The most common factors affecting the appearance of the hands are as follows:
Pigment deposition caused by any or a combination of the following: solar damage, the natural ageing process, and post-trauma.
Textural changes due to structural change, including lower collagen and elastin levels.
Volumetric change due to loss of subcutaneous fat.
Osseus change: osteoarthritic changes causing deformities and loss of range of movement.