Neck Aging and What You Can Do For It- from skincare to sugery

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Is it true that necks age first? If so, why is this the case? Generally speaking, what factors contribute to neck aging and sagging skin here?

The skin on our necks is one of the thinnest on the body, so the breakdown of collagen and elastin, loss of hyaluronic acid, and photoaging occurs more quickly and noticeably than on most other parts of the body, including the face.  So, yes, the neck area can quickly show signs of aging—faster than the face.  This is also because the skin on the neck has fewer sebaceous (oil) glands compared with the face, so the neck skin is impacted by environmental damage more strongly. 

What are the common signs of aging that people typically experience in the neck area?

Common signs of an aging neck are wrinkles and loose skin.  With more pronounced sun damage, one may even see neck lines that crisscross each other. 

Do you have any advice or recommendations on lifestyle factors that can support neck health and slow down the aging process?

Developing neck wrinkles can’t be completely prevented, but there are definitely things that you can do to slow down the development of an aging neck.  One of the best things is to decrease external causes of skin aging—and #1 culprit is UVA rays from the sun, as this ultraviolet light penetrates the dermal layer of the skin and causes the breakdown collagen and elastin.  Wearing a broad-spectrum sunscreen SPF 30 or higher on your neck every day, rain or shine, will help to decrease the negative effects of UVA rays.  Smoking also accelerates the aging process in your skin; one more reason to stay away from smoking.  

Some of the ways to prevent neck wrinkles help to combat these lifestyle factors- stop smoking and wear broad-spectrum sunscreen every day.  


In more extreme cases of sagging relate to muscle/ligament aging, which isn’t really something topical skincare can help with.  Can you briefly explain this and dive into the actual benefits you may notice with a topical skincare routine?

Developing neck wrinkles can’t be completely prevented, since the very nature of aging means that you’re going to lose subcutaneous fat and bone mass and the skin itself will start to have less organized and healthy components, such as collagen and elastin.  However, there are definitely things that you can do to slow down the development of wrinkles, including a daily neck skin care routine.


What professional treatments or procedures can help improve the appearance of the aging neck?

Professional treatments that help correct the aging neck include treatments that help stimulate the regeneration of collagen, elastin, and hyaluronic acid, while reducing hyperpigmentation changes and wrinkling.  Hydrating and oxygenating facials that include the neck can help improve neck texture, smooth lines, and make the skin more ‘available’ to active ingredients found in good neck skin care products.  Collagen Induction Therapy, aka microneedling, is a great in-office treatment that works by creating microinjuries into the skin, stimulating it to create newer, healthier skin, and helping to reduce pigmentation changes too.  Taking this up another level, radiofrequency microneedling devices, such as with Candela Profound RF, can be used on the neck skin, especially under the chin (submental region) to help treat aging neck skin.  And when used carefully and in experienced hands, light fractionated CO2 laser treatments also help treat the aging neck skin.

One can also get neurotoxin (e.g. Botox) injections into the horizontal neck lines and vertical bands (caused by the platysma muscle) to help soften these lines—repeat treatment every 3-4 months, and hyaluronic acid filler injections into the horizontal neck lines can also help to fill these lines and reduce their appearance.

Finally, a mini-necklift or lower facelift/necklift can really help to remove the excess, sagging neck skin.  At the DeRosa Center in Boston in our QuadA certified surgery center, I often combine a minifacelift with a skin procedure, such as Profound RF dermal microneedling or a light laser to optimize results.


Moving on to at-home care, what’s the difference between a regular face cream or lotion and a neck cream? Do you recommend having the latter?

Neck creams are formulated to treat the delicate skin of the neck to hydrate and increase the dermal substrates, including collagen and elastin.  Not all face products can be used on the neck. It depends on what exact face product is intended to do. Face products that are made to improve the elasticity and collagen in the skin are typically OK to use on the neck, but be careful using anti-acne products and retinols, as you’ll need a lot less of these products for the thin neck skin as compared to the face. 

So, unless you’re completely sure your face cream or lotion can be used on the neck, I recommend using a neck-specific cream.    

Please share a brief step-by-step skincare routine you recommend for neck care to help with premature aging. Feel free to include any specific products.

Your neck skincare routine can be relatively simple.  Treat your neck as an extension of your face, extending your routine to the neck and do the following at the very least:

Cleanse with a gentle cleanser, then add a hydrating serum- allowing time for it to penetrate, followed by a neck cream.  Use one pump of the neck cream and apply in upward strokes.  You’ll want to do this twice daily and add one more step in the morning:  after applying the neck cream, be sure to apply a broad-spectrum SPF sunscreen with SPF 30 or above too.  

A few of my favorite neck products are the following:

Alphascience Surface CR is an anti-aging, paraben free cream that can be used on the face and neck and is ideal for those who have early signs of aging, such as fine lines and wrinkles, and loss of firmness.  Great for all skin types, Surface [CR] is formulated with hyaluronic acid, L-Glutamine, Genistein, and a patented tripeptide. 

Alphascience Ultra Deep anti-aging cream is a fantastic answer to those whose neck skin is already showing moderate to severe aging and sagging, as well as thinning skin seen with photoaging and collagen/elastin loss. It can also help to reduce visible small blood vessels and broken capillaries.  Ultra Deep is an effective deep restructuring cream for those with normal to dry skin and can be used morning and night on the face, neck, and décolleté.