Rejuvenating the neck, décolleté and hands: treatments for the forgotten areas
The face is cared for and treated, while the neck, décolleté and hands are often forgotten and then give away a person's age all the more clearly. This page goes through them area by area: neck lines and crepey skin, sleep lines and sun damage on the décolleté, thin and blotchy skin on the back of the hand.
You will find out why these areas need more cautious settings, which technique fits where and how many sessions and how much downtime to expect. The matching SIACSKIN devices are the TULIX, the DERMAFORCE BBL PRO, the EUPHEUS M8 and the FRACO CO2 XL.
Why do the neck, décolleté and hands age faster than the face?
These three areas age visibly faster because their skin is thinner, has fewer sebaceous glands and hardly any subcutaneous fat, and is constantly exposed to the sun. The face receives skincare and sun protection daily, whereas on the neck the cream usually stops at the chin, and the hands are left without protection again after every wash. Then there is mechanical strain: the neck bends when you look down, the décolleté folds when you lie on your side, and the hands are constantly in motion. The result is horizontal lines and crepey skin on the neck, vertical lines and pigment spots on the décolleté, and age spots and thin skin on the back of the hand.
Treatment depends on the findings: pigment spots and redness with the DERMAFORCE BBL PRO, surface and fine lines with the TULIX, declining firmness with the EUPHEUS M8.
Why does thin skin on the neck and décolleté need more cautious laser settings than the face?
Because the skin there heals more slowly and copes less well with heat. After a laser treatment, new epidermis grows back from hair follicles and sebaceous glands. There are a great many of these on the face and markedly fewer on the neck, décolleté and back of the hand. At the same time the dermis is thinner, so the heat reaches deeper layers more quickly. Anyone who simply transfers facial settings risks prolonged redness, pigment changes and, in the worst case, scars. The rule is: less energy, lower density, preferably one more session and a test patch beforehand.
The TULIX can be finely graduated from 0.5 to 300 mJ and works non-ablatively, which makes it the obvious choice for these areas. On the FRACO CO2 XL, the gentle CoolPeel mode is available for sensitive areas.
What helps with horizontal neck lines (phone neck lines, tech neck)?
The combination of collagen build-up in the dermis and a smoother surface is most likely to help with horizontal neck lines. The horizontal lines are partly predetermined and partly caused by constant bending of the head, for example when looking at a phone. Over time the collagen along the line breaks down. Devices can densify the skin there and make the lines shallower; deeply etched necklace lines rarely disappear completely. Posture and sun protection help determine how long the result lasts.
The EUPHEUS M8 delivers radiofrequency into the dermis with fine needles, and the depth is adapted to the thin neck skin in 0.1 mm increments. The usual course is 3 to 4 sessions at intervals of 4 to 6 weeks. The TULIX complements this at the surface with 1927 nm and reaches the dermis with 1550 nm.
Crepey skin on the neck improves with procedures that densify the upper dermis and renew the epidermis. The skin looks like crêpe paper because elastic fibres break down through sun and age and the epidermis becomes thin and dry. Unlike with a single wrinkle, the whole area is affected. That is why fractional procedures covering the whole area are more suitable than localised solutions. The skin becomes denser and smoother, but it does not regain its former thickness. Rich skincare and sun protection are part of it.
The TULIX combines 1927 nm for the epidermis with 1550 nm for the dermis and works non-ablatively, usually in 3 to 5 sessions. The FRACO CO2 XL in CoolPeel mode has a stronger effect, though on the neck only with conservative settings.
Tightening the neck without surgery: when is ultrasound (HIFU) suitable and when RF microneedling?
Ultrasound is suitable when the skin on the neck as a whole gives way and the contour beneath the chin becomes softer; RF microneedling when wrinkles and skin quality are the main concern. Focused ultrasound places thermal points at a defined depth beneath the skin and leaves the surface untouched. RF microneedling works in the dermis itself and in doing so also improves texture and crepey lines. Marked excess skin is corrected only by surgery.
The DERMALIFT lists the neck and décolleté as applications. One session is usually enough; the result builds up over 2 to 3 months and lasts 12 to 18 months. The EUPHEUS M8 needs 3 to 4 sessions at intervals of 4 to 6 weeks and at the same time improves the skin surface. The two procedures can be scheduled one after the other.
What helps with sleep lines on the décolleté between the breasts?
New collagen in the dermis helps with the vertical lines on the décolleté, ideally combined with a different sleeping position. The lines form when, in a side-lying position, the breast pushes the thin skin together night after night. As long as the skin is elastic, it smooths out again in the morning. Over the years and with sun damage, the lines remain. The earlier treatment takes place, the better they can be softened. Deep lines that have existed for years become shallower but not invisible.
With RF microneedling, the EUPHEUS M8 places the heat directly beneath the lines, set to a shallow depth and cooled afterwards with the Cold Hammer. The TULIX additionally improves the sun-damaged surface. Sleeping on your back and daily sun protection protect the result.
How do you treat reddish-brown discolouration on the neck and décolleté caused by sun damage?
Reddish-brown, net-like discolouration on the sides of the neck and on the décolleté responds best to broadband light. The picture develops after years in the sun: dilated thread veins, brown pigment and thinning skin lie side by side. The pale patch beneath the chin, which lay in the shade, is typical. Because red and brown have to be treated at the same time, light with interchangeable filters has the advantage over a laser with only one wavelength. Treatment is carried out with low energy and several sessions, otherwise stripes or pale imprints result.
The DERMAFORCE BBL PRO lists sun damage, vessels, redness and hyperpigmentation as applications and has 9 filters; it is intended for skin types I to IV. The usual course is 3 to 5 sessions at intervals of 3 to 4 weeks.
In what order do you treat pigmentation, redness and wrinkles on the décolleté?
The order of colour, then texture, then firmness has proved its worth. First, pigment spots and redness are evened out, because they age the décolleté most and improve most quickly. Next comes the surface with fine crepey lines and rough skin. Finally comes collagen build-up against the deeper vertical lines. There is an interval of about 4 weeks between any two procedures. Anyone who starts the other way round smooths skin that still looks old because of the pigment spots.
With SIACSKIN devices this means: 3 to 5 sessions with the DERMAFORCE BBL PRO, then a course of treatment with the TULIX, followed if required by RF microneedling with the EUPHEUS M8. For darker skin types, the TULIX also takes on the first step; it is specified for pigment and sun damage in all skin types.
How do you improve thin, crepey skin on the back of the hand?
Thin, crepey skin on the back of the hand can be visibly densified with a non-ablative fractional laser, but the effect is more modest than on the face. Here the skin lies over tendons and veins with almost no fat pad and has few reserves for healing. That is why gentle procedures that leave the surface intact are the first choice. They stimulate collagen, and the skin looks smoother and less translucent. This does nothing to change visible veins and tendons, because volume is lacking beneath the skin there; a medical practice can advise on that.
The TULIX works at 1550 nm in the dermis and at 1927 nm at the surface, where it treats age spots at the same time. On the back of the hand, RF microneedling with the EUPHEUS M8 only makes sense at a very shallow setting.
Is the fractional CO2 laser too risky on the décolleté and hands?
The CO2 laser becomes risky on the décolleté and hands above all with facial settings; with reduced energy and density it can be used there. Outside the face, ablated skin heals more slowly, redness lasts longer, and the risk of pigment changes and scars increases. Treatment is therefore shallower and with greater spacing between the dots, often in several mild sessions instead of one intensive one. For many findings a non-ablative procedure is enough; the CO2 laser remains reserved for pronounced sun damage and coarse texture.
The FRACO CO2 XL can be finely dosed via pulse widths from 0.1 ms and offers a gentle mode with CoolPeel. The non-ablative TULIX, which SIACSKIN lists as a complement to the CO2 laser, serves as a cautious introduction.
How long does healing take on the neck, décolleté and hands compared with the face?
Expect markedly longer healing on the neck, décolleté and hands, often twice the time. After BBL, darkened pigment spots flake off after around 1 week on the face, but more like 2 to 3 weeks on the hands and décolleté. After the non-ablative fractional laser, redness on the décolleté often persists a few days longer, and the fine flaking can go on for up to 2 weeks. RF microneedling leaves 1 to 3 days of redness and occasionally small bruises on the neck. A practical point: the neck and décolleté can be covered with a scarf or blouse, the hands cannot.
Recovery is shortest with the DERMAFORCE BBL PRO and the TULIX, because both leave the surface intact. With the FRACO CO2 XL, more than the 3 to 4 days usual for the face must be allowed, even in CoolPeel mode.
How many sessions do the neck, décolleté and hands need before a result is visible?
It usually takes 3 to 5 sessions per area, and the first changes often show after the second. Because less energy is used in these areas, the number tends to be at the upper end of the usual ranges. Pigment spots respond fastest: after 1 to 2 light treatments, the back of the hand and the décolleté are often markedly more even. Wrinkles and crepey skin require patience, as new collagen forms over 3 to 6 months. After that, 1 to 2 top-ups per year are generally sufficient, provided sun protection is adequate.
Guide values: with the DERMAFORCE BBL PRO, 3 to 5 sessions every 3 to 4 weeks; with the TULIX, 3 to 5 sessions about every 4 weeks; with the EUPHEUS M8, 3 to 4 sessions at intervals of 4 to 6 weeks.
Should the neck and décolleté always be treated together with the face?
Yes, in most cases this makes sense, because otherwise a visible edge appears at the jawline. An even, fresh face above a blotchy neck looks incongruous and draws the eye to the difference all the more. Including these areas is simple: same session, adjusted parameters, a little more time. The settings are reduced step by step going downwards, from the face via the neck to the décolleté. For studios and practices this is an obvious additional service that visibly improves the overall result.
With its 45 × 15 mm spot, the DERMAFORCE BBL PRO covers large areas such as the décolleté swiftly. The TULIX works with a scan field of up to 20 × 20 mm and can be set individually for each area.
How do you care for the neck, décolleté and hands properly after treatment?
The key points are cooling, rich skincare, little friction and consistent sun protection. Clothing chafes the neck and décolleté: in the first few days, wear soft, low-necked clothing and avoid necklaces, woollen scarves and perfume on the treated skin. The hands need cream and sunscreen again after every wash, and gloves for housework. Do not rub off flakes and darkened pigment spots; they come away by themselves. Sauna, swimming pool and exercise should be avoided for 2 to 3 days, and intense sun for about 4 weeks.
This applies after the TULIX just as it does after the DERMAFORCE BBL PRO or the EUPHEUS M8. SIACSKIN has its own skincare for the days afterwards, including the Sensitive Cream and the Suncream Sensitiv SPF50. Details can be found in the Aftercare Guide.
Which devices does a studio need for treating the neck, décolleté and hands?
For the majority of enquiries, 2 to 3 devices are enough: light for pigment spots and redness, a non-ablative laser for the surface and RF microneedling for firmness. Pigment spots, redness and crepey skin make up the largest share of demand, and tightening of the neck the rest. Those who already offer facial treatments usually do not need a new device but adjusted settings and an offering that expressly names the areas. Who may carry out which treatment is regulated differently from country to country.
The DERMAFORCE BBL PRO takes care of sun damage and redness in skin types I to IV, and the TULIX of pigment, fine lines and skin texture in all skin types. The EUPHEUS M8 adds tightening on the neck and décolleté. Training on the device is included free of charge with purchase.
