Neck and Chest Issues

 

PROBLEMS ON THE NECK AND CHEST

Here are the top issues!  A more complete discussion can be found my book, The Surgery-Free Makeover: All You Need to Know for Great Skin and Younger Face.

Protecting the skin on the neck and chest

Your face isn’t the only area that needs protection. The skin on the neck and chest gets almost as much sun and weather as the face, and yet it is thinner.  Our Resources section has articles on sunscreens, antioxidants, and vitamin-based products that protect your skin and prevent damage.

Link to Sunscreen Information

Link to Repair Creams

Skin on the face, neck, and chest don’t match

I started sunscreening my face in my mid-20s, but it took me several years to realize that my neck and chest were getting almost as much sun as my face.  Yet I was leaving my neck and chest completely unprotected!

Some of you may have been doing the same thing for longer, in which case you may be noticing a mismatch between the skin on your face and the skin on your neck and chest. The problem may be your skin is brown and blotchy, red and blotchy or both.

Creams will only go so far in the neck and chest if the damage is bad enough. You may need lasers. Remember, if you make the investment in  laser treatments, be sure to use sunscreens, antioxidants, and laser treatments once a year to maintain that investment.

Brown spots from age and sun damage

Brown spots are essentially sun damage. You may have had them as freckles when you were younger, but they get larger and often darker as you get older. Be sure to have a dermatologist examine your skin before any cosmetic treatments to make sure you don't have a skin cancer.

The first thing to do about brown spots and age spots is to prevent more of them by sunscreening. Make sure you use a sunscreen that protects you from UVA radiation by having at least 5-10% zinc or titanium or 3% mexoryl.

You can also try over-the-counter "bleaching" creams if your age spots are localized or not too bad. "Bleaching" creams don't really bleach they temporarily decrease the production of brown pigment in your skin. Drugstore bleaching creams contain 2% hydroquinone and are not very effective. They will cost under $50 and can be found at your drugstore.

Bear in mind that continued sun exposure will stimulate the growth of brown spots, so that the bleaching creams will not protect you against the regrowth of brown spots or the development of new ones. Only sunscreen can do that.

Prescription bleaching creams all contain 4% hydroquinone plus or minus other ingredients like hydroxy acids, sunscreens, or tretinoin. These are more effective but still temporary. For some patients who are allergic or don't want to use hydroquinones, I have also used plant-based bleaching creams. These ingredients are ones like arbutin, thymol, and kojic acid. They seem to be less effective than the prescription creams.

Microdermabrasion and light peels are also options for mild-moderate brown spots. A good aesthetician can perform microdermabrasion or a low-strength peel, and these can often give good results  but need to be done in a series, usually to 3-6, to be effective. Costs vary widely but a series might run $250-800 depending on how many are done and what is used.

A medium peel, like a TCA peel or peels, can also give good to excellent results but should be done by an experienced dermatologist. 

Link to Guide to Microdermabrasion and Light Peels

Link to Guide to TCA Peels

The most effective treatment option for brown spots is a series of laser treatment. This is also, unfortunately, the most expensive.

An IPL (also called photorejuvenation) will usually give excellent results. A series of five treatments will cost you anywhere from $1,500 to $2,500, but often an IPL will also reduce any redness, stimulate some mild collagen growth, and add to your skin’s glow. You will need maintenance treatments when brown spots reappear, usually once or twice a year.

The fractional lasers are newer and may be the best option if you also have wrinkles or acne scarring.  Many clinics, including ours, are reporting excellent results.  The non-ablative fractional lasers, like the Fraxel, have a 2-day downtime, and cost $2,000 to $6,000 for a series of 3 to 5 treatments.  Some people see results quickly with the Fraxel; but results will improve over 2-6 months.  The ablative fractional lasers, like the Active FX, have a 4-8 day downtime, and cost $1,000 to $2,000 per treatment. 

Link to Guide to IPL/Photorejuvenation Lasers 

Link to Guide to Fractional Lasers

Neck and chest are red and blotchy

Having redness or broken blood vessels on your neck or even your nose does not mean that you are an alcoholic, contrary to popular myth. Often people with Celtic genes develop redness or even broken blood vessels on the nose, face and sometimes the neck and chest.  Redness and dilated blood vessels can also be caused by rosacea, sun damage, or certain diseases. You'll need a dermatologist to help you figure out the cause of your redness.

 If the redness is due to sun damage, or you have rosacea that is under control, you may want to consider IPL/photorejuvenation laser treatments to reduce the redness. These treatments cost $1,000 to $2,500 for a series of five treatments. The results are often excellent and take effect in about 6 months, as you complete your series of 5 treatments. You'll need maintenance treatments once or twice a year. If redness is due to rosacea, the first step is to look at lifestyle changes, like diet and exercise.

Link to:

Guide to IPL/Photorejuvenation Lasers

Rosacea In Depth

Necklace lines

Some people get little lines or bands running horizontally across their necks. Because they can look almost like necklaces, they are called necklace lines. Some people get them relatively young, even in their 20s or 30s. You may even notice them on children.

Your best treatment here is a small amount of Botox. Be sure to find a skilled doctor for this because the skin is thin on the neck. And an inexperienced doctor could cause weakness of the neck muscles or difficulty swallowing. The fractional lasers can also help soften necklace lines, but they are not a home run.

The costs should be $200 to $400, and you may get a good result. You will need to retreat this area every 3 to 6 months. Also, be sure to use skin care products to protect your neck and chest.

Link to Which Products Do You Really Need?

Link to Guide to Botox

Link to Guide to Fractional Lasers 

Wrinkles and crinkly skin on the neck

Some of us as we age notice that the skin on our neck acquires the texture of crepe paper. Others notice the skin can get a little loose. What can you do about loose, crinkly, or crepey skin on the neck?

Up until recently, there was no really good non-surgical option for loose or crepey skin on the neck. But, the fractional lasers have shown some promising results for this problem. A fractional laser treatment will usually cost $1,000-2,000 per treatment, and you will probably need two to four over a 4- to 6-month period. The ablative fractional lasers, like the Active FX, have a downtime of 4-8 days, and cost about $1,000 to $2,000 per treatment also.

I’m eager to see more data to clarify who will benefit, how many treatments are needed and which fractional lasers work best for this.  As of now, the results seem a bit variable. Some people get very little result and some get good results. If you budget can take it, you may want to consider this option.

Link to Guide to Fractional Lasers

Here are some things that I know do not work well for wrinkles on the neck:

• Laser photorejuvenation.  It's great for color issues, like redness or brown spots, but not for wrinkles.
• Thermage.  Thermage is great for the right person, and on the face.  But we have tried a number of different protocols on the neck and never gotten great results.  And, I have never seen studies that got consistently great results on the neck.
• Light peels and deep peels.  Light peels don't have much effect on wrinkles, and the skin on the neck is too thin for a deep peel.  If your dermatologist is experienced in a medium-depth TCA peel, you could consider that.  

 The cords on the neck stand out

Some of us notice that we seem to be getting prominent vertical bands that stick out near the upper part of our necks (the platysmal bands). The two options to treat this are Botox, if these bands are minimal, or surgery.

For $200 to $400, the Botox may work to relax the muscles that make these bands stick out, but it will only work if the banding is early. If the bands have been there for some time or are very prominent, Botox will not work and surgery is your best option. 

An inexperienced doctor can cause weakness of the neck muscles or difficulty swallowing, so find an experienced dermatologist.

Link to Guide to Botox

Wrinkles and lines on the chest

Some of us get wrinkles on our chest from our sleeping positions. I know that I sleep often on my side and will wake up in the morning to find lines and wrinkles on my chest. But wrinkles develop on the chest from sun damage too.

The best way to treat chest wrinkles is with fractional lasers.  At this point, there is a range or results from good to excellent depending on the laser and the provider. Talk to your dermatologist about what results to expect at that laser center.

Link to Guide to Fractional Lasers

Some doctors are also using Sculptra or Botox on the chest. The skin is thin on the chest, so please use only expert injectors for this to avoid lumpiness.  

Link to Guide to Sculptra

From www.SkinTour.com and Dr. Brandith Irwin. Copyright 2008 SkinTour LLC. All rights reserved. Journalists, bloggers, and media may reprint this without permission so long as they include this credit box with the article.