Will Botox Get Rid of Neck Bands?

Hello, I have had "necklace bands" or those horizontal lines that go all the way around my neck since childhood. Now they have deepened and look worse than ever.

I have a nice slim neck, but the lines are very unattractive. I have heard both yay and nay with regards to botox for necklace lines. What's the verdict? Also, are there other treatments that would work better such as laser or peels? Please help, I am desperate to get rid of these bands!

Doctor Answers 23

Necklace lines treatment

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I typically do not recommend Botox for horizontal neck lines. I have achieved great results with injecting Botox into vertical plastysmal bands, however. My recommendation for you is to seek a consultation with an experienced injector, and inquire is fillers would work well for your particular problem. Good luck!

Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Botox for neck bands

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Thank you for your question. Botox can be a very safe and effective way in helping to soften the appearance of neck bands by relaxing the muscles. I would recommend visiting with a board certified plastic surgeon or dermatologist in your area to address your concern as it is an advanced area to treat. And in addition, there may be alternatives that can be used as a standalone or in conjunction with Botox to provide an even more effective treatment.

Botox for Neck Rings

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Thank you for the question.

Unfortunately, Botox is not effective in the treatment of transverse neck "rings". Fillers are probably your best bet but will be time consuming and expensive over time.

Best wishes.

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Horizontal neck bands may not respond well to any treatment but Ulthera, Theramge and Botox may help

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Vertical neck bands may respond partially with Botox but I have not been successful to minimize horizontal neck bands with Botox although I have heard that some physicians claimed in the past that this can help.  Some, not all, patients who are undering Ultherapy have noticed improvement in the horizontal neck bands.  There have been reports of Thermage helping and even Fraxel laser, but I would be doubtful that the horizontal bands would improve much.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Vertical bands are very responsive to neuromodulators such as BOTOX

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Vertical bands are very responsive to neuromodulators such as BOTOX, Dysport, or Xeomin.  The necklace horizontal bands can respond to some degree, but do not respond well in general.  And, all of the neck treatments with BOTOX or other neuromodulators tend to require a lot of product and therefore, are not very cost effective.  The neck is a very difficult area to treat.  Usually lasers will work best.  But, if the neck bands are very deep, it may require several treatments.  Sometimes doing an injectable filler, such as Juvederm, may be helpful (depending on the depth of the lines), but you have to be careful (even when doing lasers) to not go very deeply.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Botox and "Necklace" lines

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Necklace lines are not dynamic--caused by muscle movement--therefore neuromodulators are not the correct treatment. They usually are a combination of genetic factors and photodamage factors....so choose your parents more carefully next time  :)

Neuromodulators work very well for vertical lines caused by the platysma muscles.

The best improvement I have seen with necklace lines is when a patient is consistent with good corrective skin care...like Obagi Nu Derm...they consistently protect from sun exposure, and they undergo either one or two TCA chemical peels or ActiveFx/Deep Fx laser skin resurfacing.

Reginald Rice, MD
Folsom Facial Plastic Surgeon
4.3 out of 5 stars 8 reviews

Horizontal Neck Lines

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Horizontal neck lines are a rather vexing problem and aren't treated particularly well be any individual therapy.  Botox is not something I would recommnend for this particular issue.  A series of low energy fractionated CO2 laser treatments can be helpful, but will not eliminate the problem.  The same can be said for fillers.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Botox for Neck Bands

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These neck bands that have been there since your teenage years are not likely to be removed by Botox and it effects muscle activity. I would suggest the CO2 Fraxel Laser for this and I would not expect miracles. This is a difficult problem even to correct with surgery.

Botox plus filler for neck lines

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Botox is often used for the vertical lines (platysmal bands) in the neck, but are not very helpful for the horizontal lines.  The horizontal lines can be treated with a very small amount of filler (Restylane, Juvederm) injected directly under the lines (emphasis on small amount so the filler doesn't make matters worse).  The effect can often be enhanced by injecting Botox to relax the underlying muscles.

Alison Stallings, MD
Tarrytown Dermatologic Surgeon

Botox plus Juvederm Work Well for Horizontal Necklace Lines

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The most effective approach in my experience is to inject tiny amounts of a filler (my favorite for this is Juvederm) along the entire length of each horizontal necklace line. Just enough of the material is injected to elevate the depression until it is flush with the surrounding skin surface. The results of this alone are quite gratifying to most patients. However, to prolong the duration and enhance the effect I most often subsequently (usually during the same treatment session) treat the lines with Botox or Dysport to relax the underlying thin muscle sheet.  

I have been treating necklace lines with Botox and more recently with Dysport with a great deal of patient satisfaction for over fifteen years since this was first described in the medical literature. Microdroplet amounts are injected in a beadlike fashion across the entire length of each necklace line. Until all of the material is absorbed (usually about an hour) the treatment area will look like a string of tiny mosquito-bite-like hives ringing the neck.

Years back, before the introduction of the sophisticated and versatile fillers that are available nowadays, Botox was the only treatment offered and the results were typically variable. Some people saw improvement, but many had results that were less optimal. The combination of filler with Botox or Dysport that has become my standard practice, however, has yielded more consistent improvement and only takes about ten or fifteen minutes to perform.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.