Neck Wrinkles: The Ones We Hide — and How They Improve
Horizontal lines, vertical platysmal bands, crepey laxity — neck wrinkles come in three forms. A Gangnam dermatologist explains the causes and the five in-clinic treatments that work best in combination.
This is an English adaptation of a clinical article Dr. SangYoul Yun — board-certified dermatologist and Medical Director of Delight Dermatology in Gangnam, Seoul — originally published in Korean. Read the Korean original on Naver. It has been restructured and translated for international readers; all references are the author's own.
We check the face in the mirror often, and the moment a wrinkle appears we think about treating it. But the neck is easy to overlook. This article is for those who take good care of the face yet have struggled with neck wrinkles.
Types of neck wrinkles and what causes them
Neck wrinkles fall broadly into three types: horizontal lines, vertical lines, and loss of skin elasticity.
- Horizontal neck lines — caused by contraction of the platysma muscle, which acts as a neck flexor together with the SMAS. They come with aging, but with a family history they can be severe from a young age.
- Vertical lines (platysmal bands) — the medial and lateral borders of the platysma muscle become prominent, appearing as long vertical lines running up and down.
- Loss of elasticity — as firmness declines, fine crepey lines appear.
Ultimately the root causes are aging and loss of elasticity, and sleeping on a high pillow can contribute too. The neck needs as much moisturizing and sun protection as the face, yet it is easily neglected. Once neck wrinkles are established, however, moisturizing and sun protection alone struggle to improve them — which is what brings people to the clinic.
Effective in-clinic treatments
Neck wrinkles are treated by five main methods. You can also see the overall approach on our neck tightening page.
1. Botox
Because the platysma muscle creates wrinkles as it contracts, injecting Botox thinly and densely into the skin relaxes the contracted muscle and eases the wrinkles.
2. Filler
Used for horizontal and fine wrinkles. Deep, established grooves often do not respond satisfactorily to Botox alone; here, filler is injected to gradually fill the groove and soften the wrinkle.1 Improvement can be seen when comparing immediately after treatment with the result 6 months later.
3. Rejuran
Injected densely along the wrinkle, it regenerates collagen to restore firmness.
4. Radiofrequency (RF) lifting
Devices include Thermage, Oligio and InMode. Using heat, they regenerate collagen in the dermis to improve wrinkles and soften fine lines.
5. Ultrasound lifting
Representative devices are Ultherapy and Shurink. Using the tip that acts on the more superficial layers of the skin, ultrasound creates thermal coagulation points that, again, regenerate collagen.
Prevention and combination treatment
Horizontal and fine neck wrinkles are also linked to the habit of bending the neck forward, so lowering your pillow and keeping up with moisturizing and sun protection help prevent them. But established wrinkles often can't be resolved by lifestyle changes alone. No single one of the procedures above can be called the single best; usually a combination approach is what prevents progression and improves neck wrinkles. Rather than worrying about it alone, it's worth visiting a dermatologist for a consultation.
References
Medical disclaimer. This article is general information and does not replace individual consultation. Neck wrinkles usually require a combination of treatments, and Botox, filler and similar procedures can carry side effects. The right combination for you should be decided after an in-person consultation with a dermatologist.
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