Addressing Aging for the Eyes, Neck, Chest and Hands


Most skin care regimens and products are formulated solely for the skin on the face. The forehead, cheeks, chin and nose are focal points for breakouts and pigmentation, and they are often the first things people notice about an individual.

However, the forgotten zones—the eyes, neck, décolleté and hands—are often the first to show signs of aging. Understanding the physiology of the skin in these often overlooked areas is key to preventing and treating the signs of premature aging.


The skin on and around the eyes, often referred to as the periocular area, is approximately 10 times thinner than the rest of the face. The result is less protection than other parts of the face and body. Additionally, the eye area is one of the most constantly moving parts of the body; each person blinks about 10,000 times per day.

After factoring in smiling, squinting, diet, water intake, allergies and stress, the eyes show signs of degradation more quickly and with more severity than skin elsewhere on the body.


The periocular skin absorbs and loses moisture differently than the skin on the rest of the face. With few oil glands to maintain natural moisturization, the skin around the eyes is subject to dehydration. Desquamation —the skin’s complex renewal process—occurs at a slower rate with age. As this process of shedding dead cells slows, the eye area often develops a buildup of dead cells. The collection of corneocytes results in thicker, aged, rough skin with impaired barrier function.

To maintain healthy skin around the eyes and postpone the signs of aging, collagen-stimulating ingredients to help promote regeneration and prevent degeneration should be incorporated into both daily regimens, as well as monthly professional treatments.

Palmitoyl tripeptide-38 is one of the newest matrix-building peptides that is effective in preventing the loss of collagen and increasing the production of collagen, laminin 5, fibronectin, hyaluronic acid and heat shock protein 47 (HSP47).

Dipeptide diaminobutyroyl benzylamide diacetate is also a next-generation peptide with quick wrinkle-smoothing effects. It aids in diminishing expression lines by interrupting the repeated muscle contractions around the eyes responsible for the formation of crow’s feet.

Outside of daily product usage that minimizes signs of aging, clients should avoid unprotected sun exposure. In addition to sunscreen, clients exposed to the sun should wear sunglasses and wide-brimmed hats to protect skin and prevent squinting. This protection will also help them avoid the UV-induced inflammation that can instigate melanocytes to deposit unwanted pigment.

Clients should also not participate in activities, such as smoking, that constrict blood vessels, which will reduce redness and puffiness around the eyes. Tugging, pulling or rubbing of the eye area can also exacerbate inflammation and irritation.

Neck and Chest

The skin on the neck and chest is prone to wrinkling and sagging. Far thinner and more fragile than other areas of the body, this sensitive and often forgotton area is subject to all the same environmental insults as facial skin with ineffective moisture retention and a tendency toward a crêpey appearance.

Many clients suffer from lines running horizontally across the neck as a result of environmental factors and age. Clients also complain about a so-called “turkey neck.” The chest is also thin-skinned, predisposed to excess vascularity due to UV exposure and vertical wrinkling.


Despite both these areas needing at least the same protection as facial skin, if not more, they are often forgotten during daily care regimens. Due to the fragility of these areas, the skin on the neck and chest cannot be subjected to the same intensity of professional treatments and daily care products as facial skin.

Sun damage is one of the main contributors to the breakdown of the skin on the neck and chest. UV rays penetrate glass and clothing, leaving the neck and chest without the minimum protection that the face has through sunscreen or cosmetics. As clients age, it is common to start seeing brown spots and lines in these areas—visible signs of little sun protection over the years.

Poikiloderma of Civatte is a common condition that primarily affects women and appears on the sides of the neck. The shaded region below the chin and throat are often free from abnormal pigmentation. This benign condition is characterized by mottled, red-brown pigmentation along with a vascular component. The best course of treatment is blended chemical peels to address the hyperpigmentation and skin texture and intense pulsed light (IPL) to address the vascularity.

One of the best ways to prevent these signs of aging is through topical protection. Broad spectrum sunscreen provides UV protection and prevents the premature aging of the epidermis and dermis. Products containing hydroquinone can aid in the lightening of sun-induced hyperpigmentation. As the only skin lightener approved by the U.S. Food and Drug Administration, hydroquinone can be used as a spot treatment (if tolerated) to lighten brown spots.

Choosing hydrating treatment products that contain peptides to build collagen and ingredients to reduce the redness prevalent on the neck and chest allows this skin to be repaired on a deeper level. The reduced number of sebaceous glands and decreased moisture retention necessitates that clients use richer treatment moisturizers. Gentle retinoids (vitamin A) can help prevent the skin crêping that is common in aged skin on the neck and décolleté. Vitamin A strengthens skin, helps to reduce discoloration and increases cell turnover, processes necessary for aging skin.

Professional treatments, such as chemical peels, gentle microdermabrasion and certain non-ablative lasers, can be used on the neck and chest to improve signs of aging, as well. Blended chemical peels, like Jessner’s solution and TCA blends, are gentle enough for this fragile area and can help reduce skin discoloration, strengthen skin and increase cell turnover.

A little goes a long way in these areas, so where you might apply two to three layers of peel solution to the facial skin, one layer on a monthly basis may be sufficient on the neck and chest to achieve results.


Hands take a beating, as they are put through the same environmental insults as the rest of the human body, but with more intensity. Every day the hands are exposed to: UV radiation, especially when driving; caustic ingredients; intense temperatures; weather; and repeated hand washing. All of these factors result in dry, weakened skin on the hands.

As clients age, it is common to see the skin on the hands get thinner. Elderly men and women suffer with crêped, fragile, veiny skin on the hands that breaks, cuts, bruises and bleeds easily. Years of reduced collagen and elastin production and photodamage break down the structure and protective barrier of the skin.


Additionally, UV exposure to the hands leads to hyperpigmentation as well as various types of skin cancers, squamous cell carcinoma being the most common type found on the hands, according to the American Society for Surgery of the Hand.

The hands can be difficult to treat. Maintaining hydration is vital, but a challenge when accounting for hand washing and exposure to a range of climates. Protecting the hands from UV radiation with an sunscreen is also a challenge with frequent hand washing. The answer lies in reapplication.

Applying a moisturizing hand cream with a broad spectrum sunscreen is the best way to ensure that the skin on the hands is remaining protected.

While hand washing is important, it is equally important to be cautious of what hands are coming in contact with throughout the day. Hot water, hand soaps and hand sanitizers are overly drying. To keep hands soft and moisturized ensure: that water is warm instead of hot; that all soap has been carefully rinsed off; that clients pay attention to the ingredients in their hand sanitizers; and they are using SPF moisturizers after leaving the bathroom.

Alcohol is often incorporated into hand sanitizers to kill germs, but it is drying. Encourage clients to keep a hydrating, broad spectrum SPF 30 hand lotion by their sink, at their desks or in their purses to use after hand washing to help combat the dryness and maximize protection of their hands, regardless of the time of day.

When developing a treatment menu, make sure to include both treatments and add-ons for the hands. While anti-aging peels can be used to treat the hands, professional masks are another great way to get results on these necessary areas without much, if any, downtime.

Formulations that include oat milk are high in essential fatty acids and antioxidants to soothe and calm the skin while helping to retain moisture. Pumpkin and papaya fruit enzymes exfoliate, helping to retexturize the skin on the hands. Masks that also contain green tea extract infuse beneficial vitamins, minerals and oils into the skin, and honey—a natural humectant—leaves the skin feeling soft and moisturized.

Gentle Protection

Professional treatments can be useful for improving the signs of aging on these four often forgotten areas of the body. However, the fragile skin on the eyes, neck, décolleté and hands must be carefully treated to not cause further damage and irritation. Protection and gentle treatment is key to achieving positive outcomes.

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Jennifer Linder, M.D., is a dermatologist, a Mohs surgeon, chief scientific officer for PCA SKIN, and runs a private practice out of Scottsdale, Arizona. She is a graduate of Washington University School of Medicine; interned at the University of Pennsylvania; performed her residency at Thomas Jefferson University; and was a Mohs College Fellow. She holds a clinical faculty position in the department of dermatology at the University of California San Francisco. Linder is a spokesperson for The Skin Cancer Foundation and a member of the American Academy of Dermatology, among others.

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