Frequently on show but often neglected, the skin on the chest is subject to the same ageing factors as our faces. But while we’ve managed to get our heads around paying attention to the neck, it’s often seeing the disconnect between a youthful complexion and wrinkling cleavage that finally spurs us to tackle the problem, by which time treatment is likely to be more effective than prevention.

“The skin on the décolletage is thinner than on the face and has fewer sebaceous glands, making it more prone to dryness and fine lines,” explains Dr Raquel Amado, EV Expert, and Director & Medical Practitioner at Dr Raquel Skin and Medical Cosmetics. “It naturally has a lower structural support, contributing to sagging and wrinkling faster than other areas.”

Not only does a lack of skincare application have a detrimental effect, a lack of sun protection does too. “While most people remember to apply SPF to their face, they often forget about the décolletage, which is unfortunate because it's such an exposed area,” adds Dr Ahmed El Muntasar, EV Expert, NHS GP and Founder of The Aesthetics Doctor Clinics. “Due to this combination of thinner skin and frequent sun exposure without protection, people tend to show signs of ageing in this area much more quickly. The process typically begins with redness, followed by age spots, fine lines and wrinkles, then progressive thinning of the skin itself.”

As Dr Amado notes, beyond the UV damage that causes hyperpigmentation and crepiness, the skin on the chest is subject to other aggressors including pollution, which accelerates oxidative stress leading to dullness and inflammation; perfumes that may contain photosensitising ingredients that can trigger pigmentation; and HEV or blue light, which can also contribute to oxidative stress and age spots.

With those factors in mind, the skin on the décolletage should at very least warrant a passing application of body cream. In fact, should we be approaching it with the same level of care as our complexions, from exfoliation and sunscreen to skin boosting treatments and aesthetic services such as resurfacing?

Face or bodycare – which is best? 

It makes sense, in terms of both time and money, to include the chest as part of a daily care routine when it comes to both prevention and treatment. But will face or bodycare work best? “I'd lean toward treating it as part of your facial routine, though ideally you should use products specifically formulated for the neck and décolletage,” advises Dr El Muntasar. “Given the skin's thinness, it requires specialised care. I wouldn't recommend using body products, as they typically contain much higher concentrations of ingredients. These stronger formulations would be far too harsh for the delicate décolletage.”

Dr Amado agrees that the most pro-active approach is to treat the décolletage as part of your facial skincare routine as it shares many ageing mechanisms with facial skin. “It also needs more targeted active ingredients such as antioxidants and peptides than body creams typically offer or that may not address, like pigmentation or collagen loss.” She recommends extending cleansing as well as applying serums, night treatments and sunscreen down the chest, while also eschewing harsh exfoliators in favour of gentle chemical options like lactic or mandelic acid.

In-clinic options to take south

When professional treatments are needed to help redress signs of ageing that can’t be undone via skincare alone, the reassuring news is that the most effective options are those you’ll already be familiar with for refreshing your face. Treating laxity, dullness and pigmentation patches are likely to be the main goals, for which Dr El Muntasar has a new favourite treatment called Jellagen, a biomaterial derived from jellyfish that’s already used in regenerative medicine. “It’s a new collagen stimulant that we can inject into the décolletage to help naturally increase collagen production, thickening the skin and brightening it up,” he enthuses. “It actually gives the area that life back.”

Meanwhile Dr Amado’s treatment of choice for the chest is Radiesse injections combined with NCTF (or New Cellular Treatment Factor) via mesotherapy, which she calls, “a powerful combination.” The former is a dermal filler that boosts volume while encouraging collagen for both immediate and long-term benefits, while the latter is a skin booster packed with amino acids, hyaluronic and acid and minerals that improves skin quality, smoothness and brightness.

Other treatments to consider, she adds, are chemical peels to tackle sun damage and age spots, and microneedling to boost firming collagen and elastin. The newest kids on the treatment block, polynucleotides and exosomes, will also transfer the much-celebrated benefits of making the skin on the face look younger, to the décolletage as well.