The neck and ‘V’ of the chest (or décolletage in women) usually sustains a high degree of sun exposure throughout life. Excess sun exposure prematurely ages this thin skinned area, creating a bumpy ‘chicken skin” appearance and a characteristic red-brown discolouration that looks like a permanent tan or sunburn.
These skin changes are called poikiloderma of Civatte and it is extremely common among women in Australia. Visible signs may appear in the early 30’s and without intervention will progress, creating a telltale aging imbalance between the colour of the face and that of the neck and chest, that’s in stark contrast to the harmony of youth.
Like any skin exposed to the sun, over time other types of pigmentation and blemishes occur on the neck and chest such as freckling, skin tags, sun spots, and flat seborrhoeic keratoses.
Fortunately many of these conditions are responsive to laser treatments.
An ounce of prevention…
As with facial rejuvenation, prevention is the best cure and the number one preventative measure is to apply a SPF 30+ sunscreen to ALL exposed skin on a daily basis, whether or not you intend to be in the sun.. Avoid applying perfumes to sun exposed areas.
Cosmeceutical skin care is as important for the neck and chest as it is for the face. Prescription strength lightening agents and vitamin A are sometimes recommended to treat some types of pigmentation and to improve the texture of sun damaged skin.
Redness and Brown Pigmentation on the chest or neck (Poikiloderma of Civatte)
In Australia the sides of the neck and upper chest are uniquely prone to Poikiloderma of Civatte. .Poikiloderma causes a red or red-brown discolouration with a “chicken skin” texture that characteristically spares the shaded area under the chin. Though the exact cause of Poikiloderma is unknown, contributing factors are thought to include fair skin, accumulated sun damage, use of cosmetics and perfumes that make the skin more sensitive to the sun, and hormonal factors.
Treatment of Poikiloderma: Poikiloderma can be difficult to treat, but noticeable improvement can be achieved over a course of laser or IPL treatments that target the brown pigmentation and microscopic blood vessels that discolour the skin. Because the skin on the neck and chest is quite thin, laser and IPL treatments must be applied cautiously, and never as intensely as on the face. For this reason, results accrue over a course of gentle treatments
Brown spots, cherry angiomas and surface capillaries that enlarge to form spider like spots are common signs of sun damage. These respond well to vascular laser or Broad Band Light treatment which is selectively absorbed into abnormally coloured skin.
Senile Warts (Seborrhoeic Keratoses, Seborrhoeic Keratoses)
Senile warts, known medically as seborrhoeic keratoses, are waxy looking skin growths that occur commonly on the chest, neck and back in middle age. They make the skin feel unpleasantly rough. Although the exact cause is unknown, they seem to run in families and can get quite large. They often begin as small flat brown or flesh coloured rough bumps but if untreated can thicken and spread. Senile warts are benign and treatment is purely cosmetic.
Treatment: The Erbium laser vaporises keratoses precisely, with no effect on the surrounding skin. The Erbium is computer controlled which allows your doctor to remove wafer thin slices of tissue and to treat only as deeply as is needed. New skin quickly regrows, leaving you with smoother, healthier, more vibrant skin.
Skin tags are common, benign skin growths that begin in middle age as a smooth bump and develop into a small piece of hanging skin with a small, narrow stalk. About 50% of people suffer from skin tags, which commonly occur on the neck, armpits and groin.
Treatment: Skin tags respond well to Erbium laser treatment. This treatment is particularly suitable for those with multiple tags. The Erbium laser is minimally invasive, almost pain free, and causes no disruption to the surrounding skin. Tiny pinhead grazes are simply dressed with Vaseline heal invisibly over a few days.
Sunspots, also known as solar keratoses or actinic keratoses, are rough spots that often occur against a background of sun damage in skin that is wrinkled, mottled, and discoloured from too much sun. Sun spots or actinic keratoses are generally small, 2-6 millimetres in diameter, red and rough and often have a white or yellowish scale on top. In addition to feeling rough, actinic keratoses may feel sore or painful when fingers or clothing rub against them.
Sun spots are precancerous, which means they can develop into skin cancer. The best treatment for an actinic keratosis is prevention by minimising sun exposure. Once they occur, treatments for sun spots include freezing, cutting or burning, prescription creams, laser or photodynamic therapy.
Poor skin texture
Many factors, including age, health, skin type, and the amount of sun damage, influence the treatment your doctor may recommend to rejuvenate the skin of your neck and chest. In some cases, more than one treatment may be used to produce better and longer-lasting results.
Treatment: Either prescription or “doctor’s only” skin care products both prevent and help to rejuvenate milder signs of aging, such as fine lines and superficial wrinkles. Fraxel laser is a non-invasive treatment that rejuvenates skin texture and colour over a course of treatments. Small columns of laser energy penetrate the skin to stimulate new collagen growth, safely and with minimal downtime.