Journalist Nora Ephron is not the only woman who feels bad about her neck; I, too, have become fixated on the tree trunk-like rings I’ve acquired over the years (count them, and you’ll know how old I am!), which has been punctuated by the digitally amped-up year that COVID-19 forced. It’s for this reason that skin care experts tell me the neck is a central point of concern for many people around the US.

“There is no doubt that Zoom and video conferencing has increased focus on the neck for people—we are all spending much more time staring at ourselves on the computer screen and analyzing our faces,” says double board-certified plastic surgeon David Shafer, MD, FACS. “Pinhole cameras at close range, such as on computers and also on phones, tend to distort our faces.”

Technology isn’t singularly to blame, however. Advances in facial aesthetics—such as Botox and fillers—have created a disconnect between how our skin looks above the chin and below it. According to Joshua Zeichner, MD, a board-certified dermatologist in New York City, this is for two main reasons. First, the skin on the neck is incredibly thin, and the second, it’s often neglected. In other words, it’s more vulnerable and yet most of us do less to care for it—until the dreaded day we suddenly notice a change and begin to panic about it.

And panic, we do. According to Michelle Jacobs, co-founder of menopause-centric skin-care brand Womaness, signs of aging on the neck tend to make women emotional. “It’s a sign that something’s different, something’s changed, and it’s not an easy fix like wrinkles on the forehead you can treat with Botox,” she says. “Without doing something more severe, you almost have to just live with it.” 

Almost, but not quite. Because beauty is big business, when a “problem” is identified, solutions are soon to follow. Below, skin-care experts describe the types of changes you might notice in your neck over time, and identify both prevention strategies and after-the-fact solutions.

What happens to the neck as you age

There are four main issues individuals might notice in their necks as they age, says Dennis Gross, MD, a board-certified dermatologist, dermatologic surgeon, and founder of Dr. Dennis Gross Skincare: lack of elasticity, crepiness, horizontal wrinkles or tech neck, and discoloration.

These changes occur slowly, according to Dr. Zeichner, but people seem to notice them all at once. “Brown and red blotches usually appear first, and can be visible as early as your thirties or forties,” he says. “And for some people, horizontal lines crop up on the neck, just as they do on the face, as early as in their thirties. Sagging usually becomes prominent later in life, in the fifties or sixties.”

The causes of changes to your neck

To some extent, these changes are inevitable, just as are most age-associated shifts in our appearance. But there are some common causes that can be mediated to at the very least postpone them.

1. Sun exposure

Anyone versed in skin care 101 knows that the sun is pretty much the worst for your skin. “The sun causes 90 percent of early signs of aging,” says Dr. Gross. And the neck is particularly vulnerable to this damage because, as noted above, it’s thin, and it’s also often exposed to the sun. “It’s one of the first places that people start to notice the appearance of fine lines and wrinkles or discoloration,” he says.

Additionally, chronic UV light exposure leads to a condition known as poikiloderma, says Dr. Zeichner, which is a very sexy combination of brown spots, red blotches, and thinning of the skin.

2. Tech use

I acquired my tree trunk rings the analogue way—by spending my entire childhood with my head down, buried in a book. But these days, it’s our iPhones and iPads that are doing most of the damage. “The term ‘tech neck’ refers to premature aging of the neck related to looking down at our devices,” says Dr. Zeichner. “We see early development of horizontal lines because of overworking of the neck muscles.” 

3. Menopause

During menopause, estrogen levels decline, explains Dr. Zeichner, and this is thought to accelerate skin aging. “We know that estrogen plays a role in skin cell functioning, including barrier function, wound healing, and repair mechanisms,” he says. “So low estrogen may be associated with dryness, dullness, poor wound healing, and even more prominent lines and wrinkles.”

At-home solutions for neck changes

As Jacobs noted, it’s not particularly easy to treat signs of aging on your neck; but that doesn’t mean you’re without recourse. Below, pros run through your best options.

Prevention strategies

Of course, there is no skin care treatment that works for any part of your body better than prevention, and the number one thing you can do to protect your neck from damage is to apply sunscreen to it each and every morning.

Your other lifestyle choices matter quite a bit, too. “Work on good diet and exercise, a good skin-care regimen, staying well hydrated and, of course, not smoking,” advises Dr. Shafer. “We can make great improvements for patients in the office, but if patients are not caring for themselves at home it makes it that much harder.”

Skin-care strategies

Many of us have no skin care regimen for our necks at all, which Dr. Zeichner says is a mistake. “You want to treat your neck with the same types of ingredients as you use on your face,” he explains. “The morning regimen is to protect the skin and prevent damage from the environment. The evening is a time of hydration and repair.”

To treat both crepiness and wrinkles, both Dr. Zeichner and Dr. Gross recommend relying on retinol. “Retinol is the best studied ingredient we have to fight the signs of lines and wrinkles,” says Dr. Zeichner. “It stimulates production of collagen and elastin to strengthen and thicken the skin.” He particularly likes Roc Retinol Line Smoothing Night Serum Capsules ($33), which contain a high concentration of retinol stabilized in a single-use capsule that can cover the face and neck.

For hyperpigmentation, vitamin C should be your go-to, says Dr. Gross. “It not only diminishes the appearance of dark spots but also protects the skin against damaging free radicals which can cause hyperpigmentation,” he explains.

And while those two ingredients are heroes to be sure, they’re not the only options. Ingredients such at peptides help to tighten the skin, hyaluronic acid helps restore lost moisture, growth factors can help to stimulate collagen production, etc. And ultimately, as Dr. Zeichner mentioned above, you should treat neck skin care the same way you treat skin care for your face, which means you need to find the right products to address your individual needs.

Womaness Let's Neck — $25.00

Let’s Neck is one of Womaness’ best-selling products, and Jacobs says it offers both immediate and long-term smoothing, tightening, and brightening effects. It accomplishes this through the use of  three hero ingredients: Hyaclear 7, an advanced form of hylauronic acid; Pepha-Tight, a microalgae extract that has a tightening effect; and embilica, a fruit extract that helps to brighten skin and even skin tone. But the best thing about this product (IMO) is its unique rollerball application. It’s so easy to stroke onto your neck that I keep it at my desk to apply at various points throughout the day.

Dr. Dennis Gross Ferulic + Retinol Neck — $75.00

This product uses wrinkle-reducing retinol in combination with ferulic acid so it can achieve its desired results without being overly harsh on the neck’s extra-delicate skin. It also relies upon silk amino acids and and Dr. Gross’s proprietary ECG Complex to restore the skin at its foundation. Lactic acid is tossed into the mix, too, in order to lightly resurface the skin. The overall effect is a younger-looking neck (read: smoother, plumper), and the product offers the added benefit of protecting skin from future damage as well.

SkinMedica Neck Correct Cream — $135.00

According to board-certified dermatologist Mona Gohara, MD, this is the neck product. It’s packed with collagen-boosting peptides and antioxidants, but what makes it uniquely effective is its inclusion of an ingredient called paracress extract, which works to relax the platysmal bands in your neck (aka, the vertical lines that appear when you grimace your face and tense your neck). These, explains Dr. Gohara, are what contribute most to the appearance of aging in the neck, hence why she so highly recommends this product, which is specifically formulated to address them.

SiO NeckLift — $25.00

This medical-grade silicone patch hydrates, tightens, and tones the skin around your neck. It accomplishes this by drawing moisture up from the skin’s lower layers and distributing it to the outer layers, as well as by compressing the skin so as to diminish the appearance of lines and wrinkles. Each patch can be used 10 times.

Sisley Neck Cream — $195.00

This spendy, luxurious option relies on deliciously wholesome elements to achieve its desired results. The product’s most active ingredients include the following: oat seed extract, which tightens the skin; soy fiber extract, which helps firm the skin and even out skin tone; vitamin E acetate, to protect from oxidative stress; caffeine, red algae extract, and horse chestnut to work out wrinkles; and shea butter for moisture. The result is a glowing, taunt, color-corrected, and noticeably smoother neck.

StriVectin TL Advanced Tightening Neck Cream — $95.00

The formula used in this best-selling product (literally, it was the most-sold neck skin care product in 2017, according to the the market research company NPD) is designed to tighten skin, smooth wrinkles, even skin tone, and more. It does so in part by relying on a proprietary Gravitite-CF lifting complex to restore elastin and prevent further drooping, as well as the company’s patented NIA-114, an optimized form of niacin clinically proven to strengthen the skin barrier.

Perricone MD Cold Plasma Plus+ Neck & Chest — $89.00

This moisturizer is packed with ingredients designed specifically to be used on this oft-ignored area, such as peptides, alpha-lipoic acid, vitamin B3, and vitamin C ester. “These ingredients work together to address many of the signs of skin aging including laxity, discoloration, and lines,” says Caroline Robinson, MD, a board-certified dermatologist based in Chicago. “All four ingredients work to visibly improve the thickness and firmness of the skin by supporting rejuvenation of collagen that has been damaged and lost over time.” It works on all skin types and won’t irritate sensitive skin.

In-office solutions for neck changes

I swore I would never use Botox or fillers; until the day I realized bottled skin care alone wasn’t going to give me the results I sought. That journey may resonate with you at some point with respect to your neck, too; somewhere down the line, you may want to seek a little extra assistance from the pros.

Fortunately, you aren’t without options in this arena. Below, experts list a few of the most notable treatments available to reinvigorate your neck.

1. Pulsed dye lasers like the VBeam

These lasers specifically target redness to get rid of broken capillaries that are particularly prominent on the sides of the neck and the upper chest, says Dr. Zeichner. They work by aiming an intense yellow light beam at blood vessels beneath the skin, which obliterates those blood vessels but leaves the rest of the skin and tissue intact.

2. Intense pulse light (IPL) treatments

According to Dr. Zeichner, these photofacials can target both red blotches and brown spots and are a great option for discoloration on the neck; however, they really are only an option for those with fairer skin tones, since the lasers target pigment within the skin.

3. Resurfacing lasers like Fraxel or Clear & Brilliant

“These work by punching microscopic holes in the skin, creating a control wound and taking advantage of the skins natural wound healing properties,” says Dr. Zeichner. “They can improve skin tone, texture, and pigmentation.”

4. Microneedling

If you’re unfamiliar, this treatment uses microscopic needles to create tiny amounts of damage to the skin, which then allows it to heal itself up back up stronger and healthier. “Many of the devices also contain radio frequency technology, which enhances collagen production and can give a firming benefit,” says Dr. Zeichner. “It is a great option for the neck and jaw line area.”

5. Botox or Dysport

“The best treatment for tech neck is the use of a neuromodulator like Botox or Dysport to help relax the muscles of the neck contributing to the lines,” Dr. Zeichner says. However, this is considered off-label use, so you should go to a provider you know and trust.

6. Ultherapy

Ultherapy is a non-invasive treatment that uses ultrasound technology to stimulate your collagen and tighten the deeper layers of your skin, according to Dr. Shafer.

7. Thread lift

This is a minimally invasive treatment that pulls loose skin back non-surgically. Basically, temporary sutures are used to give a lifted and tightened effect around the jawline. This also provokes the body’s healing response, which causes collagen to surge in the sutured areas.

8. Fillers

“Injections with products such as Juvederm or Voluma have FDA indication for chin augmentation,” says Dr. Shafer. “Injectable chin implants such as Juvederm Voluma have revolutionized chin augmentation with real and instant non-surgical results. It’s also reversible, so if a patient has regrets it’s easy to remove.” Injections with Kybella, meanwhile, target the excess volume under the chin, he adds.

The takeaway

TBH, I feel like a bit of a traitor to my gender for even penning this piece; obviously, your best bet for aging well is to accept that aging is a natural part of life and not balance the entirety (or even a significant percentage) of your self-esteem on the state of your skin. But not all skin care is superficial; protection measures, specifically, are an important part of maintaining your overall well-being. “People are starting to equate skin health with overall health,” says Dr. Gross. “And they are starting to look beyond just their faces.”

And if you reap mental health benefits from taking aesthetic measures, that’s a win, too. After all, there are *too many* things most of us feel bad about as it is; if we can remove our necks from that list, let’s.

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