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Neck Wrinkles | A Doctor Explains the Causes, Solutions, and Scientific Basis for Effective Treatments
Creams, massages, stretches... Many things are promoted as ways to make neck wrinkles disappear, but
"Does it really work?"
"Which method is the most effective?"
"I'd like to know what works quickly."
Perhaps some of you have questions like these.
In this article, the aesthetic dermatology team at Smart Skin Clinic explains the causes of neck wrinkles by type and the effectiveness of various kinds of care.
We will also explain the cosmetic treatments available for neck wrinkles and describe each procedure, so if you are troubled by neck wrinkles, please use this as a reference.
Group Chief Director, Smart Skin Clinic Group
Ishii Kota
Career
Graduated from Juntendo University School of Medicine
Worked at Tokyo Women's Medical University Hospital and affiliated facilities
Worked at a major aesthetic clinic in Tokyo
Affiliations / Qualifications
Board-certified specialist, Japan Surgical Society
Board-certified specialist, Japanese Society of Anti-Aging Medicine
[Conclusion & Summary]
In conclusion, with creams, stretching, changing your pillow, and other daily self-care alone,it may be better to assume that eliminating neck wrinkles is fundamentally difficult.
Self-care may offer the benefit of "not adding more wrinkles," but it can't be expected to do much to soften wrinkles that have already set in — it is essentially defensive care.
So what is the answer? We believe that turning to aesthetic medicine is the way to go.
If self-care is defensive care, aesthetic medicine can be called offensive care that lets you feel the wrinkle-reducing effects more quickly.
Types of neck wrinkles
The neck is an area prone to wrinkles, but in fact, "wrinkles" can be divided into several types, such as horizontal wrinkles, vertical wrinkles, fine crepey lines, and sagging. Each type has different causes and characteristics, and requires a different approach to care, so first let's deepen your understanding of your own wrinkles.
Horizontal wrinkles
Horizontal neck wrinkles (necklace lines) appear from a relatively young age, regardless of age.
The main causes are a decline in the skin's firmness and elasticity, and creases forming in the skin from continuous pressure on the same area.
Specific examples include using a high pillow and prolonged use of smartphones and computers. In these cases, you hold a posture that folds the neck for long periods, making horizontal wrinkles more likely to form.
Vertical wrinkles
Vertical neck wrinkles are mainly caused by age-related thinning of the skin, dryness, a decline in firmness and elasticity, and contracture of the platysma, the muscle around the neck.
Vertical wrinkles may be seen relatively more often in older and thinner people.
In addition, aging and rapid weight loss can cause subcutaneous fat to droop, and sagging from the jawline down to the neck can produce vertical wrinkles. A decrease in collagen and elastin from UV exposure, which causes the skin to lose firmness and elasticity, is another cause of vertical wrinkles.
Fine crepey wrinkles
Fine crepey wrinkles refer to the small wrinkles that appear on the skin's surface. Like the skin around the eyes and mouth, the skin of the neck is very thin and easily affected by dryness and external influences. As a result, regardless of age, fine crepey wrinkles become more noticeable under the influence of dryness and UV rays.
Sagging
The main cause of neck sagging is a combination of various factors, including the age-related decline in collagen and elastin, weakening of the platysma, and enlargement of fat cells.
Specifically, as skin thinned by age loses the tension that once kept it taut — because the contracture of the platysma no longer pulls it firm — the skin slackens.
In addition, subcutaneous fat that increases with weight gain, or fat cells that enlarge as metabolism declines with age, can also cause the skin to sag. This is because increased or enlarged subcutaneous fat is pulled downward by gravity, which, combined with slackened skin, leads to sagging.
As sagging progresses, the skin of the neck and lower jaw may droop, blurring the jawline, and steps or folds may form so that the neck skin sags in multiple layers.
Causes of neck wrinkles
The skin of the neck is thin to begin with, and it stretches very easily with the movement of the neck. On top of that, the neck is susceptible to UV rays and dryness, which reduce the skin's elasticity, making it an area prone to sagging and to having wrinkles etched into it.
In addition, because the neck supports the heavy head, it is prone to poor circulation, which in turn makes the muscles more likely to contract. Once the muscles contract and posture becomes fixed, wrinkles form more easily, creating a vicious cycle.
There are five main causes of neck wrinkles:
- Dryness
- Ultraviolet rays
- Posture
- Contracture of the platysma
- Age-related decline in skin elasticity
(1) Dryness
To begin with, because the skin of the neck is thin, it can hold only a small amount of moisture-retaining components and has a weak ability to retain moisture. On top of that, the thinness of the skin makes the barrier function easy to weaken, so it is an area where moisture inside the skin readily evaporates and dries out.
The type of wrinkle that appears depends on how deep into the skin the dryness reaches.
When dryness reaches only the epidermis, the outermost layer of the skin, the texture is disrupted and it appears as fine crepey wrinkles. If dryness then progresses further into the dermis, the skin hardens and is more likely to become set as folded skin wrinkles (horizontal wrinkles) caused by expressions and movement. When it reaches the deepest subcutaneous tissue, it slows metabolism and leads to sagging.
In addition, the weakened skin barrier function caused by dryness makes the skin more susceptible to external stimuli such as UV rays, thus compounding the effects of UV exposure, discussed next.
(2) Ultraviolet rays
UV rays penetrate into the skin and destroy collagen and elastin even when the skin's barrier function is normal. The neck is also an area that is easily exposed to UV rays, and because of the weakened barrier function caused by dryness, it can be said to be particularly vulnerable to the effects of UV rays.
Collagen and elastin are found in the dermis of the skin and give the skin its firmness and elasticity. When UV rays destroy these proteins, such as collagen and elastin, the skin loses its strength and elasticity, making wrinkles more likely to form.
(3) Posture
Neck wrinkles are often influenced by posture, and holding the same posture for long periods in particular can cause wrinkles to form. This is especially true of a forward-bent posture that puts pressure on the front of the neck, such as when using a smartphone or computer, or when using a high pillow. When a forward-bent posture continues for long periods and the same area is creased repeatedly, permanent wrinkles such as horizontal lines form.
In addition, a forward-bent posture strains the muscles and worsens circulation around the neck. Poor circulation makes it harder to supply the skin with sufficient nutrients and oxygen, undermining skin health and making wrinkles more likely to appear. At the same time, poor circulation causes the muscles to contract, and that contracture creates a vicious cycle of repeated poor posture.
(4) Contracture of the platysma
The platysma is located on the front of the neck and plays a role in supporting the skin around the neck and collarbone.
Muscle is inherently soft, elastic tissue, so it can be likened to rubber. Just as rubber becomes stiff and loses its stretch as it deteriorates, muscle likewise becomes harder to stretch when it stiffens. When a muscle stiffens and loses its range of movement, this is called "contracture," and its causes include aging, poor circulation, excessive muscle tension, and various other factors.
Normally, when the platysma contracts, it exerts a tension that pulls the skin downward. However, when the platysma undergoes contracture, this pulling force weakens, so the skin slackens and vertical wrinkles appear. This is the same principle as when you stretch laundry downward to smooth out the wrinkles, but once you stop stretching it, the wrinkles reappear.
(5) Age-related decline in skin elasticity
A decline in skin elasticity occurs as a physiological change that comes with aging. This is because collagen and elastin naturally decrease with age, and the function of the cells that produce them (fibroblasts) also declines or diminishes. It is also because, as explained so far, damage from dryness and UV rays accumulates with age, reducing the skin's strength and elasticity.
Collagen and elastin work to return stretched skin to its original state, but when this function weakens, stretched skin fails to recover and remains stretched.
In addition, as the platysma weakens, it no longer exerts the taut tension on the skin, leaving the skin in a slackened state.
At the same time, slackened skin is more easily pulled downward by gravity. An easy-to-understand example is how a fuller-figured person tends to show more noticeable sagging as they age.
As we age, a decline in metabolism causes the fat cells in the subcutaneous tissue to enlarge. Enlarged fat cells are more strongly pulled downward by gravity, so regardless of body weight, they combine with slackened skin to cause the skin to sag. For this reason, sagging tends to be especially pronounced in those with a naturally fuller figure.
Q: I'm in my 20s. Why are my neck wrinkles noticeable even though I'm young?
Even for young people, such as those in their 20s, the neck is considered an area prone to wrinkles.
The wrinkles most commonly seen in young people are fine crepey wrinkles and horizontal wrinkles (necklace lines). This is because these wrinkles readily form due to external factors such as posture, dryness, and UV rays.
In addition, people who repeatedly go on diets involving extreme weight gain and loss may develop sagging even at a young age. The reason is that when the skin stretches over a short period to accommodate weight gain, its elasticity cannot keep up, resulting in skin prone to sagging and wrinkling.
[Explained] Do the five kinds of care said to make neck wrinkles disappear really improve them?
Here we would like to explain the effectiveness of the five kinds of care thought to make neck wrinkles disappear, including creams, massage, and stretching.
Cream | With active ingredients and a moisturizing effect, effective for fine wrinkles
Creams that contain ingredients said to work on wrinkles can be expected to help soften fine wrinkles.
There are various beauty ingredients, and among those said to work on wrinkles are:
- Retinol (vitamin A)
- Niacinamide (vitamin B3)
and more.
- Retinol: a powerful ingredient that promotes collagen production and turnover, allowing it to address a wide range of wrinkles, from deep to fine lines
- Niacinamide: by supporting both moisture retention and collagen production, it may help prevent wrinkle formation and make existing wrinkles less noticeable
Care with moisturizing creams can also help prevent wrinkles from worsening.
However, the wrinkles that self-care such as creams can be expected to improve are said to be limited to fine wrinkles in the epidermis; for more established wrinkles, it is better to rely on aesthetic medicine.
Q: Can drugstore creams get rid of neck wrinkles?
Even among creams sold at drugstores,those containing "retinol" or "niacinamide" can be considered creams that may help improve wrinkles.
However, one point to note is that drugstores sell a mix of quasi-drug and cosmetic products. Quasi-drugs are recognized as having a certain wrinkle-improving effect, whereas cosmetics are, by definition, not clearly recognized as having such an effect. When purchasing, please check for products labeled "quasi-drug" or bearing the certification mark of the Ministry of Health, Labour and Welfare.
Q: Is Nivea cream effective for removing neck wrinkles?
Nivea is widely known as a long-selling skincare product in a blue tin, but when it comes to "improving wrinkles," it cannot be expected to be very effective. The reason is that Nivea is a cream composed mainly of water and oil, and does not contain ingredients that work to resolve wrinkles.
By the nature of its ingredients, it can form a protective film on the skin and prevent moisture from evaporating, so it is thought to help prevent dryness and thereby provide a moisturizing effect.It may help with fine crepey wrinkles, but resolving more established wrinkles is likely to be difficult.
Massage | Excessive massage is a no-no
Some people massage their neck wrinkles, but massage is not really recommended. The reason isthat there is, conversely, a risk of contributing to sagging.
The purpose of massage is thought to be to improve blood flow, thereby promoting metabolism, easing muscle tension, and increasing skin flexibility. However, the massage process is also likely to place stresses on the skin such as "excessive pressure" and "friction," and such stresses can contribute to wrinkles.
When massaging, use a cream or oil, and be careful not to rub the skin or apply pressure.
Stretching | Wrinkle resolution can't be expected, but muscle contracture improves
One cause of wrinkles is posture, and we explained that when poor posture continues for long periods, poor circulation causes the muscles to contract, creating a vicious cycle of repeated poor posture.
Stretching the neck, shoulders, back, and so on is effective in that it can remove the causes of wrinkles by improving blood flow and easing muscle contracture. However,we do not believe that stretching itself leads to the resolution of wrinkles.
Since stretching itself is effective for preventing wrinkles by promoting circulation and preventing muscle contracture, it is best combined with skincare that includes moisturizing and anti-aging ingredients.
Pillows | Can prevent wrinkles etched in during sleep
Using a high pillow also leads to wrinkle formation. Therefore, switching to a lower pillow that allows the neck to extendis effective for preventing neck wrinkles.Changing your pillow won't resolve wrinkles that have already set in, but if the goal is to "prevent wrinkles while you're still young" and to "keep further wrinkles from being etched in," changing your pillow can be effective. It may also be a good idea to have a pillow made to fit your body at a specialty pillow shop.
Aesthetic Medicine | Many types of effective treatments, able to address a variety of wrinkles
It is aesthetic medicine that can resolve neck wrinkles that have already set in.
This is because cosmetics are for "prevention and maintaining the status quo," whereas medicine is said to "bring about change (effects and benefits) in the body."
Aesthetic medicine offers a wide variety of treatments — injectables such as hyaluronic acid, energy-based treatments such as lasers, and surgical procedures for severe sagging — addressing a wide range of wrinkles.
Self-care is limited in how far its effects can reach, and it is said to be difficult to reverse wrinkles that have already formed. If you are troubled by neck wrinkles and want to do something about them, aesthetic medicine is worth considering as an option.
Q: What treatment do you recommend for someone with severe neck wrinkles?
The injectable procedures Profhilo injection, Jalupro HMW injection, and PRP injection are the recommended treatments. The reason is that they carry fewer risks and side effects yet still let you feel meaningful results.
In aesthetic medicine, side effects, including risks and downtime, are always present to varying degrees. These three procedures also carry risks and side effects, but they are considered relatively minor, with downtime limited to the pain of the needle insertion during the procedure and possible bruising or redness afterward.
On the other hand, these three procedures not only make wrinkles less noticeable but may also help address the thinning of the skin (such as the loss of collagen, elastin, and hyaluronic acid) that is the root cause of wrinkles. In other words, they may help resolve existing wrinkles while also supporting prevention of future ones.
[Aesthetic Dermatology Treatment] Treatments recommended by aesthetic dermatologists for improving neck wrinkles
We introduced "Profhilo injection," "Jalupro HMW injection," and "PRP injection" as recommended treatments for people with severe neck wrinkles; here we explain what each of these procedures involves.
These three treatments
- Profhilo injection & Jalupro HMW injection: non-cross-linked hyaluronic acid formulations
- PRP injection: regenerative medicine
can be broadly classified as follows.
profhilo injection
Profhilo injection is a formulation whose main ingredient isnon-cross-linked hyaluronic acidwhat is known as next-generation hyaluronic acid.
What is non-cross-linked hyaluronic acid?
Non-cross-linked hyaluronic acid refers to hyaluronic acid that is not cross-linked.
Cross-linking means chemically bonding molecules together, but unlike conventional hyaluronic acid, non-cross-linked hyaluronic acid does not stay in the injected area to create volume;it is hyaluronic acid in a form that allows the injected hyaluronic acid to penetrate easily into the skinis how it can be described.
Hyaluronic acid has both a moisturizing effect and the ability to stimulate and activate cells.Therefore, the injected non-cross-linked hyaluronic acid penetrates and diffuses widely, providing a moisturizing effect over a broad area and promoting cell activation.
Cell activation also extends to the "fibroblasts," the cells in the dermis that give rise to various cell types. When fibroblasts are activated, they replicate themselves and produce new collagen, elastin, and hyaluronic acid, enriching the dermis and strengthening the skin's self-repair function.
Incidentally, this kind ofenrichment of the skin tissue and strengthening of its self-repair functionECM remodelingis what is called (ECM remodeling).
Profhilo is characterized by its high concentration of two types of non-cross-linked hyaluronic acid — low and high molecular weight — and by its "penetrating power that reaches deep and wide in multiple directions."
When this penetrating power carries the effects of hyaluronic acid all the way to the subcutaneous tissue, moisture reaches deep into the inner skin. Cell activation is also said to extend to the subcutaneous tissue, which is thought to help restore healthy, firm skin.
If you would like to know more about Profhilo, please refer to this article.
Because of these effects of Profhilo, the dryness and the decline in collagen and elastin that cause neck wrinkles are addressed, sothe texture across the entire neck can be expected to become more even, brighter, plumper, and healthier.
Jalupro HMW injection
Jalupro HMW injection is also a non-cross-linked hyaluronic acid formulation, so like Profhilo injection it can be expected to provideECM remodelingits effects. (ECM remodeling is explained in the section on Profhilo injection, so please refer to that.)
Jalupro HMW injection is a formulation whose main ingredients are non-cross-linked hyaluronic acid and amino acids, and it is characterized by its use of high-molecular-weight non-cross-linked hyaluronic acid.
The larger the molecular weight, the harder it is to pass through the gaps between skin cells, and the longer it takes to break down. Although non-cross-linked hyaluronic acid has the property of "diffusing," compared with low-molecular-weight versions it tends to stay in the injected area, and its effects last longer.
Because of these effects and properties,Jalupro HMW is thought to be particularly effective for set-in horizontal wrinkles and the like.
In other words, when injected into wrinkles and hollows, the formulation stays there and fills in the grooves of the wrinkles. In addition, as the hyaluronic acid itself binds with the moisture it draws in, it swells and increases in volume, further reducing the appearance of wrinkles.
At the same time, the ECM remodeling effect restores elasticity and firmness to the skin around the injected area, which is expected to help smooth out skin folds.
If you would like to know more about Jalupro HMW, please refer to this article.
PRP injection
Summary | For resolving neck wrinkles, turn to aesthetic medicine
So far, we have explained the types and causes of neck wrinkles and the effectiveness of the care said to work on them.
As we mentioned at the outset,set-in wrinkles are difficult to resolve without aesthetic medicine, and self-care can be expected to do little more than address surface fine crepey wrinkles.
If you are troubled by neck wrinkles and want to make them disappear, you will likely feel the wrinkles begin to resolve sooner with the help of aesthetic treatments. And at the same time, by being mindful of postures that resist wrinkle formation and practicing daily skincare such as moisturizing and UV protection, we believe you can make the effects of the aesthetic treatments you receive last longer and maintain healthy skin over the long term.
At Smart Skin Clinic, in addition to the three injections recommended above, we offer a full range of other injectable procedures. We also have menus that can be combined with Dermapen or Water Light Injection, which may offer synergistic ECM remodeling effects, so please feel free to consult us.
While listening to your concerns and wishes, we will propose the treatment best suited to you.
Physician Who Supervised This Page
Smart Skin Clinic, Chief Medical Director / Physician
Kota Ishii
We oversee treatment policies across the entire group, tailored to the skin condition of each individual patient. The content on this page has been reviewed and approved in line with our clinic's treatment policies.
Interview with Director Kota Ishii
Kota Ishii, our Chief Medical Director, shares our clinic's approach to patient care.
Clinic List
Jimbocho Clinic
〒101-0054
3-16-1 Kanda Nishiki-cho, Chiyoda-ku, Tokyo, EX Kanda Nishiki-cho Building 8F (general reception) / 7F
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〒221-0835
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- Last supervision date: June 26, 2025