- Loose neck skin develops due to aging, overexposure to the sun’s harmful ultraviolet radiation and rapid weight loss.
- Consistent use of at-home creams or lotions and exercise can mildly improve skin laxity of the neck.
- Nonsurgical skin tightening treatments improve skin elasticity in the neck with little to no downtime.
- Cosmetic surgery is the quickest, most dramatic and longest-lasting method to tighten loose neck skin.
Loose neck skin, or “turkey neck,” is a common cosmetic issue that becomes more prominent over time and with age. Fortunately, excessive and sagging skin on the neck and jowls can be treated through a variety of at-home treatments, nonsurgical methods and plastic surgery.
What Causes Loose Neck Skin?
The aging process and excessive exposure to the sun (photodamage) gradually breaks down collagen and elastin, two proteins present within the skin. Over time, skin loses its elasticity and skin laxity (looseness) increases.
Massive and rapid weight loss can also contribute to excess skin in the neck and jowls.
As you age, collagen in your skin is broken down by enzymes called matrix metalloproteinases, or MMPs. MMPs degrade the structure of collagen fibers, reduce their strength and negatively impact the ability of your skin to produce more collagen.
As a result, your skin starts to sag and becomes loose.
Sun exposure (photodamage)
Your neck has the second-most thin skin on your body (after the eyelids). In addition, the neck is often exposed, making it frequently susceptible to UV radiation from the sun.
This leads to photodamage, which increases skin laxity by reducing the amount of collagen and elastin in your skin.
Turkey neck appears after weight loss, especially so for massive and rapid weight loss following obesity. This is due to the skin’s natural pace of shrinkage; it can’t match the rate of weight loss.
Loose neck skin can be tightened through a variety of treatments, each with varying effectiveness, recovery time and side effects.
Treatments to tighten loose neck skin and jowls may be:
- Performed at home, with over-the-counter (OTC) or prescription products, or through preventative methods
- Noninvasive, or nonsurgical, causing no damage to the skin
- Minimally invasive, sometimes requiring sedation and causing light damage to the skin
- Surgical, requiring the use of sedation and anesthesia and performed by your dermatologist or a qualified cosmetic professional
The right choice for you depends on how much excess skin you have, your preference for a given type of treatment and your tolerance for its associated side effects.
At-home treatments for loose neck skin
At-home treatments for tightening sagging skin are an effective option for those not ready—or unwilling—to undergo any type of skin tightening procedure.
Skin-firming creams and lotions
Look for topical creams and lotions that contain a combination of:
- Vitamin B3 or niacinamide, in concentrations of 5% to improve skin elasticity
- Vitamin C or L-ascorbic acid, in concentrations of 5–15% to increase collagen production and protect collagen from being broken down by MMPs
- Vitamin E or alpha-tocopherol, in concentrations of 2–20% to smooth the skin and protect against photodamage
- Retinol, or vitamin A to encourage collagen production
- Tretinoin, a vitamin A derivative, to increase skin elasticity
- Peptides, combinations of amino acids that help stimulate collagen growth and tighten skin
- Hyaluronic acid (HA) in a concentration of 0.1% to keep your skin hydrated and decrease laxity
- Glycolic acid or alpha hydroxy acid (AHA), in a concentration of up to 10% to exfoliate the skin and help other ingredients better penetrate the outer layer of skin
- Salicylic acid or beta hydroxy acid (BHA), in a concentration of 2% to exfoliate the skin
You won’t see an immediate impact after using a skin tightening cream, nor will a cosmetic product have as dramatic an effect on your loose neck skin as would a procedure or surgery. However, continued use of creams and lotions does deliver results without the cost or downtime of other skin tightening alternatives.
Facial yoga is a form of exercise believed to increase the size of facial muscles to create a more youthful appearance and firmer skin. The exercise involves:
- Opening your mouth wide
- Pulling your upper lip over your front teeth
- Placing your index fingers on your cheek and relaxing your muscles
- Smiling once more
After practicing facial yoga for 30 minutes each day over 8 weeks, and 30 minutes every other day for the next 12 weeks, you may notice visible improvement in the tightness of your skin.
Some research studies demonstrate evidence of the efficacy of facial yoga; however, the sample size of such studies is often too small to make a definitive judgment as to how effective facial yoga is for tightening neck skin.
Tighten Loose Neck Skin Without Surgery
Loose neck skin may be tightened by undergoing a nonsurgical procedure. Such procedures are either noninvasive or minimally invasive and result in little to no downtime, few side effects and risks and long-lasting (though temporary) results.
Ultrasound skin tightening (ultherapy) is a noninvasive treatment that uses ultrasound energy to send heat deep into the tissue beneath the epidermis (the outer layer of skin) without causing damage to the outer layer of skin. As the tissue heals in the wound-healing process (called fibroplasia), production of new collagen begins.
Within 2–6 months, sagging skin on the neck will start to tighten with effects visible for up to 1 year, although multiple ultrasound treatments may be required before effects are noticeable.
Ultrasound skin tightening is safe and effective, causing little to no downtime and only temporary side effects in the form of redness, swelling and bruising.
Like ultherapy, radio frequency (RF) skin tightening is a noninvasive treatment that uses RF energy to heat the tissue beneath the epidermis, triggering fibroplasia. As with ultrasound therapy, the surface of the skin remains undamaged.
RF skin tightening is an effective treatment for all skin types as RF energy bypasses the melanin (the pigment that gives skin its color) in the skin.
Patients may expect visible results within 6 months of an RF treatment, although multiple treatments may be required. Effects can be expected to last between 2–3 years.
Because the skin on the neck is thinner than most other places on the body, RF machines targeting the area use a lower temperature to ensure the procedure is as safe and comfortable as possible. As such, patients will likely only experience mild to moderate pain during the procedure, with redness and swelling lasting for up to 24 hours afterward.
Microneedling (collagen induction therapy)
Microneedling is a minimally invasive procedure in which small needles puncture the skin. This process triggers the body’s wound healing response and stimulates the production of collagen and elastin.
Though multiple microneedling sessions may be required, patients are likely to notice results after 90 days, with more significant results visible 150 days after treatment. The skin continues to tighten for up to 1 year after the procedure.
Sedation is required during a microneedling treatment. Side effects include mild discomfort, swelling, redness and skin irritation following treatment. Downtime is minimal and may require only 1 day to recover, along with some postprocedure skin care.
Laser skin tightening may be either noninvasive or minimally invasive, depending on the type of laser used, the efficacy of a given treatment and the side effects you’re comfortable with.
Laser treatment is best recommended for patients without a lot of excess skin.
Noninvasive laser treatments use nonablative lasers. Nonablative lasers cause no damage to the epidermis and function similarly to ultrasound and RF treatments: by heating the tissue beneath the epidermis to trigger fibroplasia, thereby stimulating the production of new collagen.
Nonablative laser treatments deliver immediate skin tightening, but the full effect becomes most apparent about 6 months after a procedure. In some cases, multiple procedures are required. There is little to no downtime following a nonablative procedure. Patients may experience some temporary swelling, redness or superficial blistering after a procedure.
Minimally invasive laser treatment uses an ablative laser that removes (or ablates) the epidermis. Though ablative procedures are nonsurgical, they do require sedation or anesthesia.
Similarly to nonablative treatment, an ablative laser heats the tissue beneath the skin to encourage new collagen production. However, in addition, ablative laser treatments resurface the skin by removing the top layer. When the epidermis heals, the skin will be tighter and more firm than before the procedure.
Ablative procedures are the most effective nonsurgical skin tightening method. In contrast to a nonablative procedure, the side effects of ablative laser treatment require 10 to 21 days of recovery time and postprocedure skin care.
Plastic surgery, such as face lifts and neck lifts, produces the most immediate, longest-lasting skin tightening results. However, side effects and downtime following surgical skin tightening is extensive compared to nonsurgical alternatives.
Neck lift (cervicoplasty)
While a neck lift (cervicoplasty) may be part of a full facelift, or rhytidectomy, a cervicoplasty may be done separately to focus solely on improving sagging skin on the neck.
Neck lifts require sedation or general anesthesia prior to the procedure. A cosmetic surgeon will then begin making incisions along the sideburn, ear and under the chin.
Once incisions are made, fat is manipulated and moved from the jowls and neck. Some tissue under the skin is repositioned and excess neck skin is trimmed. The platysma muscle, a muscle beneath the neck that commonly contributes to the appearance of “turkey neck,” may also be tightened.
Finally, the surgeon will pull the remaining skin up over the new contours of your neck before closing the incisions.
Cervicoplasty procedures involve less time spent in surgery compared to a full facelift. This means there is less post-treatment downtime and fewer side effects, although the surgery is still riskier than nonsurgical alternatives.
A neck lift requires 2–3 weeks of recovery time. In comparison to other treatments, however, skin tightening results from a neck lift are visible for more than 3 years.
Preventing Neck Skin from Sagging
Maintaining a healthy lifestyle and skin care routine can impede the development of loose neck skin.
- Maintain a healthy diet; sugar-heavy diets can increase signs of aging.
- Maintain a consistent weight; avoid rapid, excessive weight loss.
- Moisturize and use creams and lotions to hydrate your skin.
- Use a sunblock with SPF 30 protection to protect against photodamage.
- Get enough sleep; poor sleep can increase signs of aging.
- Avoid smoking; this habit will increase skin aging.
Loose neck skin is a result of aging and photodamage, which breaks down the collagen in your skin. Rapid and massive weight loss after obesity is also a factor in the visibility of sagging neck skin due to the skin’s inability to keep pace with the rate of weight loss.
Skin elasticity in the neck can be provided through a number of effective at-home treatments, including OTC topical creams and lotions and facial exercises. Undergoing nonsurgical procedures can have a more dramatic impact on sagging neck skin with few side effects and little to no downtime.
Plastic surgery makes for the most immediate and dramatic results in improving loose neck skin, but is also the most risky option. Downtime following surgical skin tightening may be extensive compared to other options.
- Makrantonaki, E., Bekou, V., & Zouboulis, C. C. (2012). Genetics and skin aging. Dermato-endocrinology, 4(3), 280–284. doi:10.4161/derm.22372
- Varani, J., Dame, M. K., Rittie, L., Fligiel, S. E., Kang, S., Fisher, G. J., & Voorhees, J. J. (2006). Decreased collagen production in chronologically aged skin: roles of age-dependent alteration in fibroblast function and defective mechanical stimulation. The American journal of pathology, 168(6), 1861–1868. doi:10.2353/ajpath.2006.051302
- Panwar, P., Butler, G. S., Jamroz, A., Azizi, P., Overall, C. M., & Brömme, D. (2018, January). Aging-associated modifications of collagen affect its degradation by matrix metalloproteinases. Retrieved June 30, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/28634008
- Farage, M. A., Miller, K. W., Elsner, P., & Maibach, H. I. (2013). Characteristics of the Aging Skin. Advances in wound care, 2(1), 5–10. doi:10.1089/wound.2011.0356
- Darvin, M. E., Richter, H., Ahlberg, S., Haag, S. F., Meinke, M. C., Le Quintrec, D., . . . Lademann, J. (2014, September). Influence of sun exposure on the cutaneous collagen/elastin fibers and carotenoids: Negative effects can be reduced by application of sunscreen. Retrieved June 30, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/24639418
- Elander, A., Biörserud, C., Staalesen, T., Ockell, J., & Fagevik Olsén, M. (2019, February). Aspects of excess skin in obesity, after weight loss, after body contouring surgery and in a reference population. Retrieved June 30, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/30638792
- Kerscher, M., & Buntrock, H. (2011, August). Anti-aging creams. What really helps? Retrieved June 30, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/21755353
- Feinberg, Carol; Hawkins, Stacy PHD; Battaglia, Alyse; Weinkauf, Ronni PHD. (2004) Comparison of anti-aging efficacy from cosmetic ingredients on photoaged skin. https://doi.org/10.1016/j.jaad.2003.10.112
- Bissett, D. L., Oblong, J. E., & Berge, C. A. (2005, July). Niacinamide: A B vitamin that improves aging facial skin appearance. Retrieved June 30, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/16029679
- Haftek, M. , Mac‐Mary, S. , Bitoux, M. L., Creidi, P. , Seité, S. , Rougier, A. and Humbert, P. (2008), Clinical, biometric and structural evaluation of the long‐term effects of a topical treatment with ascorbic acid and madecassoside in photoaged human skin. Experimental Dermatology, 17: 946-952. doi:10.1111/j.1600-0625.2008.00732.x
- Mukherjee, S., Date, A., Patravale, V., Korting, H. C., Roeder, A., & Weindl, G. (2006). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clinical interventions in aging, 1(4), 327–348. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
- Pavicic, T., Gauglitz, G. G., Lersch, P., Schwach-Abdellaoui, K., Malle, B., Korting, H. C., & Farwick, M. (2011, September). Efficacy of cream-based novel formulations of hyaluronic acid of different molecular weights in anti-wrinkle treatment. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/22052267
- John Van Borsel, Marie-Camille De Vos, Karen Bastiaansen, Jaira Welvaert, Jo Lambert, The Effectiveness of Facial Exercises for Facial Rejuvenation: A Systematic Review, Aesthetic Surgery Journal, Volume 34, Issue 1, January 2014, Pages 22–27, https://doi.org/10.1177/1090820X13514583
- Alam M, Walter AJ, Geisler A, et al. Association of Facial Exercise With the Appearance of Aging. JAMA Dermatol. 2018;154(3):365–367. doi:10.1001/jamadermatol.2017.5142
- Minkis, K., & Alam, M. (2014, January). Ultrasound skin tightening. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/24267423
- Juhász, M., Korta, D., & Mesinkovska, N. A. (2018, July). A Review of the Use of Ultrasound for Skin Tightening, Body Contouring, and Cellulite Reduction in Dermatology. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/29846343
- Alster, T. S., & Lupton, J. R. (2007, September/October). Nonablative cutaneous remodeling using radiofrequency devices. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/17870527
- Spero J Theodorou, Daniel Del Vecchio, Christopher T Chia, Soft Tissue Contraction in Body Contouring With Radiofrequency-Assisted Liposuction: A Treatment Gap Solution, Aesthetic Surgery Journal, Volume 38, Issue suppl_2, June 2018, Pages S74–S83, https://doi.org/10.1093/asj/sjy037
- Iriarte, C., Awosika, O., Rengifo-Pardo, M., & Ehrlich, A. (2017). Review of applications of microneedling in dermatology. Clinical, cosmetic and investigational dermatology, 10, 289–298. doi:10.2147/CCID.S142450
- Rosenberg, G. J. (1997, December). Full face and neck laser skin resurfacing. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/9393485
- Jones, B. M., & Lo, S. J. (2012, December). How long does a face lift last? Objective and subjective measurements over a 5-year period. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/23190814
- Jordan, J. R., & Yellin, S. (2014, August). Direct cervicoplasty. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/25076453
- Paul, M. D. (2014, January). Neck lift technique: The Lifestyle Lift. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/24295358
- Mueller, G. P., Leaf, N., Aston, S. J., & Stone, C. W. (2012, January). The percutaneous trampoline platysmaplasty: Technique and experience with 105 consecutive patients. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/22231408
- Katta, R., & Desai, S. P. (2014). Diet and dermatology: the role of dietary intervention in skin disease. The Journal of clinical and aesthetic dermatology, 7(7), 46–51. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106357/
- Randhawa, M., Wang, S., Leyden, J. J., Cula, G. O., Pagnoni, A., & Southall, M. D. (2016, December). Daily Use of a Facial Broad Spectrum Sunscreen Over One-Year Significantly Improves Clinical Evaluation of Photoaging. Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/27749441
- Oyetakin-White, P., Suggs, A., Koo, B., Matsui, M. S., Yarosh, D., Cooper, K. D., & Baron, E. D. (2015, January). Does poor sleep quality affect skin ageing? Retrieved July 1, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/25266053
- Helfrich YR, Yu L, Ofori A, et al. Effect of Smoking on Aging of Photoprotected Skin: Evidence Gathered Using a New Photonumeric Scale. Arch Dermatol. 2007;143(3):397–402. doi:10.1001/archderm.143.3.397