from the Summer 2007 issue
The title of Nora Ephron’s most recent book, I Feel Bad About My Neck: And Other Thoughts on Being a Woman, seems to have struck a chord with many of our patients. Several of them have commented on it, even those who hadn’t read the book but could relate to its title. So, what can we do about all those aging necks that elicit such bad feelings? Here’s a short rundown of the non-surgical remedies for neck rejuvenation.
Red neck – The medical term for this is poikiloderma of Civatte. It is basically a combination of brown pigmentation and networks of tiny red blood vessels causing discoloration. Because it is caused by chronic sun exposure, the part of the neck in the shadow of the chin is spared, and the worst discoloration is on the sides and “V” of the neck. Treatment consists of a series of FotoFacial™ intense pulsed light treatments that will help to shrink the red blood vessels and lighten the brown pigmentation.
Wrinkled neck – Just like discoloration of the neck is caused by chronic sun exposure, so too are wrinkles. Ultraviolet light breaks down collagen and elastic tissue, and because neck skin is very thin, it shows the detrimental effects of the sun more than thicker-skinned areas. Unlike the old CO2 laser, which could never be performed on the neck because of the risk of scarring, the newer “gold standard” fractional resurfacing laser called Fraxel is considered the laser of choice for resurfacing the neck. Because the Fraxel affects approximately 20 percent of the surface area at a time, leaving 80 percent intact, it is much safer with less risk of scarring than the CO2 laser. A series of four or five treatments is usually performed.
Sagging neck – Usually where there are wrinkles, there is sagging skin, and the neck is no exception. There are now a myriad of skin-tightening technologies on the market, but we still like the original – Thermage® – the best. The key to all of the skin-tightening devices is to heat the skin enough to tighten it, but not to injure it. When you hit a certain temperature,
collagen fibers contract, and this causes the skin to tighten, becoming smoother and firmer.
Vertical bands – In addition to the skin becoming lax as we age, the thin sheet of muscle on the neck (called the platysma) underneath the skin also begins to sag and form vertical bands in the neck. These bands are accentuated by grimacing, which contracts that sheet of muscle. Injections of BOTOX® Cosmetic into these vertical bands of muscle helps to flatten the bands and smooth the neck. The results last approximately four months.
In addition to office procedures, a good skin-care regimen can help rejuvenate the neck. One of my favorites for the neck and décolleté is SkinMedica’s TNS Body Lotion. It contains human growth factors to help build collagen and ceramides for moisturizing. In the morning, on top of the TNS Body Lotion, you should apply a good sunscreen containing zinc oxide. One of my favorites is Obagi SPF 35. For days of intense or prolonged exposure, use either Falene Solar Protection Formula SPF 65 or ProCyte Ti-Silc® GT Sunblock SPF 60+. At night, use a prescription-strength retinoid such as Renova, Retin-A or Tazorac either layered with or mixed 50:50 with the TNS Body Lotion. If a prescription-strength retinoid is too irritating, you can use SkinMedica’s Retinol Complex. Retinol is a milder version of the prescription vitamin-A derivatives and is easier to tolerate. Because neck skin has fewer oil glands than the face, it can become more easily irritated from the use of retinoids.
With so many treatments available, it’s time to feel good again about your neck. Call today to schedule a consultation with one of our dermatologists or our physician assistant.
If you have further questions, call one of our Patient Care Coordinators, Amanda Parrish (ext. 138) or Janie Umanzor (ext. 143).
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