When it comes to skin care, most women tend to focus on their faces, forgetting about the other parts of their bodies. Many women barely have time to deal with putting on their makeup and flossing, much less paying attention to their skin care needs from the neck down!

Yet some of the most telltale signs of aging are often quite evident from the neck down. This is especially true if you haven't been as diligent about protecting your body from sun exposure as you may have been with protecting your face. Your hands, forearms, and chest (décolletage) can look older than need be if the proper steps aren't taken. If you are over 40, sun damage (brown spots, creping, and loss of elasticity) is most likely becoming more and more evident on those areas.

One pertinent fact for skin anywhere on your body is that every inch has the same needs when it comes to skin-care products. Skin is skin and it needs to be protected from the sun and it is far healthier and softer (and, dare I say it, younger-looking) when the products you apply are loaded with antioxidants, ingredients that mimic the structure of skin, anti-irritants, and cell-communicating ingredients. Just like the face, the skin on the body can also function better and absorb moisturizer better when it is exfoliated, so the use of a well-formulated AHA or BHA product can create smooth, even textured skin like you've never experienced before. The notion that the neck, chest (elegantly referred to as the décolletage) or any other part of the body has different basic skin care needs is a way to waste money, not help your skin.
The following is a daily Do Not Forget List for those often-forgotten parts of your body.

Avoid Soap: Soap or bar cleanser is almost always drying and the ingredients that keep bar cleansers solid are not the best for skin. Whenever possible, especially if your skin is dry, your body will feel and look much better using a gentle body cleanser (also known as shower gel or body wash). And this doesn’t have to be expensive—it is shocking how similar these products are regardless of the price tag or claim on the label.

Neck and Chest (décolletage): The bottom line is that whatever you are applying to your face, you should also be applying to your neck and chest. Apply sunscreen (SPF 15 or greater with UVA-protecting ingredients, such as any Paula's Choice Sunscreens) if this area is exposed to daylight. At night a moisturizer loaded with state-of-the-art ingredients applied over slightly damp skin is extremely beneficial. An exfoliant can evenly and gently peel away sun-damaged layers of skin. For severe sun damage in this area, speak to your dermatologist about using a prescription tretinoin product (such as Renova) or having a series of AHA or BHA peels. You can also consider a skin lightening product with hydroquinone to deal with skin discolorations. (Options include Paula’s Choice Clearly Remarkable Skin Lightening Gel or Remarkable Skin Lightening Lotion.)

Hands and Arms: All of the basics for the neck and chest area apply here as well but it helps to be fastidious about your use of sunscreen. Hands get hammered from unprotected sun exposure. The crepey skin and brown discolorations that start showing up on the back of your hands and arms between the ages of 35 and 40 are all about sun damage. Every day of the year it is critical to apply sunscreen and be sure to reapply it every time you wash your hands. This is easier said than done, and it helps to keep a small tube or bottle of sunscreen in your purse, so you don’t skip this step when you’re away from home.

Knees, Heels, and Elbows: The skin over these areas tends to be thick, rough, and often callused. A topical exfoliant containing 1% or 2% BHA (salicylic acid) can eliminate the problem when used daily. Knees, heels, and elbows also benefit from application of an extremely emollient moisturizer or balm-type product.

Legs: All of the basic needs mentioned for the neck and chest area apply here. For shaving details, see The Art of the Perfect Shave.

Special Needs:

Blemishes
Though we often think of blemishes as a facial issue, for those who struggle with blemishes on other parts of their body (such as the back, neck, thighs, or buttocks), they know all too well how frustrating this can be. Regardless of where a blemish occurs, the same Skin Care Solutions that apply for breakouts occurring on your face apply from the neck down. Do not use bar soap or cleansers--the ingredients in bar cleansers can clog pores. Using a gentle cleanser, a well-formulated exfoliant (to keep pores from getting clogged) and a benzoyl peroxide product (to prevent blemishes) is state of the art for battling blemishes. For more information, see Skin Care Solutions for Blemishes.

Keratosis Pilaris
This skin disorder is one that lots of people struggle with. It is a very common problem involving tiny, benign, raised bumps found typically on the upper arms, thighs, shoulders, and back. Keratosis pilaris tends to be more severe during the winter months but no one is sure why that is the case and it definitely isn't consistent for everyone. Basically, these bumpy rough spots are clogged pores that can get red and irritated but rarely itch. Regrettably there is no available cure or universally effective treatment, though it is generally well accepted that unclogging pores and reducing inflammation can greatly improve matters (Source: eMedicine Journal, July 2, 2001, Volume 2, Number 7).

Alpha hydroxy acids (typically lactic or glycolic acid, both very effective forms of alpha hydroxy acid) can help exfoliate skin cells, but these aren't effective for dissolving the sebum (the hardened oil inside a pore) that cause the problem. As a result, alpha hydroxy acids can't penetrate into the pore and exfoliate the lining of the pore to help remove the plug. For this type of problem a beta hydroxy acid product (with the active ingredient salicylic acid) and a pH low enough for exfoliation to occur can make all the difference in the world. It is also helpful to avoid bar soaps that can irritate skin or cause clogged pores. A gentle body shampoo is best. Keep in mind you can’t scrub away the plugs, this will only inflame the area more and still leave the skin feeling rough and bumpy below the surface where the problem exists and the abrasive particles in a scrub can't reach.

Note: I hear from many readers dealing with keratosis pilaris that their dermatologist consistently recommends treating it with an AHA product, specifically LacHydrin, available at most drugstores. I'm not sure why these doctors aren’t recommending BHA products instead, but suspect it's because they’re unaware of the small number of options available. Needless to say, the comments I hear are that the AHA product did not reduce the keratosis pilaris, and the doctor had no other options to offer, which left the patient frustrated. Given what we know about keratosis pilaris and how BHA products work, it makes sense to consider them before trying an AHA product, however well-intentioned your dermatologist’s advice may be. Of course, some people may indeed see an improvement in their keratosis pilaris from using an AHA product. However, for all intents and purposes you should try a BHA product first.

Another common condition that can manifest itself as visible red bumps on the arms and thighs is bacterial folliculitis. This inflammatory condition involves an infection of the hair follicle by the bacteria Staphylococcus aureus. It begins with mild swelling and redness around the hair follicle and may eventually become small, inflamed pustules. This condition is most common in persons with a lot of body hair, but can occur on anyone. The most common form of prescribed treatment is a course of oral antibiotics (penicillins, cephalosporins) but topically applied antibiotics are also helpful (Source: The Skin Sourcebook, 1998, pages 162-164). You can also try treating the affected area with daily application of a product containing 5% or 10% benzoyl peroxide. This topical disinfectant is often helpful in keeping these inflamed, acne-like bumps under control.

Paula's Choice Skin Care Solutions for Your Skin from the Neck Down

The Basics

• All Over Hair and Body Shampoo
• Close Comfort Shave Gel
• Extra Care Moisturizing Sunscreen SPF 30
• Ultra-Light Weightless Finish SPF 30 Sunscreen Spray
• Slip Into Silk Body Lotion
• Skin Revealing Body Lotion with 10% Alpha Hydroxy Acid

For Extra Dry Areas

• Beautiful Body Butter
• Lip & Body Treatment Balm

For Battling Blemishes

• Blemish Fighting Solution or Extra Strength Blemish Fighting Solution

For Relieving Red Bumps from Shaving

• Skin Relief Treatment

For Keratosis Pilaris

Any of Paula’s Choice BHA exfoliants

• Exfoliants

For *Bacterial Folliculitis

• Blemish Fighting Solution (2.5% benzoyl peroxide)
• Extra Strength Blemish Fighting Solution (5% benzoyl peroxide)

*These over-the-counter products should ideally be used with prescription products from your doctor.


$$$ L'OCCITANE Ultra Comforting Cleansing Milk ($22.00/6.7 ounces) Wow! Here’s a L’Occitane product that does not contain any fragrance or fragrant plants (What a shock!), which makes it a very good option for sensitive skin. This fluid yet milky cleanser feels soothing, removes makeup, and rinses better than expected, though some may find they need to washcloth for complete removal. It is fragrance-free and also does not contain preservatives, at least if the ingredient list on the package is accurate. That lack of preservatives is slight cause for concern because a water-based product like this should have a reliable preservative system, although this is packaged so that the product remains hygienic during use.By the way, if this product that’s formulated without fragrance is good for sensitive skin, does that mean that all the other L’Occitane products laden with fragrance are bad for sensitive skin, by L’Occitane’s own standards? Just a question to ask yourself if you are considering purchasing from this line. 

Dear Paula,

This is actually a letter for your readers. I had no idea how much money I was wasting before reading your books and subscribing to Beautypedia. I teach cosmetology and make sure that my students know about the work you do and either purchase your book or subscribe to Beautypedia. I felt that your readers should hear this from a professional. I have worked for Aveda, Origins, Revlon, Benefit, Iman, and DermaBlend. It’s amazing the things a company will tell you in order to sell products. I’ve been told alcohol is necessary to aid in the control of oil and to heal acne, but thanks to you I’m aware of the outcome of using this ingredient on skin. It’s because of you that I was not recommending products that couldn’t live up to their promises. I did, however, get a lot of dirty looks from my fellow associates at the cosmetics counters because I was not part of the cheerleading group that couldn’t see the industry for what it was, or at least wouldn’t admit it. I was told never to mention your books or Web site because it would be unprofessional to do so. I still did and suffered only minor consequences. Again, Paula, thank you!

Brianne, via email


Dear Brianne,
Thank you for your wonderful supportive comments! I greatly appreciate them. Your experience with fellow cosmetics salespeople is one I am all too aware of; the animosity harkens back to my days of working in a Washington D.C. department store and the trouble I got into for recommending products outside of the brand I was representing. I’d like to think that it is because of the research and reporting my team and I do that many cosmetic companies have opted to present claims based more in fact than fiction. However, every time I think we’ve made some headway with the cosmetic companies, a new product crosses my desk with claims that make me want to scream. And if the claims aren’t patently outlandish, the price for what you’re really getting is! Brianne, I’m glad to have you on my side and thank you once again for acknowledging and supporting the work my team and I do.

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