PDO Threads for Crepey Neck Skin

Smooth PDO threads are sometimes placed in a criss-cross pattern under neck skin to encourage collagen and give mild support to thin, crinkled skin. For the right person, the change is modest and gradual rather than dramatic. Threads do not remove loose skin or fix strong neck bands, so people with more advanced changes are often better served by other treatments or a surgical opinion.

What "crepey" neck skin actually is

Crepey skin looks finely wrinkled, a bit like crepe paper, and often feels thin and loose when pinched. On the neck it tends to appear in the forties and fifties, though sun exposure and genetics can bring it on earlier.

Several things contribute. Neck skin is naturally thinner than facial skin and has fewer oil glands. Over time, collagen and elastic fibres break down, especially with years of unprotected sun. Weight changes, smoking and frequently looking down at a phone may also play a part. It helps to separate crepey texture from other neck concerns, because each responds to different tools:

• Texture and thinning, the fine crinkling this article focuses on
• Horizontal lines, the rings that run across the neck
• Vertical bands, cords caused by the platysma muscle
• Loose, hanging skin under the chin and jaw
• Fullness under the chin from fat

How threads are thought to help

PDO (polydioxanone) is a dissolvable material long used in surgical stitches. For crepey skin, injectors typically use smooth monofilament threads with no barbs, sometimes alongside twisted threads. They are not intended to lift the neck. Instead, many fine threads are laid just under the skin in a grid or mesh.

As the body slowly dissolves them over several months, it mounts a mild healing response. This is thought to prompt new collagen around each thread, which may thicken and firm the skin slightly. The evidence for this comes mainly from small studies and clinical experience rather than large controlled trials, so it is fair to describe the benefit as possible and modest rather than certain. If you want a broader overview of thread types, see our article on mono, cog and screw threads.

Who may see some improvement

People who tend to be better suited to neck threads usually have:

• Mild to moderate crepiness without much hanging skin
• Reasonable skin thickness, so threads are less likely to show
• Good general health and a non-smoking status, which supports healing
• Realistic expectations of a subtle, temporary change

Changes, if they come, develop slowly over two to three months. Many people find the effect lasts somewhere around six months to a year, but this varies, and some notice little difference at all.

When other options may suit you better

Threads are one tool among several, and often not the first choice for the neck. Depending on your concern, a physician may suggest:

• Sun protection and topical retinoids as a foundation for any neck skin change
• Laser or other energy-based treatments to improve texture and stimulate collagen across a wider area; see our article on laser for neck skin laxity
• Neuromodulator for prominent vertical bands
• Skin booster injections for hydration and fine texture in some people
• Surgical consultation for significant loose skin, which no injectable can remove

Sometimes the most useful outcome of a consultation is learning that threads are unlikely to give you the change you want.

What the appointment and recovery involve

After a review of your health history and consent, the neck is cleaned and numbed. Each thread comes preloaded in a fine needle or cannula, which is passed just under the skin and withdrawn, leaving the thread in place. A neck treatment may involve a fair number of threads, so the visit can take up to an hour.

Afterward, expect:

• Swelling, redness and small bruises along the neck for several days
• Tenderness or a tight feeling when turning the head or looking up
• Tiny bumps at entry points that usually settle within a week or so

Most people return to desk work within a day or two. Common advice includes sleeping on your back with the head slightly raised, avoiding strenuous exercise, saunas and swimming for several days, and steering clear of neck massage for a few weeks.

Who should not have neck threads, or should wait

Treatment is usually avoided or postponed if you:

• Are pregnant or breastfeeding
• Have an infection, rash or inflamed skin on the neck
• Have an autoimmune condition, bleeding disorder or poorly controlled diabetes not yet reviewed by your physician
• Form keloid or raised scars easily
• Have permanent filler or other implants in the area
• Have very thin skin, where threads are more likely to be seen or felt

Please share all medicines and supplements. Do not stop a prescribed medicine, including a blood thinner, without speaking to the doctor who prescribed it.

Main risks

Common effects are swelling, bruising and tenderness. Less common problems include a thread that can be seen or felt through thin skin, a thread end poking out, small dimples, uneven texture and infection. The neck has important structures beneath the skin, including blood vessels and nerves, so threads are placed in a shallow plane by a trained medical professional. Any increasing pain, warmth, redness or discharge after treatment needs prompt review.

Frequently asked questions

Will neck threads get rid of a double chin?

No. Fullness under the chin is usually due to fat, and smooth threads do not reduce fat. Other approaches are used for that concern.

How many sessions will I need?

Some people have one session, while others repeat once the threads have dissolved. Whether a repeat is worthwhile depends on what you noticed the first time.

Can I combine threads with laser on my neck?

Sometimes, but usually at different visits with healing time in between. Your physician will suggest a sequence based on your skin.

A balanced decision

Neck threads can offer a gentle, gradual improvement for some people with early crepey skin, but they are not a substitute for sun protection or surgery. If you would like an honest assessment of your neck and the options that fit it, a consultation with HealthPark Medical Aesthetics is a reasonable next step.