Skincare with Friends Ep 63 How to Treat Neck Aging

The neck is one of the first areas to show signs of aging, second to the the under eye area, because the skin is thinner as well as less elastic and the effects of gravity are more obvious in the neck/jaw/jowl area. As you get into your late 30s you may well start to see the jawline becoming less firm, some adorable pouching in the jowl area and eventually the whole thing starts to sag.

Improving the appearance of this area is a bit complex. Because there are several things that can be going on if you don’t like the appearance of your neck. It could be a double chin, crepiness, sagging, lines or a combination that you’re trying to tackle. These are the multitude of layers we need to think about-

• Skin
• Adipose/fat layer (inferior mental, submandibular jowl, submental and preplatysmal fat pads)
• Fascia aka the SMAS or Superficial Musculoaponreurotic System) which is a sheet like network of collagen and elastin
• Retaining fibrous tissue supporting the fat pads and tethering the fascia to bone
• Muscle layer (there is a sheet of muscle called the platysma which extends from the collarbone to the jawline)
• Saliva glands
• Bone, which shrinks as we age

It may be a case that you have to address all the layers to get a good result, as a cream isn’t going to improve definition. So this is not entirely a skincare issue, I’ll go through all the options.

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How to Know if Your Neck is Aging

If you’re curious as to whether your own neck is starting to age, you can have a look at he angle between your jawline and neck (the cervicomental angle). A crevicomental angle of 90-100 degrees is a nice youthful angle (cue me taking a side profile selfie). You might start to see your “pre jowl sulcus”- two little notches at your jawline either side of your chin. The skin becomes more crepey and lined.

The Causes of Neck Sagging

It might seem obvious why the neck is aging but it’s worth looking at/thinking about. For example, I have some redness, pigmentation and bumpiness where my neck meets my chest and I’m sure it was caused by sun damage that happened a long time ago. Knowing this, I can tackle it by using tretinoin (the best treatment available for sun damage).

• Gravity and time
• Genetics
• Sun damage
• Smoking
• Weight gain and loss
• Computer and phone screens???

Is “Tech Neck” a Real Thing?

From an article in the Daily Mail called “Screens put years on you: ‘Computer face’ is giving women jowls and lines”

The opinion of a Dr Prager who has a practice near Harley st- ‘The women I am seeing at the moment have only been using computers at work for the last decade or so. But women in their 20s have grown up with them and use them for every single task. ‘It will be completely different for them and I think the problem is going to become much, much worse. In another ten years, they could be looking quite awful.’Dr Prager said there were several simple steps which could stave off computer face such as regular screen breaks and stretching the neck muscles. And, of course, there was always Botox.” I checked his site and apparently he is a staunch believer in Homeopathy, so this source is spurious AF. He’s trying to sell his botox wares, so he has a vested interest in making people scared about their screen time and neck condition.

“Screens put years on you” The Daily Mail

Another article on a site called DazedBeauty.com

“Dermatologist Dr Stefanie Williams remains uncertain, “It is true that after repeated creasing of the skin in a specific area, the crease will eventually ‘edge’ itself into the skin and become permanent over time. But I’m not sure whether there is really a significant increase in neck wrinkles from working more on digital screens these days, although I guess the theory is possible.” Consultant plastic surgeon and skin specialist at The McIndoe Centre, Silva Kumar, meanwhile, points to another issue, “The rise in selfie culture means that people are scrutinising themselves much more than they did in the past. Social media certainly contributes to a desire to improve physical appearance. I believe this trend is more to blame for the rise in “tech neck” as people are noticing their wrinkles more than they did in the past. Even babies are born with neck wrinkles, so it’s unlikely that they are caused by our use of tech.”

“The Rise of Tech Neck” DazedBeauty.com

We can do another ep on the effect of tech on our skin totally, it’s quite interesting and I wonder how much is scare tactics to publicise articles.

How Exactly to Stop Your Neck From Sagging

From the research I’ve done, it seems there is very little concrete scientific evidence around treating neck aging. There is no big review studies or meta analyses of the data to go from. All I could find was some very small studies and case reports on particular treatments, none comparing different treatment types to give us an idea if there is a scientifically proven best treatment. 

I’ve canvassed opinions from internet forums to find out which treatments worked, not very scientific, but that’s all we have to go on at this point-

• Topicals– specific neck skincare and normal face skincare that you just apply to the neck. When we put the topic of neck treatments to our Facebook group, one of our group members said that she was under the impression that we can’t use tretinoin on our necks as the skin is thinner. Which is true, you are going to get more irritation in this area if you are using tret on your neck. You can still do it though, best tactic is to use it over a layer of moisturiser, you can totally do it. As we’ve said 20,000 times before, Tretinoin is the gold standard for treating aging, so it’s absolutely the best thing to treat skin aging. In the neck area, tretinoin can increase skin thickness, elasticity and crepeyness. Go to our post on Dermatica to learn more, we have exclusiveSkincare with Friends discount. It will be automatically applied at checkout. UK – https://dermati.ca/31j US – https://dermati.ca/hht. We’ve also got products like NEC by NIOD designed to increase skin elasticity. I like NEC, I haven’t been religious about using it, but I feel that it does improve the texture of the top layer of skin. I looked at a lot of “neck creams” and couldn’t find anything that appeared to have magical powers. Lots of moisturisers that sound nice and have ingredients like niacinamide and plant oils, but nothing magical that could potentially lift the skin and cure sagging. Eg It Cosmetics Confidence in a Neck Cream £44 80ml has a peptide, niacinamide, Shea Butter Coconut oil, sounds like a nice nice cream. You could get the same effect with the products you use on the rest of your face essentially. Tretinoin is you best bet for improving skin firmness and make sure you use plenty of spf.
• Face yoga– this involves exercises that train muscles to lift the skin. i guess it might work, if you have the energy to do the exercises every day
• At home electrical collagen stimulating devices– Like Nuface (£229) or Ziip (£425). There is almost zero scientific evidence available and before and after photos online show modest results. You have to use them really consistently for them to work.
• At home LED device– Find out the in depth details on the evidence around LED therapy for aging in our LED therapy post. In short, they might work if they have enough power, and have to be used really regularly for a long period of time/forever.
• Microneedling– creates micro channels in the skin to allow skincare to penetrate, also microinjuries that stimulate collagen production by creating mini scars. Good for improving small scars, increasing firmness and increasing effectiveness of skincare products. Can be done at home (with derma rollers) or by a professional (rollers or with electrical pen devices). You’ll need several professional treatments to see results, it costs around £150 per treatment. 
• HIFU/Ultrasound/Ultherapy– Ultrasound energy is targeted to transmit heat energy to the deep skin layers and SMAS to stimulate collagen and elastin production. Costs around £600. You need yearly treatments
• Radiofrequency– Similar concept to Ultherapy- electromagnetic waves generate heat in the deep layers of skin and cause contraction of collagen fibres in the short term, and stimulate collagen production in the long term. Similar cost but you need several treatments. Both HIFU and RF have limited effects, they might give a little lift if the sagging is fairly minor but won’t address surface issues. Best combined with other treatments and or skincare. It takes a couple of months for the full visible results, while collagen is buidling. I’ve had HIFU done myself and the results were pretty modest. 
• Botox– Good for mild drooping I’m the jawline and “turkey neck”- those vertical bands seen under the neck skin. Helps to smooth out the neck. Doesn’t improve appearance of the skin and only suitable for certain cases. Won’t help with double chin or severe sagging.
• Fillers– Highly cross linked Hyaluronic Acid creates a firm gel that can be injected under the skin at the jawline to create definition and smooth out jaw contour. You can add filler into the pre jowl sulcus to improve the appearance of jowls, it works nicely. Costs around £300 and will need to be repeated around once a year. Wouldn’t be effective for severe cases of neck/jaw sagging.
• Profilo– a skin booster that contains Hyaluronic acid. It isn’t filler- the lack of cross linking means it doesn’t keen it’s structure (it has a watery texture), but it hydrates the skin from within and stimulates the bodies own collagen production. Good for improving skin texture and hydration, very safe, few side effects but it might not do anything much at all. You need two treatments 1 month apart. Costs around £700
• Fat dissolving injections– Kybella (USA) or Aqualyx (UK), for double chins, There is pain and swelling afterwards that last around a week, may need 3 treatments, can be very effective but in some cases results are modest. Costs around £300
• Threads– Thread lifts involve inserting dissolvable threads under the skin, there are lots of different designs but in general little barbs catch on to the tissues and when the thread is pulled taut it tightens the skin and pulls it up. The results can be subtle and generally lasts around 6 months. There is pain and swelling post procedure and complications include some puckering of the skin. Costs around £300-£700
• Surgery– neck lift, liposuction, a more risky option with more downtime, but you are much more likely to get satisfactory, visible lasting results. Costs around £4000

Take Home Message re Neck Aging

• Use all your skincare on your neck and décolletage especially spf
• Beware that tretinoin and acids can cause more irritation in this area, buffer with a moisturiser or use lower percentages
• Do your research before trying non surgical treatments- get a good clinician who can talk you through all the options
• The more severe the aging the more difficult it is to get results

Hope that helps, join in the fun on the Skincare with Friends Facebook group, leave us comments, let us know you’re in the gang.