Plus, the treatment options for signs of aging.
If you’re of a certain age, you might have given some thought to the creeping signs of aging, like fine lines and wrinkles. There’s a reason why medical professionals performed 7.7 million Botulinum Toxin Type A (like Botox, Dysport, and Xeomin) procedures in 2019. Minimizing the appearance of fine lines in various areas of the face is a big business, and it’s only getting bigger (there’s been an 878 percent increase in these types of injectables from 2000 to 2019), which is why we weren’t surprised to learn that dermatologists are seeing more and more patients that are concerned about their chests.
Many industry professionals will tell you that if your skin-care routine doesn’t go beyond your jawline, or even your neck, you’re in trouble. Renowned aesthetician Joanna Czech is fond of telling her clientele that “your face stops at your nipples” as a way to encourage people to start applying their products to their decolletage. And although you may not notice this area as often or as prominently as you do your face, it is still at risk for signs of aging like wrinkles, as well as crepiness.
“Crepey skin gets its name from a crêpe, like the thin pancake-like French [dessert],” says board-certified dermatologist Dr. Corey L. Hartman. “It’s the thinness of the skin where it easily wrinkles when it’s folded or manipulated, and [you] have fine little crinkles on the surface that give the skin an aged appearance.”
He cites our initial drop in collagen and elastin levels (which begins at age 22) for the eventual appearance of crepiness and fine lines around our chests, but there are also numerous lifestyle and environmental factors that can exacerbate their appearance. Board-certified dermatologist Dr. Dendy Engelman adds that we typically see sagging and folding of the skin in areas where it is thinner, like the eyelids, neck, and decolletage, and where there is frequent movement.
If you’re worried about warding off signs of aging in this area, or are looking for ways to minimize their appearance, there are a few things that you can do.
Start with Prevention
Both Dr. Hartman and Dr. Engelman stress that, similar to the face, sun damage is the number one culprit for signs of aging on the chest. “Oftentimes, we have sunscreen and/or makeup on our faces, but the neck and décolleté are exposed and unprotected,” says Dr. Engelman. “This can cause acceleration of the signs of aging.” So, for as much as you may not want to take the time to apply your daily SPF all the way down your neck to your chest, it is the best line of defense that you can take. And if you’re already seeing crepiness, fine lines, or even dark spots and discoloration, combining both a physical and chemical formula will ensure full protection.
Many of the same active ingredients that benefit your face can also be applied to your chest—the only thing to take note of is that this area of skin is thinner, which means it can be more sensitive. Dr. Engelman encourages her patients to use a form of retinol to increase cell turnover in the area, and to keep it adequately hydrated. She prefers oils like ylang ylang, neroli, and jojoba as they “penetrate into deeper layers of the skin because they have lower molecular weights than most lotions and creams.” Also, peptides—the short chains of amino acids that build essential proteins like collagen and elastin—are a powerful ingredient to help prevent signs of premature aging, as well as protective antioxidants like vitamins C and E.
In addition to these topical options, Dr. Hartman suggests several lifestyle choices to help keep your chest looking healthy and youthful (as well as the skin on the rest of your body)—first and foremost, hydration. “You can drive as much hydration as you can into your skin from the outside, but you [also need] a good foundation, [meaning] you’re drinking plenty of water and exercising (which can increase blood flow to the area) to keep things as youthful as possible,” he says.
Even the way that you sleep can have an effect on how your chest ages. Says Dr. Engelman, “Side sleepers tend to get horizontal rhytides [aka wrinkles] on the chest from their sleep position.” If you’re not able or unwilling to change your sleeping position, Dr. Hartman recommends switching out your bed linens, since cotton sheets can cause increased friction to this skin, thereby worsening wrinkles. “Silk or satin pillowcases and sheets can be a lot friendlier to the skin and the passive aging process that occurs when we’re just trying to get a good night’s sleep,” he says.
And similar to all areas of skin aging, things like a poor diet, smoking, and stress can cause increased wrinkling, discoloration, and general lack of radiance.
Treatment Options for the Chest
Taking care of your skin is a multi-prong approach no matter what area of the body you’re focusing on, but since our chests are relatively prominent, there’s nothing wrong with exploring options beyond over-the-counter topicals to treat signs of aging.
Among the various in-office procedures available to patients, Dr. Hartman cites Fraxel, a fractionated resurfacing laser, as his favorite for the chest. “It can stimulate collagen production through small channels of heat that it creates,” he says. “It does it in a way that does not [require] a lot of downtime and your skin can bounce back pretty quickly.” The skin will look tighter and firmer after you recover from the redness and swelling, and Dr. Hartman recommends undergoing the procedure once a year to maintain the results.
In addition to this type of non-ablative laser, Dr. Engelman is a fan of radiofrequency and microneedling devices like NuEra Tight and Lutronic Genius to treat the decolletage, which would require a similar experience of numbing, 20–40 minutes of targeted treatment, and a recovery time of roughly a week.
Dr. Hartman also predicts that fillers will increase in popularity for minimizing crepey skin in the chest area, specifically Radiesse (calcium hydroxyapatite) and Sculptra (poly-l-lactic acid). Regarding the former, Dr. Hartman says, “It’s more of a paste and has to be diluted with saline. It’s an off-label use, but it does a nice job of laying down a nice sheet that your body can start to stimulate collagen production on top of.” Sculptra has a similar effect on the skin.
Interestingly, however, neither filler provides that instant satisfaction of hyaluronic-acid dermal fillers for the cheeks or lips. “It’s not something that you’re going to see an improvement on immediately,” says Dr. Hartman. “It takes a while for your body to build that collagen, and it takes about three treatments [to see results]. But there’s nothing else like it.”
With more innovations in the aesthetics space being developed every year, our options to treat the signs of aging in the chest area will only increase. Both doctors note that while they do see the occasional patient in their 20s or early 30s, deep wrinkling will likely not develop until your 50s or 60s. Says Dr. Engelman, “Genetics, ethnicity, sun exposure, sleep position, and lifestyle all play a role on if and when these start to show.” So for now, the best course of action is to prioritize prevention with plenty of SPF and a healthy lifestyle. And maybe, if you can manage, sleep on your back while tucked into a luxurious silk sheet set.