One of my best friends has cycled a ton, gotten way too much sun, and still has a great neck!  Hers is genetic…..not fair! Thank you for writing and Poikiloderma can be persistent so see below.

Necks can be:

  • Blotchy and red
  • Sagging and wrinkly
  • Show horizontal or vertical bands or creases
  • Develop brown spots or skin tags

4 Ways to Improve  Your Neck

  1. If blotchy and red, and most Poikiloderma falls in this category (although some are also brown), then it’s sun damage.  And sometimes in combination with perfumes some of which react with light. Try increasing the zinc in your daily sunscreen to 12-20%, and be sure to reapply if out in the afternoon or sweating.  Make sure the hat has a wide brim, not just a baseball hat.  IPL/BBL will help but 3-5 treatments will probably be needed.  If really brown, Fraxel Dual can help lift the brown out.  It will make the red component look temporarily worse, but that can be treated later with BBL/IPL.   If it’s itchy and dry, please talk to your dermatologist.  Could a new product be irritating it?
  2. If saggy and wrinkly, then deeper modalities are needed …….like the deep radiofrequency microneedling (we like Profound).  But….enough pulses need to be done.  I’ve seen several patients from other offices who didn’t see results but pulse counts seemed low.  Using between 300-600 depending on age and surface area may be helpful, and 1-4 treatments.  CO2 laser can also be used effectively on the neck.
  3. Horizontal bands very often respond to Botox/Dysport.  It takes several treatments to see results though.  Vertical (platysmal) bands usually improve with the same.  Experts only please, so that too much Botox/Dysport is not injected into the neck (FDA off-label).
  4. Brown spots (flat) are often lentigos (freckle like), or if raised skin tags.  Please see your dermatologist and don’t self diagnose if there is any question!   All dermatologists have seen patient self diagnose, and wait too long only to discover they have a skin cancer that could/should have been treated earlier!  There are multiple ways to remove these spots and that can be done by your derm.

I hope this helps,

Dr. Brandith

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