Help with crepey skin on neck. Microneedling? Lasers? Topical treatments? (photos)

Question

I will be 40 this year. I have good skin overall. I do not drink, smoke or tan. I have been diligent about sun protection and have little to no wrinkling or obvious sun damage. For the past year or two I have noticed a crepey patch on the front of my neck. I have tried SkinTyte with multiple treatments over the past 2 years, topicals etc...My neck and jaw are tight overall and this appears to be a texture issue. I don't want to do more harm than good since this skin is so thin. Advice?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Larry S. Nichter, MD, MS, FACS · Answer

Without a personal examination it is difficult to give the best advice. In general,
Radio Frequency, and laser energy devices as well as chemical peels can tighten the skin and reduce fine wrinkling. Your doctor can council you which is best for your skin type and exam.

Jason Emer, MD · Answer

A combination approach would give the most improvement. Kybella, PDO Nova Threads, lasers, microneedling/prp, Ultherapy and/or ThermiRF treatments (Venus Legacy) are non-invasive options that would do well in combination for skin tightening. Please see a cosmetic dermatologist for a long term treatment plan.  Best, Dr. Emer.

Payman Kosari, MD, FAAD · Answer

Radiofrequency microneedling such as Infini is my preferred approach for this but you will find that there are many different approaches to rejuvenating the neck.  I would get a consultation and speak with the doctor.  Your preference on downtime can also play a part regarding what is chosen.  Best of luck!

Haroon Mojaddidi, MD · Answer

I agree you have taken very good care of your skin, but unfortunately there are age related changes that are almost unavoidable.  That being said, the area in your skin would best be treated with a combination therapy of laser skin tightening like Titan and micro-needling with PRP which will take about 4 months to see great results but has very little down time. Thank you and good luck.

Reza Tirgari, MD · Answer

Your skin actually does look pretty good, so you have several options available to you.  You also don't need anything too aggressive:
1- you could do laser skin tightening with either an RF-based device or a CO2 laser, depending on how much down-time you can afford.  We use both in our practice with a great deal of success.
2- another option is micro-needling, which can also address any scars you may have. This is an option for those who have had, say, thyroid surgery, etc.
It  doesn't look like you have any fat under your neck, so Kybella or other fat removal methods may not be needed.  I would always start with a personal consultation and go from there.

Jean M. Casello, MD · Answer

Congratulations on doing all the right things to maintain skin health.  What you are seeing is part of the normal aging process.  There are many different procedures that can improve the texture/ tighten the skin in this area, In my office we use the lutronic infini which should give you the improvement you are looking for.  A more superficial approach would be  the excillis a radiofrequency device. Lasers both ablative and non ablative can also be used. A more aggressive treatment will result in more recovery time.  You should consult with an experienced provider who can advise you as to the best procedure for you.

Help with crepey skin on neck. Microneedling? Lasers? Topical treatments? (photos)

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