Neck lines in your 20s and horizontal neck lines: why do they form, and how do you manage them?
“I'm still in my twenties and I've got lines on my neck.” Everyone touches their neck as they say it. Let me start here: seeing lines at that age isn't rare, and the lines aren't a disease in themselves. But of all the causes and fixes you hear about, fewer have been confirmed by research than you'd think.
The short answer
Horizontal neck lines in your 20s are often simply lines showing early where the neck folds every day. The claim that smartphones cause them is still a guess at case-report level, and I couldn't find a study that measured how much each cause contributes. Care starts with taking your sunscreen and moisturiser down onto your neck. The neck cream study had 35 people over 84 days and no control group. For lines that have deepened, hyaluronic acid injections showed an 85–88% response with both products in a 188-person trial, but that trial had no untreated group to compare against. At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700, I look at how deep the lines are first.
Why would I get horizontal neck lines in my 20s?
Your neck folds forward more times a day than anyone could count. Skin at a fold tends to keep a line, and because neck skin is thin, that line shows early. How much flesh you carry, the length of your neck and the skin you were born with also change how it looks.
That's my explanation from what I see in the consulting room. I couldn't find a study that measured what percentage of it comes from what in people in their 20s. So I can't point at one thing and say “this is the cause”.
Neck lines also differ from facial wrinkles. On the face, the first conversation is often about relaxing expression lines with Botox. With horizontal neck lines, I have to look at the folding and the skin itself together.
→ More: Types of facial wrinkles: does each need a different fix?
Is it because I look at my phone too much?
It sounds plausible, but it hasn't been proven. A 2015 report from Korean dermatology describes two people, aged 29 and 32, and even its authors wrote about the head-down posture only as a “possibility”. Two cases can't tell you a cause.
I couldn't find a study that directly measured smartphone time against neck lines, one that checked whether correcting posture fades them, or one that compared pillow heights. There is an analysis showing that sleep positions press on the face and create wrinkles, but that's about the face.
I still tell people to raise their screen to eye level. It does your neck and shoulders no harm. Just don't expect it to erase a line that's already there.
Do neck creams or masks work?
| Method | Studies I checked | How much weight I give it |
|---|---|---|
| Sunscreen | 903 people, randomised, 4.5 years, though it did not measure the neck | Do this first |
| Neck cream | 35 people, 84 days, no control group, manufacturer study | Use it to moisturise, and keep expectations low |
| Neck masks and patches | I couldn't find any | Hydrated while it is on, more or less |
| Stretching and massage | I couldn't find a study that measured neck lines | If your neck feels more comfortable, that is enough |
| Hyaluronic acid injections | 188 people, randomised, two products compared | Worth a consultation for deepened lines |
In the neck cream study, 35 Chinese women applied it twice a day for 84 days and reported improvement in horizontal lines and firmness. There was no control group, and several of the authors work for the manufacturer. Moisturising alone can make lines less visible, so this result can't tell you whether the ingredients did it.
Plenty of people stop their sunscreen at the jaw. The 903-person trial didn't measure the neck, so I have no number for it. But that skin gets the same sun, so I ask you to go down onto the neck.
Do I need a procedure already, in my 20s?
Mostly, no. In your 20s, sun protection, moisturising and looking after the skin barrier usually come first, and if the lines are faint I don't recommend a procedure. I also couldn't find evidence for getting injected early as prevention.
If the line still looks like a groove through your make-up and it keeps bothering you, that's a reasonable time to come in. In the 188-person randomised trial, a non-crosslinked hyaluronic acid compound solution was injected 3 times, 4 weeks apart. Four weeks after the last injection, the share of people improving on the wrinkle scale was 88.30% and 85.11%. But the trial compared two products with each other, and it enrolled people with moderate or worse lines. Adverse reactions were reported in 27.66% and 40.43%, with no serious cases.
The neck is thin and it never stops moving. There's a case of widespread granuloma appearing 4 years after a long-lasting material was placed there, so I don't suggest non-absorbable materials in this area.
→ More: Neck line treatment in Daegu: injections or radiofrequency, which comes first?
Could it be something other than a line?
Yes. If the real issue is flesh coming down under the chin, or if vertical bands are standing up, the approach is different. And if the skin has changed colour, itches or has small bumps along with it, a skin examination comes before any care for the lines.
Even if we get as far as talking about radiofrequency, I won't do it that day if you have metal or electronic implants, are pregnant, or have skin inflammation.
→ More: Jawline sagging in Daegu: the order for choosing lifting devices and boosters
Neck lines in your 20s: frequently asked questions
Are neck lines inherited?
I do notice in the consulting room that some people show them early because of their neck shape and skin. But I couldn't find a study that measured the genetic share.
Will sleeping with a neck patch make the lines go away?
I couldn't find a study testing neck patches. The lines may look softer while the skin is hydrated under the patch, but I can't tell you they'll disappear.
Does a high pillow cause neck lines?
I couldn't find a study comparing pillow height with neck lines. All I can say is to use a height that keeps your neck comfortable.
Where can I get a neck line consultation in Daegu?
At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700. Weekdays 11:00–19:00, Saturday 10:00–16:00, closed Sundays and public holidays.
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Related treatments: Neck line treatment · Anti-ageing treatments for thin, dry skin · Types of facial wrinkles
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, director of Miso Clinic, Daegu. The treatment standards and injection design set out here are the ones we use in practice.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- Case report of neck lines in younger patients — Hyun MY et al. Novel treatment of neck wrinkles with an intradermal radiofrequency device. Ann Dermatol 2015;27(1):79-81. PMID 25673937. Two cases, aged 29 and 32.
- Neck cream study — Young MB et al. A Rejuvenating treatment targeting “tech neck” lines and wrinkles in Chinese women. J Cosmet Dermatol 2023;22(1):226-35. PMID 36374589. 35 people, 84 days, no control group, many of the authors employed by the manufacturer.
- Randomised trial of hyaluronic acid injections for neck lines — Jiang M et al. Safety and Efficacy of Hyaluronic Acid-Based Filler for Neck Wrinkles. Clin Cosmet Investig Dermatol 2026;19:586105. PMID 41873431. 188 people, comparing two products.
- Complication of non-absorbable material in the neck — Kim KJ et al. Artecoll granuloma. Dermatol Surg 2004;30(4 Pt 1):545-7. PMID 15056148. One case.
- Randomised sunscreen trial — Hughes MCB et al. Ann Intern Med 2013;158(11):781-90. PMID 23732711. 903 people, 4.5 years.
- Sleep wrinkles — Anson G, Kane MAC, Lambros V. Sleep Wrinkles. Aesthet Surg J 2016;36(8):931-40. PMID 27329660.
- Korean medical advertising law — Korean Medical Service Act Article 56(2) (no treatment testimonials, no comparisons with other clinics, no superlatives). This is why this column carries no prices, reviews or before-and-after photos.
- Miso Clinic practice guidelines — for hollow cheeks, dissolvable hyaluronic acid filler is considered first; no RF treatment that day if there are metal or electronic implants, pregnancy or skin inflammation; only absorbable threads are used and their material and approval information is shown to the patient; the plan is kept conservative for patients aged 50 and over; liposuction is not performed.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.