.

He explains: ‘When a filler is injected, there is naturally some inflammation in the skin, which can cause skin ageing and also make the filler break down.

‘Mannitol is a powerful antioxidant that reduces inflammation, so the skin appears younger and smoother. It moisturises and improves texture from the inside, boosts collagen and also greatly slows the rate at which the filler disappears from the body.

‘It lasts between 18 months and two years. Ordinary hand rejuvenation can last only six months. The other advantage of Stylage is that it is extremely smooth, so gives an immediately youthful appearance.’

Instead of multiple injections using needles, Dr Roman delivers the filler via a thin cannula, which is inserted via a tiny needle hole in the back of the hand. The cannula can then deliver filler to the entire back of the hand area. ‘The saggier and looser the skin, the better the result and the less uncomfortable it is,’ says Dr Roman. ‘My older patients often find it completely painless.’

Michelle Gilder, 47, an interior designer from Buckinghamshire, underwent the treatment earlier this month. ‘I felt I was ageing pretty well other than my hands,’ she says. ‘They looked rather lumpy, the veins were more visible and, despite using hand cream, they were very dry.’ The mother-of-three was intrigued after reading about Dr Roman’s treatment. She travelled to the Medical Aesthetic Clinic near Harley Street in London, where he examined her hands.

The phenomenon has been dubbed the Madonna problem and the singer can often be seen wearing gloves to hide it

The phenomenon has been dubbed the Madonna problem and the singer can often be seen wearing gloves to hide it

‘He told me I have muscular hands with very tight skin, which was good news except that the procedure might be more uncomfortable,’ says Michelle. ‘He applied a local anaesthetic but I found it quite painful. It’s also an odd sensation as the cannula burrows under the skin. Though the whole thing took less than five minutes per hand, I was grateful when it was over. My first impression was that my skin felt incredibly smooth and soft. Wrinkles and pores had vanished and there was a new plumpness. There was only a small mark where the cannula had gone in. I was able to leave straight away.

‘For the remainder of the day my hand was tender but not painful. Over the next couple of days I developed a bruise the size of a 10p piece on my left hand but not on my right. Four days later I felt the gel had produced a mound on the back of my hand and at that point I thought, ‘‘I don’t like this. It doesn’t look natural.’’ However, after day five, the mound levelled out and I just thought, “Wow!” ’

Consultant plastic surgeon Rajiv Grover says: ‘Normal hand rejuvenation with Restylane can last 18 months. There is quite a lot of science with this treatment so it is well proven. The only other treatment is fat transfer, which is much more invasive and can give unpredictable results. I have no experience with Stylage and mannitol and have not seen scientific studies that show it would last much longer.’

But Michelle says: ‘A friend who knew I’d had the treatment was dying to see the result. She’s eight years younger but when we put our hands side by side, mine looked younger.’