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Skin Condition · Kensington, London
Neck and Chest Wrinkles, Crepey Skin and Sun Damage
Neck and chest ageing shows as crepey, slack skin, horizontal necklace lines, vertical bands down the front of the neck and mottled red-brown discolouration across the upper chest. The skin here is thinner than facial skin and carries fewer oil glands, it takes daylight every day, and it is the area people protect least — so it ages ahead of the face above it.
- Sun damage and laxity
- Whole area examined first
- Kensington clinic
- Medically reviewed by Dr Prasad
This page reflects how ageing of the neck and chest is assessed and managed at Faciem, and is reviewed for clinical accuracy.
Last reviewed: 15 September 2026.
Patient information only. Sun-damaged skin on the chest can hide lesions that need examining, and any treatment plan follows a face-to-face consultation with Dr Prasad.
Patients since 2019
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TL;DR
Neck and chest ageing is the combination of thinning skin, declining collagen and elastin, and accumulated sun damage across an area exposed daily and protected rarely. It shows as crepey texture, horizontal necklace lines, vertical bands down the front of the neck, and the mottled red-brown discolouration known as poikiloderma of Civatte, which characteristically spares the shaded skin under the chin. Pigment, redness and skin quality are treated as three separate problems, and improvement is gradual. Assessment at Faciem is by Dr Prasad, a GMC-registered doctor with 20 years in dermatology.
- Thinner skin, fewer oil glands than the face
- Sun damage spares the shade under the chin
- Texture, redness and pigment treated separately
About the Condition
What Is Neck and Chest Ageing?
Neck and chest ageing is the loss of collagen and elastin from skin that is thinner and more sun-exposed than the face. It produces crepey, slack texture, creases that hold when the skin is pinched, and uneven brown and red discolouration across the upper chest. Most people meet it earlier than they expect.
What ageing on the neck and chest looks like
Three changes appear together on the neck and chest, in varying proportions. Texture goes first: skin that once sprang back holds a pinch, looks finely crepey in raking light, and develops fine vertical creases on the chest. Lines follow — horizontal necklace creases that settle into fixed folds, and vertical bands running down the front of the neck where the edges of the platysma muscle stand proud. Colour comes last: mottled red-brown discolouration across the sides of the neck and the V of the chest, with fine vessels visible inside it. That pattern has a name, poikiloderma of Civatte, and a useful giveaway — the shaded skin directly under the chin stays pale, because the jaw shields it from the sun.
Who tends to notice it
Ageing of the neck and chest becomes noticeable from the forties onwards in most people, and earlier in those with fair skin, a history of sunbathing or sunbed use, or the habit of applying sunscreen to the face and stopping at the jawline. Poikiloderma of Civatte is considerably more common in women and in fair skin types. Smoking speeds the whole picture up by degrading elastin. Skin tone is graded on the Fitzpatrick scale — I to VI, from skin that always burns to skin that rarely does — before any peel or light-based treatment is chosen for this area. Deeper tones, Fitzpatrick IV to VI, show less redness and less vessel change, but uneven pigment and slack texture still occur and can be treated; the strength, depth and interval are pulled back and a test patch counts for more, because the risk being managed here is post-inflammatory pigmentation on skin that already heals slowly.
What it is often confused with
Not everything on an ageing chest is simple sun damage. Actinic keratoses are rough, scaly, sandpapery patches of sun-damaged cells that come and go; they need assessing, not moisturising. Sun spots sit as discrete brown marks on otherwise normal skin, while poikiloderma is a mottled background. Seborrhoeic keratoses look stuck on and feel raised to the touch. Erythema ab igne leaves a lacy brown pattern where heat, not light, has done the damage — classically a laptop or a hot water bottle. Rosacea can extend below the jaw, but its redness flushes and settles, whereas sun-related redness stays put. A fungal or heat rash across the chest can also discolour the skin, though both usually itch and sun damage does not. Any single scaly patch that persists, bleeds or grows should be examined, not creamed.
Causes & Contributing Factors
What Causes Neck and Chest Ageing?
Neck and chest ageing is caused by cumulative ultraviolet exposure acting on skin that was thinner to begin with. Collagen and elastin break down faster than they are replaced, pigment cells respond unevenly, and small blood vessels dilate and stay visible.
Cumulative sun exposure
Ultraviolet light breaks down collagen and elastin and drives the mottled pigmentation and visible vessels of poikiloderma of Civatte. The neck and chest take daily incidental exposure — walking, driving, sitting by a window — and are the areas most often missed when sunscreen goes on.
Thinner skin with fewer oil glands
Skin on the neck and chest is thinner than facial skin and carries fewer sebaceous glands, so it holds less moisture and turns crepey sooner. It also heals more slowly, which is why it tolerates strong treatment less well than the face does.
Collagen, elastin and volume loss
Collagen production falls steadily from the twenties onwards and more sharply around the menopause, while sun-damaged elastin builds up as disorganised material. Volume is lost from the tissues underneath at the same time, so the skin loses recoil and starts to hold creases that once relaxed on their own.
Repeated movement and posture
Horizontal neck lines deepen with constant flexion, and the vertical bands down the front of the neck are the edges of the platysma muscle becoming more prominent with age. Long stretches looking down at a screen add to the horizontal creasing.
Smoking and lifestyle
Smoking degrades elastin and reduces the blood supply to the skin, accelerating laxity and dullness. Sleeping on one side creates vertical chest creases over years, and significant weight change alters how much the skin has to retract.
Treatments We Offer
How Neck and Chest Ageing Is Treated at Faciem
Neck and chest ageing is treated as three separate problems: the pigment and redness of sun damage, the quality and hydration of the skin itself, and the lines produced by muscle movement. Because this skin heals more slowly than the face, everything used here is pitched more conservatively than the same treatment above the jawline.
01
Medical-Grade Skincare
Topical retinoids, antioxidants and pigment-directed actives improve texture and even out sun-related discolouration on the neck and chest over months. Daily broad-spectrum sun protection applied below the jawline is what stops the damage accumulating further.
Best for: mottled discolouration and early crepey texture
Read about Medical-Grade Skincare
02
Chemical Peels
Peels lift sun-related pigment and refine rough texture across the chest, working alongside skincare that slows new pigment forming. Depth is kept more conservative here than on the face, because neck and chest skin heals slowly and marks readily.
Best for: established pigment and rough texture
Read about Chemical Peels
03
Injectable Skin Boosters
Hyaluronic acid skin boosters such as Juvederm Volite are placed into the dermis to improve hydration and the fine crepey creasing of the neck and chest. They add moisture and skin quality, not volume or lift, and the effect builds gradually and is then topped up.
Best for: crepey texture and fine vertical chest creases
Read about Injectable Skin Boosters
Microneedling and Profhilo are also used at Faciem to stimulate collagen in this area, and anti-wrinkle injections can soften prominent vertical neck bands where muscle movement is the main driver. Skin that has become genuinely lax will not be tightened by any of this, and Dr Prasad says so at the outset. Which options are used, and in what order, is decided face to face, and how much each person gains differs.
When to Seek Medical Advice
When Should You See a Doctor About Neck and Chest Skin?
See a doctor about neck and chest skin when one patch behaves differently from the background change around it. Sun damage is diffuse and roughly symmetrical; a single rough, scaly, growing or bleeding spot inside sun-damaged skin is not, and that difference is what needs examining.
Worth getting checked
- A rough or scaly patch that persists, keeps returning or feels like sandpaper
- Any spot that is growing, bleeding, crusting or failing to heal
- A new or changing mole on the chest, back or shoulders
- Redness that flushes and burns instead of sitting as fixed discolouration
Conditions that can look similar
- Actinic keratoses, seborrhoeic keratoses, sun spots and early skin cancers all arise in the same sun-damaged skin as ordinary ageing change, and they are easy to overlook against a mottled background. Mole checks matter as much on the chest, back and shoulders as on the face. Anything changing, bleeding, spreading or not settling should be seen in person.
Self-Care & Prevention
What You Can Do at Home for Neck and Chest Skin
Sun protection below the jawline does more for the neck and chest than anything applied afterwards, because ultraviolet exposure drives most of the change seen here. The second priority is treating the area as a continuation of the face, not an afterthought at the end of a routine.
Do
- Apply broad-spectrum SPF 50 to the neck, chest and backs of the hands every morning, and reapply every two hours outdoors
- Take your facial skincare down over the jawline, neck and chest twice a day, morning and night
- Use a richer moisturiser on this area twice daily, since the skin here carries fewer oil glands
- Introduce a retinoid here twice a week for the first four weeks, at a lower strength than you use on the face
Avoid
- Sunbeds and deliberate tanning of the chest, and direct sun between 11am and 3pm, which drive the mottled discolouration
- Strong acids and high-strength retinoids on the neck; stop actives 3 to 5 days before any peel and leave them off for 7 days afterwards
- Scrubbing or exfoliating rough patches more than once a week, which irritates the skin without removing them
- Ignoring a scaly patch in sun-damaged skin that keeps returning or has not settled within 4 to 6 weeks
This is general guidance and does not replace individual assessment. What suits the skin on your neck and chest depends on how much sun damage is present and on your skin tone.
Why Patients Choose Faciem
Why Faciem Treats the Neck and Chest Differently from the Face
The neck and chest are not simply an extension of the face. The skin is thinner, heals more slowly and marks more readily after treatment, so protocols that suit facial skin are not carried down here unchanged.
- Sun damage, texture and movement lines assessed as three separate problems
- Assessed by Dr Prasad, a GMC-registered doctor with 20 years in dermatology
- Conservative depth and strength in an area that heals more slowly than the face
- Clear from the start about what improves and what is laxity treatment cannot correct
Experience & Expertise
Why the Neck and Chest Need a Medical Assessment
The neck and chest are where cosmetic change and clinical change sit side by side. The same ultraviolet exposure that produces the mottled discolouration of poikiloderma of Civatte also produces actinic keratoses and, over years, skin cancers — and against a background of uneven pigment, the one lesion that matters is easy to miss. Caution is practical as well as clinical: this skin has fewer hair follicles and oil glands to drive healing, so peels and energy-based treatment pitched for the face can leave lasting marks here if the depth is not adjusted. Dr Prasad examines the whole area before treating any part of it, separates sun damage from anything needing investigation, and sets out which changes are likely to improve and which are structural laxity that treatment will not correct.
- Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
- Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
- Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
- Face-to-face medical consultation and examination of sun-damaged skin, with dermoscopy where a lesion needs checking
- 20 years’ experience in dermatology, including sun damage and skin ageing across every skin tone
Patient Reviews
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Neck and Chest Ageing FAQs
Your Questions, Answered
Below are the answers given most often when patients ask about crepey skin, neck lines and sun damage on the chest. Anything specific to your own skin is best raised at consultation.
What causes wrinkles and crepey skin on the neck and chest?
Wrinkles and crepey skin on the neck and chest are driven mainly by cumulative sun exposure acting on skin that is thinner and lower in oil glands than the face. Collagen and elastin decline with age and around the menopause, pigment cells respond unevenly, and small vessels dilate and stay visible.
How soon can I go back to work or to an event after neck and chest treatment?
Most neck and chest treatment allows a return to work the same day or the next. A superficial peel typically leaves the chest pink for 24 to 48 hours and lightly flaking for three to five days, while skin boosters leave small raised bumps and occasional bruising that settle over two to five days. If you have a wedding or a strapless dress in mind, schedule the last session at least two weeks ahead, since a v-neck shows everything the collar usually hides.
What is poikiloderma of Civatte?
Poikiloderma of Civatte is the mottled red-brown discolouration, flecked with fine visible vessels, that develops on the sides of the neck and the V of the chest after years of sun exposure. It characteristically spares the shaded skin under the chin. The discolouration itself is harmless, but it marks skin that has absorbed a great deal of ultraviolet, so lesions within it are checked at the same appointment.
How do I get rid of crepey skin on my neck and chest?
Crepey skin on the neck and chest improves gradually with topical treatment that supports collagen, peels that refine the surface, and hyaluronic acid skin boosters placed into the dermis. Improvement is partial, builds over months and needs maintaining, and skin that has become genuinely lax responds least of all. Daily sun protection below the jawline decides how much of the gain holds.
What are the vertical bands down the front of my neck?
The vertical bands down the front of the neck are the edges of the platysma, a broad sheet of muscle that stands out more as the skin covering it thins and loses recoil. Because movement drives them, these bands often soften with anti-wrinkle injections. Fixed horizontal necklace creases and loose skin behave differently and are assessed as separate problems.
Can I sunbathe or go on holiday after treatment on my neck and chest?
Not immediately. Treated skin on the neck and chest is kept out of direct sun for at least four weeks after a peel, with SPF 50 applied below the jawline every morning through the course and after it. Sun on freshly treated skin is what produces post-inflammatory pigmentation, and that clears more slowly here than on the face. Courses are usually planned for autumn and winter for exactly that reason, and a holiday booked mid-course is worth mentioning at the outset.
What determines the cost of neck and chest treatment?
Cost depends on which of the three problems is being treated — pigment, skin quality or movement lines — on how much of the neck, chest and shoulders is covered, and on how many sessions the course runs to. Each option carries its own from-price on its own page, such as chemical peels for sun-damaged skin. Your total is confirmed at consultation before anything starts.
Sources & Further Reading
- Poikiloderma of Civatte — DermNet NZ
- Skin ageing — DermNet NZ
- Actinic keratoses — NHS
These are general sources of patient information and do not replace individual medical assessment. Your own diagnosis and treatment plan come out of your consultation.
Neck and Chest Ageing in Kensington, London
A Doctor-Led Clinic in the Heart of Kensington
Dr Prasad assesses and treats ageing of the neck and chest at Faciem Dermatology & Medical Clinic, on Kensington Church St in Kensington, London. High Street Kensington station is a few minutes’ walk away, Notting Hill Gate around ten, with Kensington council underground parking nearby for patients driving in from further out in West London. The clinic is open Monday to Saturday, 10am–7pm, and closed on Sunday. Because this area is worked on over months, the first appointment is spent examining all of it — neck, chest and shoulders — not only the part you came in about.
Plan Your Visit
- Faciem Dermatology & Medical Clinic
- Phone: +44 20 7131 3539
- 7 Kensington Church St, London W8 4LF, United Kingdom
- Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
- Parking: Kensington council underground car park nearby
- Open Monday–Saturday, 10am–7pm · Sunday closed
- Consultations bookable online; the whole area is examined before any treatment is planned
- Consultation-first — no treatment without medical assessment
- Serving Kensington, Chelsea, Notting Hill & Central London
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Laxity along the jawline, which develops alongside neck ageing and behaves in much the same way.
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Faciem Dermatology & Medical Clinic · Kensington
Book a Neck and Chest Assessment in Kensington
A consultation with Dr Prasad separates sun damage from texture and laxity, checks anything on the chest or shoulders that warrants a closer look, and sets out what treatment can realistically change in skin that heals slowly. Book online or call +44 20 7131 3539.
Prefer to talk? +44 20 7131 3539