Caring for the skin on the face is routinely discussed. Treating other parts of the body that are obvious indicators of a person’s age, yet often overlooked, is explored with much less frequency. As the population ages and many are living longer, more active lives, the search for strategies to make our bodies as a whole look and feel youthful continues to intensify. Many of the same ingredients and treatments that deliver excellent results for the skin on the face can also be employed for treating other areas of the body, yet there are physiological differences between skin on these varied areas that must be considered in order to achieve optimal results. We will explore the physiology of the skin on the neck and décolleté, the hands, and the eye area and identify ingredients and treatments that will deliver dramatic, visible results. THE NECK AND DÉCOLLETÉ The skin on the neck and décolleté is much thinner than the other skin on the body. Therefore, it is more susceptible to sagging and wrinkling. The Physiology The skin on the neck and décolleté contains fewer sebaceous glands than the skin on the face. These glands provide the skin with natural lubrication and protection, so with fewer on the neck and décolleté, this area is highly susceptible to dryness and dehydration. In addition, the skin on the neck and chest is thinner and is supported by less adipose tissue with increased vascularity. Another challenge for this delicate skin is that as the skin ages, the calcium distribution gradient in the epidermis is not well-maintained, resulting in the loss of keratinocyte function and a thinning of the dermis. While this affects all the skin on the body, the thinner skin on the neck and chest are quick to develop sagging and a crêpe-like appearance as well as an increase in chest-area wrinkling. This unfortunate combination of thinner skin, increased vascularity, loss of calcium, and dehydration can greatly impact the appearance of the neck and décolleté, resulting in an increase in lines and wrinkles, a red and blotchy appearance, and increased hyperpigmentation. Ingredient and Treatment Strategies The delicate skin on the neck and chest are best treated with products that are specifically formulated for these delicate areas. There are novel products available containing a variety of ingredients that are beneficial, yet several stand out. A blend of calcium hydroxymethionine and 3-aminopropane sulfonic acid demonstrates the ability to target the sagging, crêpe-like appearance common in aging skin on the neck and increases firmness and elasticity, improving the overall tone and texture. There are also many peptides available that can effectively address a variety of common challenges. Palmitoyl tripeptide-38 is a next-generation messenger peptide that stimulates the synthesis of extracellular matrix (ECM) components, including collagen, fibronectin, hyaluronic acid, and laminin-5. This peptide also increases the activity of heat shock protein 47 (HSP47), a chaperone protein that works to ensure collagen and other matrix proteins reach maturation. Palmitoyl tripeptide-5 encourages skin-strengthening by supporting the production of collagen. Retinol, a synthetic form of vitamin A, is proven to stimulate collagen and elastin production while suppressing matrix metalloproteinase (MMP) enzymes and the melanogenesis process; it is an antioxidant and also speeds up cell turnover to create a brighter, more even look to the skin. Because the neck and chest are more sensitive areas with thinner skin, it is wise to use only lower percentages of retinol on them in order to reduce the chances of irritation and inflammation. The hyperpigmentation and redness often presented in these areas are effectively addressed with the same ingredients that would be used on the face or other body areas. Hydroquinone, licorice root extract, and kojic and lactic acids are effective melanogenesis inhibitors and are well-tolerated by most clients, providing dramatic results. Bisabolol, brown and red algae, and caper bud extract have shown the ability to reduce weakened capillaries by minimizing inflammation and strengthening the capillary wall. These ingredients work to suppress inflammation and reduce chronic redness. The B vitamin niacinamide is also a useful ingredient. It plays a role in multiple biochemical reactions within the skin, including the reduction of hyperpigmentation and diffuse redness. Additionally, niacinamide has the ability to reduce the maillard response that leads to a yellowing of the skin with age. THE HANDS The skin on our hands is some of the hardest working, yet most neglected, on the body. You may think that feet take more stress, but they are often covered and protected from ultraviolet exposure. Every day, hands are exposed to abrasive cleaning products, as well as the drying effects of water, hand sanitizers, and harsh soaps. They are also exposed to damaging ultraviolet rays while driving, playing sports, walking, and other activities. The Physiology Approximately 90 percent of the aging markers on our hands, such as wrinkles, brown spots, and a dry/leathery appearance, are due to overexposure to harmful ultraviolet rays. Skin cancer of the hands is another important consideration. Squamous cell carcinoma (SCC) is the most common type of skin cancer on the hands, according to the American Society for Surgery of the Hand, followed by basal cell carcinoma (BCC) and melanoma. The fingernails must be protected as well; due to the tissue under the fingernail being metabolically active, it is susceptible to melanoma and squamous cell carcinoma. Ingredient and Treatment Strategies There are several effective strategies for keeping skin on the hands looking young and healthy. To help mitigate unnecessary stress on hands, follow some of these helpful tips: When applying antioxidant, age, and hyperpigmentation controlling serums to the face, dispense a little extra. After smoothing them onto the face, apply the remainder to the backs of the hands and forearms. Follow this same rule when applying sunscreen. Ideally everyone should be applying adequate broad spectrum sunscreen to all exposed areas 30 minutes prior to exposure. Be aware of where you rest your hands when driving. UVA rays travel through glass, so while driving, try to position your hands out of direct ultraviolet ray exposure. This is, of course, only if it does not impair your ability to drive safely. Every evening before bed, apply a therapeutic lactic acid moisturizer to the whole body, concentrating on hands, cuticles, and elbows. If you have spa gloves, these can help increase penetration of beneficial actives. THE EYES Our eyes tell many stories about us. A person with expression in their eyes that frequently smiles will likely develop crow’s feet wrinkles from the repeated muscle contractions required sooner than someone who does not. The Physiology Additionally, fatigue, allergies, dehydration, and other medical conditions can lead to under-eye edema and dark circles. The skin in this delicate area is also thinner than the skin on other parts of the face, making any discoloration from melanin or blood flow even more evident. As we age, the tissue on the eyelid begins to droop, leading to a hooded appearance. The combination of all these challenges can lead a young person to look prematurely aged if the right treatment strategies are not employed. The daily use of ingredients designed to specifically address this area’s unique combination of issues will lead to a brighter, more youthful appearance overall. Ingredient and Treatment Strategies Instead of focusing on the correction of one or two specific skin issues, look for products that deliver maximum potency of the newest ingredients to address the eye area as a whole. By taking a multi-directional approach to treatment, it is possible to rejuvenate, brighten, and firm this all-important facial area. There are many effective peptides available for treating this area that fill wrinkles, reduce under-eye bags, and minimize the repeated muscle motions that cause wrinkling. There are also nonapeptides available that act similarly in the skin as retinol, but without creating any surface irritation. Exclusive botanicals improve upper-eyelid sagging; reduce under-eye dark circles and puffiness, and act as fibroblast and epidermal growth factor alternatives. Additionally, stem cell extracts from oranges have the ability to strengthen dermal structure and increase matrix integrity and elasticity in the skin. Another feature in some eye products is optical diffusers. These mineral extracts offer a more immediate cosmetic benefit by delivering instant brightening of the eye area. Professional treatments for the eye area must be chosen carefully. Always cleanse with a gentle wash that will not irritate the skin. Hydrating masks are a good option, as properly hydrated skin appears plump and more youthful.Although the skin on specific areas of the body differs physiologically, utilizing appropriate ingredients, products, and treatments, as well as incorporating lifestyle changes, will help keep the skin on the face, as well as the entire body, healthy, and beautiful. As a board-certified dermatologist, pediatrician and fellowship-trained pediatric dermatologist practicing out of Scottsdale, Ariz., Dr. Cynthia Price is dedicated to providing excellent, innovative and compassionate patient care. She specializes in adult, pediatric, surgical and cosmetic dermatology. Dr. Price is a fellow of the American Academy of Dermatology and the American Academy of Pediatrics, as well as a member of the American Society for Dermatologic Surgery, the Society for Pediatric Dermatology, the Women’s Dermatology Society, the Phoenix Dermatology Society and the American Medical Association.Want to read more? Subscribe to one of our monthly plans to continue reading this article.