Neck Area

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Neck Lines

Neck lines, also known as “necklace lines,” are horizontal creases that develop across the neck. These lines can become more pronounced with age and may significantly affect the appearance of the lower face and neck contour. Given the thin, mobile nature of neck skin, this area is particularly vulnerable to early signs of ageing.

Typical Concerns Include:

• Fine or deep horizontal lines across the neck

• Creases and folds that become static over time

• Mild to moderate skin laxity

• Disruption of neck contour and definition

What Causes Neck Lines?

Neck lines develop due to a combination of intrinsic ageing and external factors of the platysmal muscle area:

• Ageing: With time, collagen and elastin levels decline, resulting in thinner, less elastic skin that creases more readily with movement.

• Muscle Activity: Repetitive contraction of the platysma muscle contributes to the formation and deepening of horizontal lines.

• Sun Exposure: The neck is often neglected in sun protection, leaving it exposed to UV damage that accelerates collagen breakdown.

• Genetics: Some individuals are more prone to developing neck lines due to inherited skin type and structural factors.

• Lifestyle: Smoking, dehydration, and prolonged neck flexion (e.g. looking down at devices – “tech neck”) can all exacerbate these lines.

Primary Treatment: Botulinum Toxin

The most effective treatment for dynamic neck lines caused by repetitive muscle activity is botulinum toxin. When strategically injected into the platysmal bands and superficial layers of the neck, toxin reduces muscular tension, softens horizontal creases, and improves neck contour.


Benefits include:

• Smoothing of dynamic horizontal lines

• Softening of vertical banding

• Subtle lifting effect in the lower face and jawline (“Nefertiti lift”)

• Minimal downtime and natural-looking results


Toxin is particularly effective for early to moderate neck lines and can be used preventatively to delay further deepening of creases.

Complementary Treatment Options

While toxin addresses the muscular component of neck ageing, adjunctive treatments are often beneficial for improving skin quality, texture, and resilience:

• Skin Boosters: Deliver deep hydration and improve elasticity, helping to plump fine lines and smooth the skin’s surface. Ideal for dehydrated or environmentally damaged skin.

• Polynucleotides: Support tissue regeneration and fibroblast stimulation, offering long-term improvements in skin firmness, tone, and crepiness.

• Platelet-Rich Plasma (PRP): Stimulates natural collagen production using the patient’s own growth factors. Effective for restoring skin vitality and structure over time.

• Microneedling: Induces controlled collagen production to improve texture and fine lines.

• RF Microneedling: Combines mechanical stimulation with radiofrequency energy to tighten and remodel the deeper dermal layers. Particularly effective for laxity and deeper lines.

• Dermal Fillers: For more established static lines, very soft dermal fillers may be used to restore lost volume and smooth deeply etched creases, although this is typically used selectively and in combination with regenerative treatments.

A comprehensive consultation is essential to assess the degree of neck ageing and determine the most appropriate treatment plan. In most cases, toxin serves as the foundation for rejuvenation, while other therapies complement and extend results through skin quality improvement.

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