Education6 min readBy Trace Cohen|Last updated: 2026-05-27

Botox for Horizontal Neck Lines in Men (Necklace Lines)

Quick Answer

Horizontal lines across the neck — called necklace lines — are different from vertical neck bands. Botox can soften these creases, especially when combined with skin-quality treatments. Here's what men need to know about treating horizontal neck lines.

The neck is one of the most age-revealing areas of the face — and one of the most neglected in men's aesthetic treatment. Two distinct aging patterns affect the male neck: vertical bands (from the platysma muscle) and horizontal creases (called necklace lines or neck rings). These are separate phenomena with different causes, different treatments, and different outcomes. This guide focuses on the horizontal lines that can appear anywhere from the base of the chin down to the base of the neck — and what Botox can and can't do for them.

What Are Necklace Lines (And What Causes Them)?

Necklace lines are horizontal creases that run across the neck. They form from a combination of factors: the natural folding of the neck during head movement (bending the neck forward and side to side), UV-related skin laxity in the neck's thinner skin, loss of neck subcutaneous fat volume with age, and in some men, habitual forward head posture (tech neck) that keeps the neck chronically flexed. Unlike the forehead lines that are purely muscle-driven, necklace lines have a more complex, multi-factor origin — which means treatment requires a more layered approach.

Can Botox Treat Necklace Lines?

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Yes — with nuance. Botox is useful for the component of necklace lines that has a muscle-tension element: specifically, men who have platysmal activity that exacerbates the horizontal lines. In these cases, micro-doses of Botox along the horizontal crease can reduce the muscular tension pulling the skin into the fold. However, Botox alone won't fully resolve deep, established necklace lines — because skin laxity and volume loss contribute significantly in most men over 40. A combination approach (Botox + skin-quality treatments) typically produces the best outcomes.

Treatment options for necklace lines in men:

  • Botox — targets muscle-driven tension component; works best for mild to moderate lines in men under 50
  • Profhilo/Skinbooster injections — deep skin hydration that improves skin quality and reduces shallow creases
  • Laser resurfacing — stimulates collagen in the neck skin; best for surface-level fine lines
  • Radiofrequency (Morpheus8, Sofwave) — tightens neck skin by stimulating deep collagen; good for laxity component
  • Filler (used carefully) — occasionally used to soften deep neck creases, requires high skill to avoid complications

For men with deep, established necklace lines that include a significant laxity component, a consultation is more valuable than a single treatment. A provider who can assess the muscle vs. skin-laxity vs. volume contribution will give you an honest assessment of what Botox alone can accomplish.

The Tech Neck Factor

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Men who spend long hours looking at screens — smartphones, laptops, monitors — often develop accelerated necklace lines from the chronic flexed-neck posture (tech neck). The neck skin is repeatedly folded in the same creases hundreds of times per day, etching horizontal lines that deepen over years. For these men, treatment needs to be paired with posture correction to prevent rapid reversion. Botox can relax the neck tension component, but if you're folding your neck 200 times per day looking at your phone, the lines will re-etch faster than in someone with better posture.

If you're concerned about neck aging, find a provider near you who assesses both the face and neck comprehensively at /find-botox-near-me — neck treatment should never be done in isolation from overall lower face planning.

What Results Can Men Realistically Expect from Botox for Necklace Lines?

For men with mild necklace lines that are primarily tension-driven (visible when neck is neutral, not deep folds), Botox alone can produce noticeable softening. Expect 30-50% improvement in line depth, and a smoother appearance when the neck is in a neutral position. For men with deep, established creases — especially those over 50 or with significant sun damage — Botox will be a partial solution. Combining it with radiofrequency skin tightening or a skinbooster treatment addresses both the muscle and the skin quality simultaneously for a more comprehensive result.

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Frequently Asked Questions

Is Botox for necklace lines different from neck band Botox?

Yes — they treat different things. Neck band Botox (platysma Botox) targets the vertical ropey bands that appear in the front of the neck in some men and women, especially when turning the head. Necklace line treatment targets the horizontal creases across the neck and involves different muscles and techniques. A provider may treat both in the same session, or may recommend one over the other based on your specific aging pattern.

How many units does Botox for necklace lines require?

Treatment varies widely based on the area covered and muscle contribution. Small doses of 10-25 units are typical, placed in micro-injections along the crease lines. Because neck skin is thinner and more sensitive than the face, technique matters more here — this is an area where provider experience is especially important.

Can necklace lines be prevented in younger men?

To a significant degree, yes. Consistent SPF on the neck (most men don't apply sunscreen to their neck), improving forward-head posture from screen use, starting Botox before deep lines establish, and maintaining neck skin quality with retinol are all preventative. Men who start addressing these factors in their 30s have dramatically better neck appearance in their 50s than those who don't.

Do necklace lines come back after Botox wears off?

The muscle-driven tension component returns as Botox wears off, yes. But the lines won't be deeper than they were before — there's no rebound effect. With consistent treatment and parallel attention to skin quality, progressive improvement in resting line depth is the typical long-term trajectory.

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