It's one of the places we forget to put daily sunscreen, the neck, where thinner skin can show signs of damage more quickly.
No results are as good as a surgical lift, but Wrinkle Free Friday found some easy fixes.
At 64 years old, Kris Capshaw of New Orleans, is in shape, lean from Pilates. But something was starting to bother her.
"Well it's getting loose and sagging a little and seeing those lines in the pictures, didn't like that as much," said Capshaw about her neck.
She does not want surgery on her neck so her dermatologist, LSU Health Sciences Center's Dr. Deirdre Hooper, is using Botox to lift the skin of her neck and sculpt her jaw line.
As Dr. Hooper gives the tiny injections she tells her patient, 'Clench, clench your teeth,' so she can see where the muscles band.
"Botox in the neck is ideal for a person who doesn't have a lot of fat along their jaw line or fat deposits under their chin. It's not good for a person who has a lot of sagging or loose skin," said Dr. Hooper, who's uptown clinic is called Audubon Dermatology.
Temporarily weakening neck muscles that are very strong and pulling skin down, will give her a lift.
Mirta Valdes is also 64 years old and grew up in the Cuban sun. She wants LSU Health Sciences Center dermatologist Dr. Sarah Jackson to fix the crepiness caused by damage from ultraviolet rays. So she has turned to Nectifirm, a non-prescription cream dispensed in doctor's offices.
"It's just softer and people notice you, know people who haven't seen me for a while. 'Smooth,' it is the first word that I hear. 'Your skin looks smooth,'"
Since the skin of the neck is much more sensitive with fewer oil glands and hair follicles, many people can't tolerate the number one proven anti-wrinkle cream, a prescription retinoid such as Retin-A, Renova or Tazorac. So they turn to Nectifirm, an anti-aging concoction of antioxidants, peptides and growth factors.
"The basic science behind the product is good and when you have happy patients who say that a product works, that's what I go by," said Dr. Sarah Jackson, of Audubon Dermatology, who explained that the product as a whole was not subject to scientific studies for FDA approval.
"It's one of our most popular products," said New Orleans Dermatologist Dr. Mary Lupo.
So Dr. Lupo had me do an experiment. She took 'before' pictures of the insides of my elbows in the creases. There is a lot of crepiness from those years and years of massive sunbathing in my youth. She told me every night to take some Nectifirm and only put it on the inside of my left arm. Then, three and a half months later, she took 'after' pictures to document the difference. We also had people in her office guess to see if they could tell which one was the one that had be exposed to Nectifirm.
Directions are to use it twice a day. I used it only once a day. Most of the women on her staff, but not all, guessed the correct arm.
"There have been studies that have been done whether it's crow's feet or around the neck, just sheer hydration alone can improve some of the crepiness and can improve some of the fine lines and wrinkles. So we think that these creams work primarily as hydrators as emollients and probably less as firming agents," explained Metairie dermatologist Dr. Patricia Farris, who is also a spokeswoman for the American Academy of Dermatology.
Since there are many different causes of neck skin problems, a board certified dermatologist can best tell you what treatment will be the most effective for you. Many combine Botox and Nectifirm. Dr. Jackson tells her patients to try Nectifirm for four to eight weeks. If patients don't see a benefit, laser or other heat devices may be needed. Dr. Lupo agrees.
"When you use Botox in conjunction with a product like Nectifirm and with a product like a radio frequency heating device, like Exilis, you can get some very good
nonsurgical improvement of the aging neck," said Dr. Lupo.
Nectifirm is sold in doctor's offices for $60. According to Dr. Farris, the product may mostly work by constantly hydrating, but it may also offer some long term firming by building collagen.
Doctors say it may be a little too thick for some people to use on the face.
Editor's note: Dr. Patricia Farris is no relation to Medical Reporter Meg Farris.