Just like the skin on our face experiences a loss of elasticity and collagen over time, leading to a slack, drooped appearance, the skin on our legs does the same, and the knees are no exception. “The knees take on a lot of stress because they are a weight-bearing area and they have to bend, so the skin is constantly stretching,” says Sugar Land, TX, plastic surgeon Ankur Mehta, MD. “This, along with aging, sun exposure and volume loss, can lead to loose skin around the knees.” Sagginess can also be attributed to a lack of hydration, which is why it’s important to keep your skin moisturized, as well as protected from the sun.
These are the best ways to do it.
Create new collagen
While moisture plays a role to some degree, Miami dermatologist Joely Kaufman, MD, says the best way to combat crepey skin is with topical application of ingredients that stimulate the growth of collagen and elastin, such as retinol. Look for hydrating body products that contain these ingredients in formulas, as applying a cream with retinol, peptides and collagen-stimulating ingredients to your knees (and beyond) every night will help prompt your body to create new collagen for firmer, smoother skin.
“I like to alternate a retinol body lotion with a topical exfoliating lotion for problem areas,” says Dr. Kaufman. “This helps skin by hydrating it, boosting collagen and exfoliating the stratum corneum, so the legs don’t look like they have ‘fish scales.’” Our top skin-firming pick for below the neck: Alastin TransFORM Body Treatment ($195).
Tighten + lift
If topical treatments don’t deliver the effects you’re looking for, you may need to visit a doctor for a stronger, in-office solution. “Loose skin above the knees is difficult to treat. I have used the Infini device (microneedling with radio frequency), focused ultrasound and radio-frequency machines, and although they provide some improvement, unfortunately there is no magic cure for crepey skin,” explains Dr. Kaufman.
Ultrasound treatments, such as Ultherapy, which require about three treatments (some patients can see results after one), can work to tighten the area, too.
Some doctors, like Chicago plastic surgeon Julius Few, MD, choose to couple radio-frequency treatments with filler for more severe cases. “The use of both modalities lets the skin beneath the surface be built up,” he says.
Fort Lauderdale, FL dermatologist Dr. Matthew Elias turns to radio-frequency microneedling such as VirtueRF, and couples the treatment with a hyperdiluted biostimulatory filler like Radiesse or Sculptra.
Spokane, WA dermatologist Wm. Philip Werschler, MD notes that his go-to treatment for the tricky area involves Ulthera, plus the addition of a stimulatory filler such as hyperdiluted Radiesse or Sculptra.
Cut it out
For extreme cases of loose skin around the knees that don’t seem to respond much to noninvasive treatments and procedures, Dr. Mehta says surgically tightening the skin on the thighs with a thigh lift can actually help to tighten some of the skin around the knees, too. “Direct excision of the excess skin on the knee can be performed as well, but should be carefully considered because this procedure can leave a visible scar on the knee.”
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