Skin Care For the Neck, Decollete and Hands: Treatments to Reverse Signs of Sun Damage, Aging and Skin Cancer


Most skin care regimens are recommended for the face to reverse signs of sun damage and aging. What is forgotten is the fact that the neck, hands and decollete (upper chest area) are often subjected to the same or even greater amounts of sun damage. Because these areas are often neglected in a daily skin care routine, and they are much more sensitive, Dr. Matthew Schulman, Board Certified Plastic Surgeon and Assistant Professor of Plastic Surgery at Mount Sinai School of Medicine, has offered these tips for proper skin care of the neck, decollete and hands.

Exfoliate Daily

A gentle exfoliation with alphahydroxyacid or enzymes should be done daily. Do not use creams or cleansers that contain crystals or beads for exfoliation as these products are too harsh for the sensitive areas of the neck, decollete and hands and could actually cause irritation. Cleansers that contain glycolic acid, lactic acid or a combination are recommended. Enzyme cleaners (like pumpkin) also work well.

Use a Good Quality Moisturizer Often

Body moisturizing often gets overlooked. Lotions or creams should be applied shortly after showering to get good penetration into the skin. Moisturizers containing peptides have shown greater penetration into the deeper layers of the skin. For the neck, decollete and hands, it is possible to get a slightly heavier moisturizer than used on the face because makeup won’t be applied on top. In addition to sun exposure, the hands are regularly exposed to toxins, irritants and frequent hand washing, so it is vital that moisturizer is reapplied to the hands throughout the day.

Do Not Forget Sunscreen

The neck, decollete and hands receive significant sun exposure and are areas that show sun damage such as pigment irregularity and skin cancers. Check labels carefully to be sure that the sunscreen contains protection from both UVA and UVB. Sunscreen should be applied in the morning and reapplied if significant time is spent outdoors. An SPF of 30 is adequate for daily use. Exposure to strong sunshine for long periods will require the use of a stronger sunscreen.

Retinol and Retin A

Retinols are by far the most powerful skin care ingredient and have been clinically proven to reduce lines, wrinkles and more importantly reverse early skin cancers. Retinols are the over-the-counter version of more powerful prescription retinoids (Retin A). Retinols should only be used at night because they are inactivated by sunlight. Because it can be irritating to the skin at first, use it on the neck, decollete and top of hands every 3 nights for 2 weeks, then every other night for 2 weeks and if it is tolerated, increase to every night. Because these areas are more sensitive than the face, it is fine to continue use every other night. Slight redness and flakiness are normal during initial use. The key to minimizing irritation is to only use a small amount and to only apply it to skin that has adequately dried. This means waiting a half hour after washing and drying the skin before applying. Improvements will be seen after about 6 to 8 weeks.

Suppressing Pigments with Kojic Acid

Kojic acid is a pigment suppressing compound derived from plants. Available in lotions and creams, it is used to reduce pigment irregularities in the face, neck, decollete and hands by lightening dark spots and evening out irregular skin tones. Continued use of kojic acid is important or the pigment irregularities will return with sun exposure. Improvements will be seen after 2 weeks.


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