REMEMBERING PROF. MANSOOR HASSAN BY HIS LECTURE ON MYOCARDIAL INFARCTION

Whenever one thinks of Prof. Mansoor Hassan, the image that comes to our mind is that of an extremely soft spoken, wise, pious and profoundly knowledgeable person steeped in Lucknavi tradition of tehzeeb and tameez. By his very appearance in all whites he radiated an aura of gentle grace and divinity that was simply unmatched. He was loved by students, held in absolute awe by his residents, and literally worshiped by his patients. Whether his patient was a minister or a labourer, his behavior towards them was always the same – gentle, reassuring and loving. Every patient considered him to be a member of their extended family and knew that in his presence and under his treatment they were getting the best treatment in the world.

 

We, the under-graduate students, were convinced that he was specially gifted, and had he been in the Indian Foreign Services, there would have been no wars. Though he was invariably surrounded by a swarm of sick patients and a hive of their anxious relatives, Prof. Mansoor Hassan never lost his cool, never raised his voice, and the ever-present smile never left his face. His presence among his patients was almost like that of a peer or saint among his disciples, pious, somber and always reassuring.

 

Prof. Mansoor Hassan was awarded the Fellowship of Royal College of Physicians of London and Edinburgh. He was extremely sophisticated in his demeanor and a very well read person. He could quote with effortless ease from Vedas, Shrimad Bhagwat Geeta, Quran and Bible and mesmerize his audience with his treasure trove of Urdu Shairi. We all knew great things awaited him and he went on to establish the Lari Cardiology Centre, a comprehensive cardiac diagnostic and therapeutic service and started the superspeciality DM Cardiology program of King George’s Medical College there.

 

Being one of the best cardiologist in Lucknow, he has joined Divine Hospital with a mission and project to make the finest cardiology services available to the state of UP at an appropriate and yet affordable cost. His keen interest in Preventive and Rehabilitative Cardiology is evident from his intimate involvement in various social and outreach programs. 

 

I had a very long association with him even after he superannuated from King George’s Medical College. We were together in Sahara Hospital and during this time the Government of India decorated him with Padmashree. The recognition came late but for a person of his stature and popularity the Award was blessed by being associated with him. Prof. Hassan taught us Cardiology and we had to rush to his class to take the front rows because he spoke so softly that he was often not clearly audible at the back. There was usually pin drop silence, lest we miss what he was saying. This is one such lecture on Myocardial Infarction, which I could salvage from my class notes.

 

If anyone wakes up in the middle of the night with chest pain, his mind might automatically think he is having a heart attack. After all, it’s the number one killer disease. And the number one symptom is the vague term “chest pain”, which can be misleading because it’s not always painful nor always in the chest. In most cases, people imagine they will have severe chest pain and dismiss the actual symptoms of a heart attack, go back to sleep and suffer one. So, it is vital to understand the symptoms your patient will and won’t feel if he/she is having a heart attack This should be clearly understood by all who are at risk of a heart attack so that they know exactly what to do, and when to seek immediate medical attention.

 

Who is at risk of a Heart Attack (Myocardial Infarction)?

1. Older Age

The older you get, the more you are at risk of a heart attack. Although you can have a heart attack at any age, the risk increases significantly after age 45 for men and after menopause, i.e. around age 50 for women.

2. Gender

Heart disease is the number one killer of both men and women, however, men have a greater risk than women of heart attacks. At older ages, women are more likely than men to die from a heart attack. The women get it less frequently, but tolerate it poorly.

3. Heredity

The risk of a heart attack increases with a family history of heart disease. Race also has an impact on the risk. This has been studied in the U.S and African Americans, Hispanic Americans, and American Indians have higher risks than Caucasians of heart attacks.

4. Smoking

One out of five deaths from a heart attack is due to smoking. Smoking cigarettes can double to quadruple the risk of having a heart attack. Risk is higher for smokers because smoking limits the amount of oxygen to the heart, increases blood pressure, damages blood vessels, and increases the likelihood of blood clots. So every patient, who is a smoker, must be advised to quit smoking immediately.

5. High Blood Cholesterol

Cholesterol levels in the blood can be affected by uncontrollable factors, but there are things we can do to make sure the cholesterol level stays within healthy limits. Increasing the dietary fiber intake, eating healthy and low-fat foods, and exercising can help lower cholesterol levels.

6. High Blood Pressure

High blood pressure is a very common risk factor of heart disease. When the blood pressure is high, it makes the heart work harder. This can stiffen the heart muscle and lead to heart attacks. Anti hypertensive drugs, proper exercise, a low-salt and low-fat diet, limited intake of alcohol, healthy weight, and stress management, can lower the blood pressure.

7. Physical Inactivity

Lack of physical activity can lead to many problems, including heart disease. On average, people should exercise at least 30 minutes a day.

8. Obesity

Excess body fat can contribute to higher blood pressure, higher cholesterol, and a higher risk of heart attacks. A healthy diet and proper exercise are essential for getting to and maintaining a healthy weight.

9. Diabetes

Diabetes can have a damaging effect on heart, especially if it is not controlled. Nearly 68% of diabetics over the age of 65 die from heart disease. Diet, drugs and exercise I judicious combination, can help in managing diabetes.

10. Stress

A negative response to stress can increase the risk of a heart attack. Physical exercises, non-competitive sports, breathing exercises, better inter-personal relationships and better time management can all contribute in de-stressing..

 

How chest pain from a heart attack feels?

The typical pain described is a feeling of tightness, squeezing or heaviness in the chest. The Latin term angina pectoris, meaning sensation in the chest, is a more accurate description. This pain has been described as feeling like a band or weight is being tightened around the chest. The pain is often on the left side and above the bottom ribcage, although it’s often difficult to determine its exact location. Other typical symptoms include:

·        Shortness of breath

·        Cold sweating

·        Nausea

·        Anxiety

·        Pain in the left arm, jaw or neck

·        Light headedness

·        Racing heart

Some atypical symptoms of MI are:

·        Pain not on the left side but is located on the right, center or top of the abdomen

·        Abdominal pain and indigestion

·        No pain – some people don’t experience pain and only feel shortness of breath.

·        Pain is often referred to other areas of the body – neck or throat, shoulders, upper back – between the shoulder blades, left or right side of jaw and left or right mid to upper arm.

 

How long should the chest pain last?

The next indication of whether you are suffering a heart attack is pain duration. Consider the following 3 factors:

1.      Heart-attack-related chest pain comes on over several minutes and not suddenly. Sudden severe pain is a reason for concern, but it is not consistent with angina.

2.      The chest pain lasts for at least 5 minutes and doesn’t last continuously for more than 20 to 30 minutes.

3.      Pain that comes on during rest, or doesn’t go away after exertion, also indicates a heart attack.

 

What it shouldn’t feel like

Some chest pain is not consistent with having a heart attack.

·        Sharp and brief pain – stabbing pain that lasts only a few seconds is not coming from the heart.

·        Persists for hours – heart attack chest pain will last for 20-30 minutes at the most and typically ends with a heart attack.

·        Gets worse with movement – the sort of pain that worsens when pressed on is usually from chest bone or muscle pains and not the heart.

·        One can pinpoint the pain with a single finger – heart chest pain tends to be difficult to locate exactly.

But, when in doubt, treat a chest pain like heart attach, unless proven otherwise by investigations.

 

Investigations

Tests to diagnose a heart attack include:

• Electrocardiogram (ECG or EKG). This is the first test done to diagnose a heart attack. It records electrical signals as they travel through the heart. Sticky patches (electrodes) are attached to the chest and sometimes the arms and legs. Signals are recorded as waves displayed on a monitor or printed on paper. An ECG can show ST elevation or T wave inversion.
• Blood tests. Certain heart proteins slowly leak into the blood after heart damage from a heart attack. Blood tests can be done to check for these proteins (cardiac markers) - creatine kinase-MB (CK-MB) and lactate dehydrogen-ase-1 and -2 (LDH-1/2).
• Chest X-ray. A chest X-ray shows the condition and size of the heart and lungs
• Coronary Angiography. A long, thin catheter is inserted into an artery, usually in the Femoral artery in the groin, and guided to the heart. Dye flows through the catheter to help the arteries show up more clearly on images made during the test. The coronary arteries – Rt. Coronary A. and Left Main Coronary A. are examined for blockage

 

Treatment

Each minute after a heart attack, more heart tissue is damaged or dies. So urgent treatment is needed to fix blood flow and restore oxygen levels. Oxygen is given immediately. Specific heart attack treatment depends on whether there's a partial or complete blockage of blood flow.

Medical Treatment

Medications to treat a heart attack might include:

• Aspirin. Aspirin reduces blood clotting. It helps keep blood moving through a narrowed artery. 300 mg Aspirin should be given at home before transporting the patient to a hospital.
• Other blood-thinning medicines. Heparin may be given by an intravenous (IV) injection. Heparin makes the blood less sticky and less likely to form clots.
• Nitroglycerin. This medication dilates the blood vessels. It helps improve blood flow to the heart. Nitroglycerin is used to treat sudden chest pain (angina). It's given as a pill under the tongue, as a pill to swallow or as an injection. Again it should be given at home, before transporting the patient to the hospital.
• Morphine. This medicine is given to relieve chest pain that doesn't go away with nitroglycerin.
• Beta blockers. These medications slow the heartbeat and decrease blood pressure. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. They are given to most people who are having a heart attack.

Surgical Treatment

• Coronary artery bypasses grafting (CABG). This is open-heart surgery. A surgeon takes a healthy blood vessel , usually the Great Saphenous Vein from the leg and use it to bypass the blocked Coronary Arteries and create a new path for blood in the heart. The blood then goes around the blocked or narrowed coronary artery. It may be done as an emergency surgery at the time of a heart attack. Sometimes it's done a few days later, after the heart has recovered a bit.
• Balloon Angioplasty. This is now being practiced in the Western countries and will soon be available here. A thin, flexible catheter is passed into the narrowed part of the heart artery. A tiny balloon is inflated to help widen the blocked artery and improve blood flow. A small wire mesh tube (stent) may be placed in the artery during angioplasty. The stent helps keep the artery open. It lowers the risk of the artery narrowing again. Some stents are coated with a medication that helps keep the arteries open.

 

Complications

The complications of Myocardial Infarction are:

·        Arrhythmias

·        Heart Failure

·        Heart valve issues

·        Stroke

·        Sudden Cardiac Arrest

·        Cardiogenic Shock

·        Depression and Anxiety      

 

That is how our class on Myocardial infarction ended. Those were the days when there was no echo-cardiography, Heart MRI, Heart CT, MUGA Scan, and Nuclear Heart Scans – SPECT or PET. Even Troponin T test, ACE inhibitors and statins were not there. Good history taking, physical examination, ECG and a good clinical sense was all that was there at our disposal. But teachers like Prof. Mansoor Hassan were patient with us and taught us the highest standards of clinical medicine.

 

 

 

 

SOME INESCAPABLE TRUTH ABOUT SUCCESS

Dreaming about success and achieving that success are two very different things. Visualizing your dreams can be a powerful tool. Imagine yourself reaching your goals in detail. This makes them feel closer to your heart. It gives you focus and pushes you to work towards what you want. Dreams have deep spiritual and psychological meanings for many. Everyone sees success differently. Some view it as achieving goals; others see it as reaching their full potential. These dreams often show personal growth and the joy of overcoming challenges.

 

But, you cannot stop here and keep dreaming. While it is perfectly normal for people to have dreams and goals, but there is a clear difference between those who make their dreams come true and those who spend their lives thinking about what they could have achieved. One of the inherent traits of human beings is having the drive to be something more, to do something better. This is why there are many inventors and entrepreneurs, as they see a need or a gap and they do their utmost to fill it. To fulfill your dreams, you need to become a better version of yourself. You have to accept some harsh truths that might be preventing you from reaching your full potential. These are the harsh truths that you need to hear: 

 

1. You’re the Only Thing that is holding yourself back

Many people don’t even make it to Step 1 of fulfilling their dreams because they stay on Step 0 forever. This means that even before they have made an effort to reach their dreams, they have already put themselves down or held themselves back. Many people are just too afraid or do not believe in themselves enough. Whatever it is that you keep telling yourself, stop, as it’s holding you back before you even try. Many simply waste time procrastinating on absolutely unimportant instant gratification issues, which can lead to no achievement and no lasting glory. Dreaming is good, if you can dream it, you can become it, but only day dreaming leads to nowhere.

 

2. Step One is Always the Hardest

The journey of a thousand miles begins with a single step, and it is not easy to take that step. Even if you have finally psyched yourself up to follow your dreams, you might find that the beginning is the toughest, most confusing, and most discouraging step of all. There are a number of reasons for this. One is that the goals might be too big and therefore, too difficult to plan for and execute. You have to break them down into small steps and take one small step at a time. Not only will this make your dream seem more achievable, but you will also break down that huge goal into smaller and more measurable ones.

Another reason is the lack of information. You might have a fantastic idea, but simply lack the knowledge to figure out how to proceed. In this case, it’s very important to do your research, ask people, observe, and do some small experiments so that you know what the status quo is and where your idea fits in the big picture. Internet and AI are excellent tools to help you in this direction and it has given you geographical neutrality. You don’t have to be in Columbia and Harvard in person to seek their resources and assistance. If you have a worthy project and an analytical mind help and resource is far easy to access today than ever before.

 

3. Great Things Take Time and Effort

Once you have identified your main and smaller goals, you need to simply start making it reality. For example, if you’re developing a programme or a product, you should be prepared to spend a lot of time designing, testing, creating, and improving it before you can go further. While our brains are hardwired to lean towards instant gratification, you can dictate to yourself that your goal might take much more time and work.

Great things take time. Whether it is your investment in bonds and stocks, or the wisdom that you are gathering with age, or the expertise you acquire in your chosen profession, hobby or sports, your fluency in a new language or your skills with the violin or piano, they all take time and they all take a lot of dedicated efforts.

Yashaswi Jaiswal’s story is an embodiment of unwavering determination and the power of chasing dreams. His journey began at a young age when he left his home in Bhadohi, Uttar Pradesh, at the tender age of 13. Driven by his unwavering passion for cricket, he embarked on a solo journey to Mumbai, the city of dreams, to pursue his cricketing aspirations. However, his journey was far from easy. Facing immense hardships, Jaiswal found himself living in tents outside the city’s maidans, a stark contrast to the life he envisioned. He sold snacks to meet his expenses but kept on chasing his dream till he eventually established himself as an elite cricketer of the Indian cricket team.

 

4. Not Everyone Will Support You

While those close to you might be your biggest fans, you will encounter many critical people nevertheless. Some might be discouraging you out of jealousy, but you must simply accept that you’ll never be able to please everyone. No matter how good you are at what you do, there’s a certain level of envy that comes with success. Some people feel the need to set themselves up as the opposition to your success just because they are jealous of your accomplishments. Your life will be a lot more fulfilling when you don’t think about what other people say or think. That does not mean disrespecting a contrarian view point. If it is a worthy objection, this is the time to counter it, in its infancy, and not when it has become an ugly monster.

People aren’t going to like you for working hard and being productive. Do what is best for you, and show the world what you can do. Not everyone will be happy for your success. It can be discouraging to have people with negative attitudes around you when you are trying to make a headway in life. If such people surround you, you need to change your company. Surround yourself with a circle of genus, positive thinking, always encouraging people, who are willing to go all the way to fulfill your dreams.  

 

5. You Cannot Succeed without Taking Big Risks

You’ll never be 100% sure that you will succeed, which is why you have to take huge risks at times. If you wait, you’ll never get started. Unfortunately, in life and in business, just because your idea makes complete sense doesn’t mean that everyone will agree and support you. You might have a great concept, but you’ll never be able to fully predict how people will react to it. A researcher in India is usually satisfied with a good publication, because till this point there is no risk or minimum risk involved. The next stage is patent, which will involve some risk. The next logical step is monetizing the patent, which will involve even larger risk. But, how else can you succeed?

Jeff Bezos, a Princeton University graduate had secured a high-paying job on Wall Street as the senior vice president of hedge fund D.E. Shaw & Co. However, Bezos felt called to entrepreneurship. In 1994, he risked it all by sacrificing his job in finance to found Amazon, which began as an online bookstore run out of his garage. Today, he also heads the spaceflight company Blue Origin, and is the wealthiest man in the world!

 

6. You Cannot Control Everything

As letting go of control goes directly against our modern, industrialized way of living – we are go-getters, doers, architects of our destiny, build things and make things happen on our own terms; we don’t wait for anything to happen on someone else’s terms! The unfortunate truth is that, despite your best efforts, you cannot make everything go your way. This is especially true when it comes to other people’s actions and behavior. In these kinds of situations, you just need to let go and let things happen the way they’re supposed to happen. Of course, this doesn’t mean that you don’t take action and simply wait for things to happen, but the art of letting go is vital in managing expectations and measuring effort.

This is true from personal goals to international trade, everything will not follow expected mathematically calculated trajectory. Things like losing contact with a lunar module even happen to the smartest ISRO glitterati. Trump’s tariffs have brought tsunami in international trade. These are uncontrollables that we will have to learn to live with and negotiate from time to time.

 

7. You Can’t Do It All

No one can be jack of all trades. Even as an entrepreneur, you’ll need to get some individuals involved to make your business come to life. For example, if you want to eventually manufacture a lot of products, you’ll need to work with a reputable logistics company to find ways to decrease your work and improve efficiency. When you let go and let other people contribute, you free yourself up to focus on other more important things as well.

Research also works similarly – each associate from different speciality contributes his/her bit and that is invariably better than what would be on table if you tried to do everything. So, we must collaborate, respect our colleague’s domain expertise and acknowledge their contribution. While compiling a multi author text book of Plastic Surgery, the only one in English published outside U.S and U.K, we realized the importance of collaborating with the best and the brightest minds!

People are putting in crazy hours to get ahead at work and then dive into driving the kids to music lessons, soccer practice, and homework, and off course, cooking dinner. They also feel the need to exercise and get the six-pack abs or train for a marathon. It’s non-stop demands that mortal humans can’t meet, and you are a mortal human, so you will never get it all done. So, whether at work, or at home, some work has to be delegated.

 

8. It is Okay to Fail

Failure gets a really bad reputation because of our drive and desire to succeed. However, in the history of inventors, the great products came about only after a number of mistakes and failures. The good thing about failing is that you can figure out what went wrong and improve it to make it work the next time.

Pacemakers used to be huge – the size of televisions. Then Wilson Greatbach made a mistake that revolutionized medicine. When building a heart rhythm recording device, he pulled out the wrong sized resistor and plugged it into the circuit. When it was installed he realized it sounded like a human heartbeat. With some work, he miniaturized the device to two cubic inches. The result was an implantable pacemaker, which has since saved thousands of lives.

Engineers Marc Chavannes and Al Fielding created bubble wrap in 1960 in an attempt to create a trendy new textured wallpaper. This was a total failure, as was a later attempt to market it as housing insulation. When the wrap was eventually used by IBM to package a newly launched computer during transport, it suddenly became an overnight success. Today, few people even realize that bubble wrap began as an abject failure.

 

9. Habit versus Inspiration

While willpower and inspiration do matter in terms of pushing yourself to accomplish your dreams and becoming successful, the right habits will influence whether you’ll survive or not. The important habits of an entrepreneur such as hard work, discipline, and thoroughness can have a direct effect on your finances and lifestyles. When you develop the habit, you can continue doing the action even without thinking twice about it.

 

These wildly successful entrepreneurs are living proof that success is not about being risk-aversive or about taking uncalculated risks. Success lies somewhere between the two. To future-proof your future from disruption, you’re going to have to take some risks – and make some mistakes along the way. When you stumble, knowing how to make your failures work for you will get you out of the slump, even propel you to the next level of possibility and success.

DO YOUR HANDS GIVE AWAY YOUR AGE?

 

 

Do your hands look old, dark and wrinkled? They are aging with you but they need not give away your age a lot quicker than your face.  If you don't have a youth-preserving plan for the delicate, oft-abused skin and nails on your hands, it'll be a dead giveaway of your age.

 

How are the hands aging?

1.      Age spots: The funny thing about age spots is that they actually have nothing to do with age: Age spots are the result of sun exposure. Short of wearing gloves 24/7, you should be smoothing on a dime-sized dab of hand cream with SPF 30 before heading out the door each day—and reapplying after you wash your hands or every two hours if you're exposed to even a little sunlight. Night application of 2% hydroquinone

2.      Crumpled skin: If the backs of your hands are starting to get a crumpled look reminiscent of gift bag stuffing, use a prescription retinoid cream to improve texture and jumpstart the growth of thickening collagen. Topical application of  lotion containing a retinol or glycolic acid can help.

3.      Prominent veins: Lasers address this problem best and topical applications are not of much use. Sclerosants too are useful.

4.      Scaly skin: Nothing about dry, scaly skin says "young and healthy." Return them to smooth-and-plump status overnight with this quick pre-bed routine:

·        First, slough off rough, dead skin with a gentle scrub

·        then create an all-night moisture mask by smoothing on a glycerin and plant oil-containing hand cream like Elovera Moisturizing Cream

·        cover hands with plastic wrap and putting cotton gloves on top (skip the plastic and you'll just end up with really well moisturized gloves).

5.      Stained nails: If your nails are turning yellow or brown and are painful, then this is a fungal infection. If your doctor rules out fungal infection, you can relax, as the discoloration is likely a harmless side effect of some medication or wearing dark polish. Run your nails with a lemon wedge, just like you would when you're rubbing off nail polish (the natural fruit acids will lighten the nail bed), or soaking in denture cleaner for 15 to 20 minutes to remove the stains. Also make sure to apply a base coat before you reapply your favorite oxblood lacquer.

6.      Brittle nails: Water or chemical exposure, seasonal weather changes, and even genetics, can all lead to brittle, breaking nails. But the right supplements can help. Taking a 2.5 mg dose of the B vitamin biotin improves nail strength and reduces brittleness after six to nine months.

7.      Outdated manicure: Science is constantly changing and your idea of manicure may be outdated. Seek professional help once in a while.

8.      Give up smoking: Smoking tobacco hastens atherosclerosis and hands, and particularly the fingers, being terminal organs are least vascularized and lose the youthful turgor.

How to prevent hand aging?

With proper care, and this handy advice, your hands will keep your age hidden for longer.   

Wash your hands correctly

Too much soap can make your hands dry and flaky, so keep these essential tips in mind:

·        Don't use antibacterial soap unless absolutely necessary. Opt for a moisturizing soap instead (Pears, Dove), such as one with jojoba oil, olive oil or aloe vera.

·        Wash your hands with warm, but not hot water - this will help preserve the natural protective layer. 

·        As opposed to electric dryers, opt for paper towels instead. 

 

Wear gloves

Hands are constantly affected by external factors such as cold, chemicals and dry air. To minimize the damage to your skin, wear gloves as follows:

·        Use leather, fur gloves or mittens for cold weather.

·        Wear rubber or latex gloves for household chores - washing the dishes, mopping floors, cleaning the bathtub etc.

·        Use cloth gloves for gardening.

 

Moisten your hands regularly

Your body needs to stay hydrated to keep each cell and tissue refreshed. Apart from crucial functions like flushing toxins from your body, water also keeps your skin healthy and hydrated from the inside. Dehydrated skin can turn brittle, weak, and thin, eventually leading to wrinkles on your hands. Your aim should be to drink at least eight glasses of water every day.

·        A good hand cream is as crucial as soap or shampoo. Keep these tips in mind:

·       Clip your nails, and purchase a vitamin E cream for the cuticles. 

·        Be sure to drink plenty of water.

·        When the Apply the cream as needed, though no less than twice a day. If your hands are dry, keep hand cream by the sink and apply it after every time you wash your hands. Pick a hand cream that contains glycerin andalpha-hydroxy acids. These are beneficial ingredients that work as humectants to attract moisture from the air to your skin. 

·        Moisturize the room air, turn on the humidifier.

·        Use Emollient - Lack of water can dry the top layer of your skin. It cracks the surface of the skin and leaves spaces between the skin cells. Emollients, or softening agents, fill these empty spaces between your skin cells and make your skin smoother.

 

Remember to scrub

Your hands need scrubbing and masks at least once a week:

·        Make a hand mask from the products you have in your fridge. Mix 20 ml. milk, an egg yolk and a tablespoon of lemon juice, applying it to your hands and letting it rest for 20 minutes. 

·        Use a mix of olive oil and sugar as a scrub.

·        If using a body scrub, apply that to your hands. 

As we age, the skin's natural exfoliation process slows down. Thus, the skin builds up dead skin cells. When we exfoliate our hands with a mild scrub we get rid of dead skin cells. It helps in turn to speed up cellular turnover while softening fine lines and wrinkles on our hands.

Use sunscreen

To protect your hands from the sun, apply a broad-spectrum, water-resistant sunscreen with SPF 30 or higher to your hands every day before going outdoors. Hyperpigmentation following sun exposure can make your hands look older than your age. But this does not occur due to aging or liver dysfunction, but rather, the effect of the sun. To avoid pigment spots do the following: 

·        Regularly apply sunscreen to your hands.

·        Citrus fruits are a good natural 'whitener,' so make a mask out of 1 tbsp lemon juice, 1 tbsp milk, and 1 tsp honey. 

Use a Retinoid at night

One of the most popular anti-ageing ingredients, retinoids are derived from vitamin A. Retinoid is also the most widely used prescription treatment for wrinkles. Retinoids can increase collagen production in the skin. They also encourage skin regeneration and promote the formation of new blood vessels. Hence, your skin appears smooth, soft, and healthy. Use it only in the night, as sun exposure after applying retinol is not recommended. Pregnant women must avoid it.

Healthy Diet

Maintain a healthy diet with vitamins, antioxidants, and omega-3 fatty acids.

Non surgical hand rejuvenation

1.      For sun spots

·         Cryosurgery (freezing)

·         Laser therapy

·         Chemical peeling

·         Microdermabrasion

·         Skin-lightening creams and lotions

 

2.      For loss of youthful fullness

·        Fillers -   Dermal fillers or soft tissue fillers can be used to reduce wrinkles. These fillers are substances designed to be injected beneath the skin surface to add volume. It also provides fullness and reduces wrinkles temporarily.

·        Fat grafting – fat is aspirated from lower abdomen or thigh and injected under the skin of hand

 

3.      Prominent veins

·        Sclerotherapy - injects a substance into the vein to destroy it. This causes the vein to disappear slowly.

·        Lasers

 

4.      Wrinkled skin

·        Chemical peel – every 1 to 3 months

·        Lasers

 

5.      Loose skin

·        Radiofrequency, a procedure that sends heat deep into the skin, can tighten loose skin. Most people need only one treatment on their hands

·        Lasers

·        Fillers

The clock won’t stop for your hands. You can take action to ensure your hands maintain your desired look and feel. As you age, remember that surgical options like laser therapy, hand lifts, and fillers are always an option to keep your hands looking young.