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Ask Dr. Bailey: How to Treat Deep Vertical Chest Wrinkles

Vertical Chest Wrinkles

I was asked by a blog reader if I prescribe tretinoin (Retin-A) to treat one of the most common aging skin problems on the chest - deep vertical wrinkles. In this area, skin is often also covered with red and brown blotchy color, crinkles, and crepey wrinkles. These same issues are true for the neck as well.

Dr. Bailey, I, like the other commentators, have benefited a lot from your advice. I really appreciate how detailed your guidance is, especially for someone like me who has an intense case of rosacea. Regarding this discussion on retinoids, how do you feel about their use on the neck and chest? I have deep vertical chest wrinkles – I think from sleeping on my side as well as sun exposure. I have used an OTC Neutrogena product which contains retinol for over a year, and I don’t think it has lessened the depth or the number of wrinkles. Would using a prescription product have more of a chance of success? Thanks for your time!  Sophie

Since vertical chest wrinkles are a skin issue many women face, I want to share my dermatologist recommendations for the best anti-aging skin care for the neck and chest.

Hello Sophie, Thank you for telling me that my advice has helped! Regarding the chest lines and neck, yes, I commonly have my patients use tretinoin in these areas. I consider it an important part of the most powerful skin care routine to fight aging neck and chest skin. People often focus on their facial skin care, but it is important to include the neck and chest in treatments because the face, neck and chest are often seen in one vision when we wear the most common types of shirts.

Does tretinoin and retinol work to treat sun damage on the chest?

Tretinoin works nicely to improve the appearance of the neck and chest skin. For more information on exactly how tretinoin works, read How to Correctly Use Retin-A Tretinoin for Anti-Aging and Acne Skin Care, and How to Apply Tretinoin Cream and create a skincare routine. That said, those vertical lines are often very deep and don’t budge easily with skin care products alone. Importantly though, the skin texture and color improve, which makes the lines less noticeable. Also, bright and clear skin reflects light better so textural details are less apparent to the eye.

best treatment for deep vertical chest wrinklesIt is important to know that a person’s ability to tolerate tretinoin on these areas will vary. For some people, it causes redness and irritation that they just can't work through. Other people find it a breeze. For those that can't tolerate tretinoin, my Retinol Intensive Anti-Wrinkle Night Cream is a professional strength alternative. Retinol has the potential to offer all the benefits of tretinoin but is much less irritating.

How to use retinol and tretinoin on chest wrinkles and for neck sun damaged skin

I have personally used both tretinoin and my Retinol Cream on my chest and neck for well over 30 years without much problem. The same is true for many of my patients. In my dermatology practice, I always start my patients on a low strength retinoid and work up.

With tretinoin, we start with the 0.025% concentration twice a week and the goal is to work up to nightly application of the 0.1%. This process is done gradually. To achieve success with tolerating tretinoin, I always tell my patients that waiting 15+ minutes after skin has been wet really makes a difference and helps skin tolerate tretinoin. The caveat is that if one has night sweats, the tretinoin can become irritating. This is my personal struggle - gotta love menopause! 

For people who can't tolerate tretinoin, or who don't have a prescription, my Retinol Intensive Anti-Wrinkle Night Cream is the best other option. As a retinol cream, it is in a class all its own for non-prescription retinoid products. It is very strong and formulated by a pharmaceutical lab and chemist to give you the highest retinoid benefits without a prescription. Retinol is much less irritating than tretinoin but has the same benefits and mechanism of action for fighting wrinkles and skin aging. My Retinol also has green tea antioxidants to fight inflammation and it is a great way to start treating this area. I personally use the Retinol more often than the tretinoin because of the night sweats.

What is the best invisible sun screen to prevent chest skin from becoming sun damaged?

best sunscreen to prevent chest wrinkles

Any improvement in chest sun damage means that you must use a really good zinc oxide sunscreen every day. I personally use my Sheer Strength Pure Physical Invisible SPF 50+ Sunscreen on my chest every day because it is invisible and does not damage the fabric of my shirts. Daily sun protection of your chest skin is important to prevent the undoing of all the good work you are doing with retinoids to reverse and prevent chest wrinkles. 

Can you use glycolic acid to get rid of chest wrinkles and sun damage?

best skin cream to get rid of chest wrinkles and age spotsAgain, understand that chest skin is slow to respond to anti-aging skin care routines. This area often needs a lot of different treatments used at the same time to improve and reverse the signs of sun damage and skin aging. I often use strong glycolic acid products to rejuvenate the chest skin. In fact, the more active ingredients and procedures we do, the better the results we get. I commonly combine a retinoid with glycolic acid, but the combination is tricky. I have my patients apply my Glycolic Acid Body Lotion to the area twice a week. It is important that the skin not be irritated from the tretinoin when you use glycolic acid. I start either the glycolic acid or the retinoid first, and once the skin has adjusted, we add the other. This process usually takes about a month.

What skin treatments can help get rid of deep vertical chest wrinkles and sun damaged skin problems?

In addition to the skin care routine I just mentioned, we often include our best technology to counter skin aging on the chest and neck too. We use intense pulsed light (called IPL) to treat the neck and chest. It works really well. I want patients to do an initial series of 3-5 monthly treatments to get the skin where we want it followed by 2 treatments a year to maintain results.

We also use our Profractional Laser Treatments (a fractionated erbium laser) on the neck and chest to fight the wrinkles and crinkly skin. I recommend two treatments done at 6-week intervals, and then one treatment done annually.

My aesthetician can help maintain results with microdermabrasion and acid peels. These can be done with a facial. It all sounds like a lot of work but the results are worth it. It is common to put the effort into facial skin care and it's not that much more work to reach down the neck and chest and treat the skin there too.

Know that laser and IPL can only be done when a person is not tan and will not be going into the sun. Not every skin type is a candidate for these technologies, and darker skin complexions often need pre-treatment with pigment lightening products including tretinoin!

I personally avail myself of all-of-the-above, and my 60+year-old previously sun baked type II chest and neck look okay for an old blonde gal! However, it does take work to counter nature in this anatomic area. That’s the fun of it actually!

To summarize, my recommendations for the best skin care products to fight deep chest wrinkles and skin aging on the neck and chest:

  1. A retinoid such as prescription tretinoin or my Retinol Anti-Wrinkle Night Cream
  2. Glycolic Acid Body Lotion used after the bath or shower at least twice a week.
  3. Zinc Oxide Sunscreen 356 days a year. My favorite for the neck and chest is my Sheer Strength Pure Physical Invisible SPF 50+ Sunscreen.

Your question is so great I wanted to post it as part of our "Ask Dr. Bailey" series. Thank you for your question!


Cynthia Bailey, MD, Board Certified Dermatologist

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