Skin Damage Control from Neck to Knees forums

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Feb 12, 2005
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Sun, smoking, yo-yo dieting -- these sins take a toll on skin. We're savvy about what to do from the chin up. Now, here are the best, newest fixes for everything else.

We, with the help of science -- and an arsenal of tricks from anti-aging creams to eye-lifts -- have figured out all the ways to keep time at bay on our faces. Problem (if we think it is a problem) nearly solved. Now dermatologists and cosmetic surgeons have rushed into the breach with an array of fixes for just about every other body part. How far will you go to repair the rest of you? The choice is yours, from simple, at-home fixes to more serious procedures performed by doctors.

Your Hands

Telltale signs: In your 40s, freckles and light splotches start darkening and spreading. Eventually, the already-thin skin on the backs of hands thins further, revealing veins and developing a dry, papery texture. "You'll also notice more dramatic changes in winter -- extreme dryness, cracking, or redness," says Bruce Katz, MD, clinical professor of dermatology at the Mount Sinai School of Medicine.

At-Home Solutions

Block further damage: Use a sunscreen or lotion (such as Lubriderm Skin Renewal Age Defying Hand Cream SPF 15) daily, whether or not you'll be outdoors. Says New York University dermatologist Deborah Sarnoff, MD, "Sunscreen allows skin to recoup and fade damage that's already surfaced."

Fade brown spots: Lighten with an over-the-counter hydroquinone lotion or a cream designed to diminish pigment, such as Philosophy A Pigment of Your Imagination or Clinique Active White Lab Solutions Hand Cream. You'll see results in about eight weeks.

Avoid self-tanners: "You'd think they'd camouflage spots, but they don't," says Deborah Sarnoff. "The tanner is absorbed and darkens them."

A dermatologist can ... Upgrade your lightener: A stronger hydroquinone cream such as EpiQuin Micro can lighten spots in eight weeks. (Cost: $95/tube.)

Zap spots with a laser: Often, all it takes is one treatment. (Cost: $500-$700.) "We can typically do both hands in under an hour with a q-switched ruby, Alexandrite, or Nd YAG laser," says Sarnoff. "You get tiny scabs that last two weeks, but you can cover them with concealer." For difficult-to-treat splotches, check out the Sinon. "This laser vaporizes the pigment without harming skin," says Mitchel Goldman, MD, associate clinical professor of dermatology at University of California, San Diego. "It's best for lighter skin tones."

Pump up hand volume: Fillers such as Restylane or Hylaform are injected in a series of a few syringes, at $750 each. Your hands may look a bit swollen and bruised for a day or so, but you can go back to work that day. "These last four to six months and have no serious side effects," says Sarnoff.

Neck and Chest

Telltale signs: You're likely to see (in order of appearance): dry texture, uneven pigmentation, sun spots (including precancerous lesions), broken blood vessels, crepiness, creases and banding in the neck. "The skin on your neck and chest is often unprotected in the sun. The skin is very thin and has few sebaceous oil glands and, consequently, little natural moisture, so signs of aging tend to appear," says dermatologist David E. Bank, MD, of Mount Kisco, New York.

At-Home Solutions

Even out pigment: This area is sensitive; overtreatment can leave hypopigmented, or light spots and scars. Avoid hydroquinone creams, but try face or body creams with alpha-hydroxy acid (such as Vaseline Intensive Care Lotion, Healthy Body Complexion) or vitamin C (such as Neutrogena Visibly Even Exfoliating Body Wash).

Protect, protect, protect: Apply sunscreen daily, making sure to cover the sides of your neck. Sun exposure is the cause of poikiloderma, a reddish/brownish discoloration from the bottom of the ears down the sides of the neck. "Most women mistake it for a rash, but it's a mixture of broken blood vessels and pigment caused by sun damage that's fairly common," says Bank. Sunscreens with zinc oxide or nanotitanium dioxide (such as DDF Matte Finish Photo Age Protection SPF 30 or Neutrogena Ultra Sheer Dry Touch SPF 45) offer complete protection with the sheerest finish.

A dermatologist can...Prescribe a lightening cocktail: Tri-Luma Cream (a combo of retin-A, hydroquinone, and an anti-inflammatory; $90/tube) and Kinerase Lotion ($60/ tube) both work to lighten discolorations without irritation.

Balance out mottling: If you've got severe "pebbling" discoloration that makes skin appear rough, there's a breakthrough: Photodynamic therapy, used to treat skin cancer, can also zap hundreds of spots (including precancerous lesions) in three to five sessions. "The doctor applies a photosensitizing solution and passes over it an intense pulsed-light or pulsed-dye laser which selectively eliminates the damaged cells," says Goldman. (Cost: About $700 a session.)

Smooth neck banding: The wrinkling and banding that were once treatable only with surgery can be successfully reversed by Botox. "Whether you have vertical bands or horizontal 'necklace' bands, Botox will smooth them out by relaxing the bunching of the platysma muscle that runs across the neck and chest," says David Bank.

Erase wrinkles: The filler Restylane is the treatment of choice if you have deep creases or wrinkles in your decolletage area. Or, consider the LED light treatment called Gentle Waves, recently approved by the FDA for firming skin. The light stimulates the skin to increase collagen and elastic tissue. The catch: It doesn't have a long track record; tends to take half a dozen treatments to work (at about $100 per session) and results vary.


Telltale signs: Calves and thighs may start to sprout vascular roadmaps, from tiny spider veins and broken capillaries to large, swollen varicosities. You may also notice more dryness, flaking, and ashiness, as well as knee sagging.

At-Home Solutions:

Fight dryness: Slather on a body lotion that contains retinol, or at least an 8 percent alpha-hydroxy acid (such as Avon Skin-So-Soft Renew & Refresh Age-Defying Body Lotion or Alpha Hydrox AHA Enhanced Lotion); both speed cell turnover.

De-sag your knees:Do lunges and step-ups twice a week: "Exercise builds muscle and muscle lifts sagging skin," says Kelli Roberts, group fitness manager for Equinox in Pasadena, California.

A dermatologist can... Inject veins and capillaries: Saline sclerotherapy injections, the traditional fix for veins, have been scrapped for glycerin or foam solutions to treat both spiders and some varicose veins, with none of the intense burning and cramping associated with conventional formulas. (Cost: $300-$600 per leg.)

Zap instead of strip: The worst varicose veins, once treatable only with a painful stripping surgery, are now being cleared with endovascular laser closure, in which the doctor inserts a laser fiber into the vein, causing it to collapse. "It turns a grueling, operating-room procedure into an in-office one that uses local anesthesia," says Mitchel Goldman. (Cost: about $2,500-$5,000.)

Firm sagging knees: The newest procedure is an in-office technique called micro-liposuction. "The doctor suctions out fat through a tiny incision above your knee," says Deborah Sarnoff. Expect two days of swelling and soreness, plus about a week of wearing an Ace bandage. (Cost: $1,500-$4,000.)

Tone loose skin: Since lipo doesn't address loosened skin, some doctors combine it with four to eight sessions of one of the new skin-firming radiofrequency devices, such as Thermage. (Cost: $400-$600 per treatment.)

Upper Arms

Telltale signs: The skin can become freckled and loose. (The triceps area is a fat depot in women.) The elbows may become rough.

At-Home Solutions

Smooth it out: To ease roughness, try a product containing alpha- and beta-hydroxy acids, such as Neutrogena Skin Smoothing Body Lotion.

Conquer darker spots: Combine a glycolic acid lotion with a hydroquinone fade cream (such as Glyquin Cream; about $75/tube). You should notice results in six weeks.

Muscle up:Combining arm-firming moves (triceps dips, triceps pushups) along with regular cardio can really trim and tone this area.

A dermatologist can... Cream away browning: Tazorac Cream (about $100/tube), a strong prescription retinoid, lightens spots usually in about six weeks.

Laser stubborn spots: The Sinon or the diode laser can remove even the darkest, largest spots, often in a single treatment ($500-$1,000).

De-jiggle: Micro-lipo and radiofrequency machines can be used to lessen wiggle here.


Telltale signs: You may feel a lack of "snap" in your abdomen. Stretch marks, new moles, skin tags, and tiny red "cherry" spots may also appear.

At-Home Solutions

Rub away marks: Retinol creams may lighten pinkish stretch marks.

Crunch a new way:Try yoga or Pilates. Ab muscles need to be worked from all directions and in all ways, pulling, twisting, stabilizing.

Do a mole patrol: If you notice any with irregular borders or colorations, or any larger than a pencil eraser, see your dermatologist. (Skin tags and cherry spots are programmed to appear with age, but can be removed.)

A dermatologist can... Laser off spots and marks: Lasers (typically ones used to treat pigment or vascular problems) can zap them in a single session ($300-$600).

Mask stretch marks: The Xtrac Excimer laser temporarily repigments skin for about a month. (Cost: $100.)

Tighten, tuck-free: Doctors are reporting success with radiofrequency options like Thermage for firming. It takes up to ten treatments to see whether Thermage is working. (Cost: $2,000-$2,500.)

Aging Advantages

Phew! Some things actually improve with age.

Cellulite: While no one has actually quantified it, menopause often brings about a reduction. "Cellulite is more prominent in estrogen-sensitive areas (hips, thighs, butt)," says University of Miami dermatologist Deborah Price. "As women get closer to menopause, they often find that the dimples become shallow and much less noticeable."

Back and chest acne: Body breakouts start to decrease when oil production slows down and skin becomes a bit drier. Acne becomes increasingly infrequent and, eventually, disappears.

Body hair: With age, body hair becomes finer, thinner, and slower-growing. Many women find that by the time they reach menopause, they only need to shave every few weeks. And waxing may become something done only a few times a year.

Excessive perspiration: Like oil production, perspiration peaks in adolescence and then starts to decrease. As you age, you'll notice less sweat and, consequently, less body odor.

May 13, 2005
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great info marisol, but i must admit that at my age it left me feeling a bit exposed!

May 6, 2004
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Great post Marisol! I've noticed a few skin tags have started to appear over the past few months and they're freaking me out. Gonna get my doctor to zap them off!


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