Horizontal neck lines
Horizontal neck lines are creases that run across the front or sides of the neck. They can appear in younger people because of normal folding and posture, then become more visible as skin loses elasticity. They are distinct from vertical platysma muscle bands.
What you may notice
- One or more horizontal neck creases
- Lines visible at rest or when looking down
- Uneven depth across the neck
- Fine crepey texture around deeper folds
Why it can happen
Normal neck movement and individual skin attachments create repeated folds. Intrinsic ageing, ultraviolet exposure, smoking and reduced skin elasticity can deepen them. Posture may make lines more visible but is not the only cause.
What may help
Sun protection and moisturiser support skin quality. Retinoid or resurfacing approaches may help fine texture when appropriate. Selected fillers can soften some established creases, and energy-based treatments may provide modest improvement, but the thin mobile neck has a higher risk of irritation, pigment change and contour irregularity. Surgery addresses laxity rather than an isolated fine line. Avoid retinoids during pregnancy or when planning a pregnancy.
When to consult
A consultation can identify whether the main issue is a crease, texture or broader laxity. Seek medical assessment for a new painful line, rash, swelling or other neck symptoms.
Evidence and sources
- DermNet. Ageing skin [Internet]. Auckland: DermNet New Zealand Trust; 2018 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/ageing-skin (new tab)
- DermNet. Facial lines and wrinkles [Internet]. Auckland: DermNet New Zealand Trust; 2004 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/facial-lines-and-wrinkles (new tab)
- American Society of Plastic Surgeons. Neck lift [Internet]. Arlington Heights (IL): American Society of Plastic Surgeons; [cited 2026 Nov 7]. Available from: https://www.plasticsurgery.org/cosmetic-procedures/neck-lift (new tab)
- American Society of Plastic Surgeons. Skin rejuvenation and resurfacing [Internet]. Arlington Heights (IL): American Society of Plastic Surgeons; [cited 2026 Nov 7]. Available from: https://www.plasticsurgery.org/cosmetic-procedures/skin-rejuvenation-and-resurfacing (new tab)
- European Medicines Agency. Updated measures for pregnancy prevention during retinoid use [Internet]. European Medicines Agency; 2018 [cited 2026 Nov 7]. Available from: https://www.ema.europa.eu/en/news/updated-measures-pregnancy-prevention-during-retinoid-use (new tab)