Now Trending: #TechNeck

Help patients reverse the damage from obsessive device use.

We live in a world in which we are all hopelessly reliant on our mobile devices. And these days, this attachment often starts at a young age. A Kleiner Perkins Caufield & Byers report shows that the average American in 2017 spent 5.9 hours of their day engaged with digital media content.1 On average, most Americans check their phone 46 times per day, and that number is almost double for those between the ages of 18 and 24.2 Therefore, it’s not surprising that because they are constantly bending their necks downward to look at mobile devices, young people (under the age of 35) are developing wrinkles in the neck area at a much earlier age than their predecessors did. This early emergence of neck aging— characterized by horizontal neck lines and crepey neck skin—has been dubbed #TechNeck. 

At NicholsMD, we have refined an off-label, three-step protocol that helps our patients minimize the appearance #TechNeck. This combination treatment is done in only one session, takes approximately 45 minutes, lasts six to nine months, and should only be done by an experienced injector. 


The first step of the #TechNeck treatment is the use of high-frequency micro-focused ultrasound energy with ultrasound visualization (MFU-V). We use a Merz product called Ultherapy. 

The principle of high-frequency micro-focused ultrasound energy is to induce cellular damage of the target area by producing microthermal injuries through the accumulation of high-frequency ultrasound beams without causing any damage to the epidermis or surrounding tissue.3 We average 100 Ultherapy lines per treatment, using both the 1.5mm and 3.0mm transducers. 


For Step Two of the #TechNeck treatment, we inject a neurotoxin to relax the muscles of the platysma. We use 40-60 units of neurotoxin and inject in a zig-zag fashion around the horizontal neck rhytids. 


The finishing touch of the #TechNeck procedure is to inject a hyaluronic acid dermal filler into the horizontal neck rhytids 

Practice Management Notes

> Include a photo on your cosmetic questionnaire showing what TechNeck looks like. Until this treatment becomes mainstream, like we predict it will, patients may not know what you’re referencing without a visual. 

> Package this treatment as one combination treatment, rather than three individual treatments. This way, patients understand that best results require all three steps. 

> Counsel patients on ways to further prevent TechNeck, such as by holding the phone in front of your face but also by putting the phone down. 

> Host a “Preventative Aging” night and feature the TechNeck as one of your treatments. 

Watch it Now

Dr. Nichols discusses her approach to managing #TechNeck in a DermTube video. 

Watch now:

Disclosure: This is an off-label treatment and should only be done by an experienced board-certified physician specialized in aesthetics. 

Kim Nichols, MD, FAAD is a board-certified dermatologist and cosmetic surgeon in Greenwich, CT, where she owns her own practice, NicholsMD of Greenwich. She is a graduate of Harvard University as well as the NYU Medical School. She is a Key Opinion Leader and physician trainer for companies such as Allergan, Candela, SkinCeuticals, and Merz. 

Emily Anne Scalise, MA, is the Director of Operations and Business Development at NicholsMD of Greenwich. She received her master’s degree in psychology from Columbia University. Her medical articles relating to business development have been published in journals such as Practical Dermatology, and Emily is a frequent speaker for SkinCeuticals. 

1. Marvin, R. Tech Addiction By the Numbers: How Much Time We Spend Online. PCMag website. https://www.pcmag. com/article/361587/tech-addiction-by-the-numbers-how-much-time-we-spend-online. Updated June 11, 2018. Accessed February 4, 2019. 

2. Global mobile consumer survey: US edition. Deloitte United States website. technology-media-and-telecommunications/articles/global-mobile-consumer-survey-us-edition.html#. Updated February 28, 2019. Accessed March 3, 2019. 

3. Park H, Kim E, Kim J, Ro Y, Ko J. High-Intensity Focused Ultrasound for the Treatment of Wrinkles and Skin Laxity in Seven Different Facial Areas. Ann Dermatol. 2015;27(6):688–693. doi:10.5021/ad.2015.27.6.688 

4. Andrews A. Explaining “Tech Neck,” a Growing Concern of the Social Media Age. W Magazine. Updated September 13, 2017. Accessed February 4, 2019. 

5. Brucculieri J. How To Get Rid Of ‘Text Neck,’ According To A Plastic Surgeon And Dermatologist. https://www.huffpost. com/entry/can-you-get-rid-of-text-neck_n_5aba6277e4b054d118e74d5b. Updated September 27, 2018. Accessed February 4, 2019 

6. Eadicicco, L. Americans Check Their Phones 8 Billion Times a Day. Time website. Updated December 15, 2015. Accessed February 4, 2019. 

7. Metzger, C. *This* Is How Many Selfies Women Take Before They Actually Like One. Marie Claire website. https://www. Updated on January 9, 2018. Accessed March 11, 2019.