By LIV Clinic · Medically reviewed by Dr. Narathai Vichienkalayarut, M.D. · Published October 17, 2026

Horizontal lines and vertical bands look like one problem and need two completely different answers.

What is the best treatment for neck lines and bands? Vertical platysmal bands respond to Botox, which relaxes the muscle causing them, while horizontal neck lines are creases in the skin needing skin boosters, microneedling or resurfacing — and loose neck skin is a separate problem again.

Three different neck concerns

Bands, lines and laxity

Vertical cords running down the neck are muscle. Horizontal rings are creases in the skin. General sagging is laxity. Each needs a different treatment.

Why people get confused

All three often appear together, so a treatment aimed at one can disappoint if another is the dominant concern.

• Vertical cords running down the neck — muscle
• Horizontal rings across the neck — skin creases
• General sagging and jowling — laxity
• Crepey, thin texture — skin quality
• Heavy, hanging skin — excess skin

Vertical bands: Botox

Relaxing the platysma

Vertical cords come from the platysma muscle. The Cleveland Clinic describes botulinum toxin relaxing targeted muscles, which softens the visible bands.

What to expect

Results appear over 3 to 14 days and last about three to four months, as with facial Botox. Dosing here requires an experienced injector.

Horizontal lines: skin treatment

Creases, not muscle

Horizontal neck rings are skin creases, deepened by posture, sun damage and thin skin — relaxing muscle does little for them.

What helps

Skin boosters hydrate and thicken the skin, while microneedling and resurfacing remodel the crease — see what microneedling is good for. Fine filler is occasionally used in deeper lines.

Loose skin: tightening

A separate problem

General neck laxity responds to focused ultrasound or radiofrequency — see treatment to tighten neck skin.

Significant sagging

Heavy, hanging neck skin usually needs surgical assessment rather than devices.

Matching treatment to concern

Most people need two of these addressed.

Why the neck ages faster here

Thin skin, constant sun

Neck skin is thinner than facial skin, moves constantly and is heavily sun-exposed — particularly on an island.

The skincare gap

Most people stop their routine at the jawline, which accelerates the difference between face and neck over years.

Posture and devices

The ‘tech neck’ factor

Repeatedly looking down at a phone deepens horizontal creases over time, so posture genuinely contributes.

Simple changes help

Raising your screen to eye level reduces the repeated creasing that treatment is working against.

How to treat neck lines and bands

A practical sequence:

1. Have a consultation to identify bands, lines, laxity or a combination.
2. Treat vertical bands with conservative Botox if present.
3. Use skin boosters or resurfacing for horizontal creases.
4. Add tightening if laxity is the dominant concern.
5. Extend your skincare and sun protection to the neck daily.
6. Raise screens to eye level to reduce repeated creasing.

Neck treatment at LIV Clinic Koh Samui

At LIV Clinic, Dr. Narathai assesses which neck concern dominates before recommending Botox, skin treatment or tightening. Book a consultation.

Frequently asked questions

Safety and consultation

Neck treatment is a medical procedure and, like any injectable treatment, carries some risk — common temporary effects can include redness, swelling, bruising or tenderness, and less common reactions are possible. Results vary from person to person, and no specific outcome can be promised. This article is general information, not medical advice.

At LIV Clinic, every treatment begins with an in-person assessment by Dr. Narathai Vichienkalayarut, M.D., who reviews your skin, medical history and goals before recommending a personalized plan. Book a consultation to find out whether this treatment suits you.