Sure, people are still obsessing over getting fuller lips and contoured cheeks, but lately there’s been quite a buzz surrounding a less in-your-face body part. We’re talking about your neck. Despite the fact that the neck shows evidence of sun damage much faster than the face, this sensitive area has commonly been one of the most neglected spots on the body in terms of sun protection and anti-aging action, says dermatologist Elizabeth Tanzi, MD. That is, until now.
From the scads of lifting creams landing on our desks daily, to the latest jaw-line tightening treatments hitting the market, to the new under-the-chin fat-melting injectable Khloe Kardashian is promoting, suddenly it seems like neck products and treatments are everywhere.
Subtle changes often start in the neck area — dry or thinning skin, fine lines, a loss of crispness along the jaw — in a woman's late thirties. Larger “issues” tend to develop a decade or so later. But many people are concerned about their necks regardless of age, and the beauty industry is tapping into these insecurities big time. For better or worse, we’ll let you decide. We don't judge what anyone does (or doesn't do) with or to his or her body — neck and all — we're just here to let you know what's out there.
Ahead we talked to a handful of dermatologist about all things neck-related, from the most basic products they recommend to the most extreme procedures.
Sunscreen
Of course, we recommend using sunscreen on your face daily for protection and preventative measures, but be sure not to forget your neck. “Because we have less fat underlying the neck skin, it gets crepe-y and lax faster than the face,” says Whitney Bowe, MD. Sunscreen and antioxidants can preserve padding by preventing UV rays and free radicals from depleting skin-plumping collagen. Broad-spectrum mineral sunscreens, like Elta MD UV Clear SPF 46, are super-effective and gentle, making them ideal for the delicate neck and chest.
Creams & Serums
“Many women in their twenties and thirties are using expensive face creams and coming in regularly for face-focused tweaks, but very few think to take care of their necks before 40,” says Paul Jarrod Frank, MD, a derm in New York City. Using a cream or serum chock-full of non-irritating peptides will trigger collagen growth and thicken things up. You can find these peptides in Estée Lauder New Dimension Tighten + Tone Neck/Chest Treatment, 111SKIN Y Lift Neck & Décolletage Serum, PCA Skin Perfecting Neck & Décolleté, Olay ProX Hydra Firming Cream, and Liftlab Lift + Perfect Total Rejuvenation.
Most firming/lifting potions also throw in antioxidants, hyaluronic acid (for instant plumping via hydration), and polymers, which “lay down an invisible elastic film over the skin to deliver an immediate stretching effect that gives a more youthful look for a full day,” says cosmetic chemist Jim Hammer, who is most impressed with a type of “smart polymer” called poloxamers (found in Science Serum Tightneck Clinical Anti-Aging Neck Serum), which become “very thick and tight when they reach body temperature,” he says.
At-Home Gadgets
For those looking to score preventative extra-credit points, there’s a new at-home gadget for the face and neck called the Conture Kinetic Skin Toning System. According to New York City-based dermatologist Dendy Engelman, MD, who assisted with the company’s clinical trial, the tool uses vacuum and massage to “improve skin’s ability to absorb the actives in anti-aging products, to boost circulation and radiance, and to tighten skin for a noticeable reduction in sagging.” Following the eight-week study, 70% of subjects saw a significant lift, and 64% experienced an improvement in firmness.
Lasers
The chin throws a bit of shade on the skin directly south of it, but the sides of the neck are left exposed — and susceptible to sun damage. One of the earliest signs of said damage is a type of red and brown mottling called poikiloderma, prevalent in die-hard sunbathers (can you believe there’s still such a thing?). Dr. Bowe recommends a combination of Fraxel Dual (a non-ablative resurfacing fractional laser) and V-Beam (a redness-relieving vascular laser), which can generally eradicate pigment in two visits (at $1,000 to $1,500 per). Fraxel lasers also jumpstart collagen synthesis to smooth away any burgeoning crepe-y-ness. Expect a few days of ruddiness and possible bruising afterward.
Note that doctors have to be extra-cautious when attempting to treat the neck with high-powered lasers and microneedling devices, as it’s prone to scarring, and can take twice as long to heal as the face following such procedures.
Injectables & Microneedling
Kybella is a deoxycholic acid injectable (“the same substance our gall bladder secretes to break down fat in the body,” says Dr. Bowe), FDA-approved only for treating fat right below the chin — injecting it too far into the sides of the neck (jowl territory) can cause nerve damage. It’s generally done under local anesthesia to make the needle pricks (you can receive up to 50 per session) less torturous, and results in major swelling that can last a week or two. “You’ll look like you have a grapefruit under your chin, and the swelling is usually coupled with a week of numbness or discomfort,” says Dr. Frank, adding that most people need three or four treatments at $2,000 a pop.
“I'm having more and more millennials coming in asking for Kybella by name, many of them referencing Khloe Kardashian,” says Jeannette Graf, MD. “It's giving these girls a new way to make a small change in their appearance that has a huge impact. For most, they have just this little lump of genetic fat under the chin that will not go away no matter how much they diet or exercise. Kybella offers the most exact way of getting rid of it — and in these cases with millennials, we usually don't see that much swelling because we're treating a minimal amount of fat with a small dose of the drug. If they need a second dose, we use even less Kybella, and they see even less swelling the second time around."
Dr. Bowe also uses the CoolMini (sometimes in tandem with Kybella), a new neck-specific applicator for the fat-freezing CoolSculpting device. It's relatively painless and side effect-free. However, because of the way the device attaches under the chin, patients can’t move during the hour-long procedure, which can make some feel claustrophobic, warns Dr. Bowe. It costs about $1,000 and requires one or two sessions. Both Kybella and CoolMini take about three months to show results.
When it comes to neck lines, while our experts agree that a series of microneedling treatments can help improve creases over time — by piercing the skin with tiny needles to spur collagen growth for a smoothing effect — injecting necklace lines with a fine-line filler, like Belotero or Restylane Silk, offers a more immediate boost, “improving them by [over] 80% and lasting a few years,” says Dr. Frank. Prepare to pay between $750 and $900.
For women who want an actual neck lift, but don't want surgery, Dr. Frank offers his “cannulift technique”— injecting thick volumizing fillers (like hyaluronic acid-based Voluma or Restylane Lift) along the jaw bone with a blunt cannula to lift and sculpt the area. Since several vials of filler are usually needed, the procedure isn’t cheap ($1,700 to $2,500), but results can last up to a year.
Micro Botox ($750) can also “make a significant difference in 40-somethings who want that little bit of lift,” says Dr. Frank. The procedure entails placing very dilute amounts of the neuromodulator right under the skin, all throughout the neck, to relax the platysma muscle enveloping the area, and relieve that downward pull.
Ultrasound Therapy & Radiofrequency
The jaw will soften over time — in profile, those angles don’t look as razor-sharp as they used to, mostly due to waning elasticity and the sheer downward pull of gravity on the lower face and neck. Ultrasound-based Ultherapy and radiofrequency-fueled Thermage are many derms’ go-to devices for tightening such skin (around $3,500). Their popularity has skyrocketed recently, with numbers jumping 58% from 2014 to 2015, according to the American Society for Aesthetic Plastic Surgery. Both tools deliver heat to the deeper layers of the skin to ramp up collagen production, “so you see a gradual tightening of the area within six months,” says Dr. Bowe, who finds that teaming up the two devices — using Ultherapy first, then Thermage three months later — gives the most dramatic outcome.
New devices, like the Infini, marry radiofrequency and microneedling to deliver heat deep into the skin via needle tips, encouraging new collagen growth and more extreme tightening. “It works well on all skin types, and the skin heals better and faster than it would following aggressive lasers,” says Dr. Frank. (Most have a sunburn-like reaction for about five days, and require two or three sessions as $1,500 each.)
As another faster-acting alternative to lasers, Dr. Frank developed his UltraTight procedure — a sort of lipo-ultrasound hybrid — to slim and shape the neck and jaw line. The technique, done under local anesthesia, involves inserting an ultrasonic wand under the skin (through one or two tiny holes in the base of the chin) to tighten skin from the within while simultaneously melting fat before it’s sucked out. (It can cost $3,000-$5,000 depending on the size of the area being treated.) He compares the 24- to 72-hour recovery period to that of a root canal.
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