Written by Kerri Lewis, Co-founder | Medically reviewed by Nurse Natalia Ostrowska RGN INP, The Skin to Love Clinic, St. Albans. May 2026.
The face tends to attract all the attention. Body skin, the upper arms, the abdomen, the inner thighs, the décolletage, is largely left to get on with it. It shouldn't be.
Crepey skin on the body is not something to simply accept. The biology behind it is well understood, the body skin laxity treatment options are there, and at The Skin to Love Clinic in St Albans it is a common concern. What follows is the straightforward briefing: what actually causes it, and what can genuinely be done.
What actually is crepey skin?
Left unaddressed, the underlying biology does continue; collagen loss doesn’t pause. To understand crepey skin, you need to understand what gives young skin its bounce, resilience, and plumpness, and what happens when those things start to change.
Collagen and elastin loss
Your skin is held up by a scaffolding of proteins. Two of the most important being collagen and elastin. Collagen provides the structure; think of it as the beams and joists that give the skin its firmness, smoothness, and thickness. Elastin provides the spring; the quality that lets your skin bounce back after it has been stretched or pressed.
From your mid-twenties, the body starts producing less collagen; roughly 1% less each year. By your forties, you may have lost around a quarter of your skin's structural collagen. The picture with elastin is even starker: elastin production largely stops after puberty. Once elastin fibres are degraded, they are very difficult for the body to replace on its own.
The result is skin that gradually becomes thinner, less resilient, looser, and loses that characteristic ability to snap back after it has been stretched.
Hormonal changes: perimenopause and menopause
“For many women, the most noticeable shift in skin quality happens during perimenopause and menopause.” explains Nurse Natalia. “This is not coincidence”. Oestrogen activates receptors in the skin that are directly responsible for collagen production. As oestrogen levels fall, collagen production falls with them. Research suggests women can lose up to 30% of skin collagen in the first five years following menopause.
This is not about ageing badly. It is biology and it can happen faster, and more significantly, than most people are told to expect.
Sun damage
UV radiation is one of the most significant drivers of skin ageing. This is true for crepey skin on the body and it is particularly relevant to areas that get regular sun exposure. “When UV rays penetrate the skin, they cause elastin fibres to become thick, tangled, and dysfunctional.” says Nurse Jane. “This process, called solar elastosis, accumulates over decades, progressively degrading the skin's ability to maintain its structure and firmness”.
This is why the décolletage, knees, and upper arms are so frequently affected. These are areas that see significant sun exposure across a lifetime, often without the same level of SPF protection as the face.
Weight changes and pregnancy
When skin is stretched by weight gain or pregnancy and then the volume reduces again, the skin does not always return to exactly where it was. If the elastin fibres have already been or is then further compromised by age, hormones, or sun damage, the skin's ability to rebound is further reduced. This is not a failure of willpower or fitness. It is a structural reality of how skin works.
Why does crepey skin on the body feel different from facial ageing?
“Most conversations about skin ageing focus on the face and that is understandable, because it's what we see most clearly in the mirror every day.” notes Nurse Natalia. But body skin ages by the same biological processes: collagen loss, elastin degradation, hormonal change, sun damage.
The difference is partly structural. Body skin has fewer sebaceous (oil-producing) glands than facial skin, which means less natural hydration. Combined with collagen loss, this is part of why body skin can take on that fine, papery quality in a way that can feel more pronounced than the face.
There is also a practical difference in how aesthetics has historically treated body skin. Facial rejuvenation has been studied and refined far more extensively than body skin laxity but that has changed quickly. The evidence base for treating crepey skin on the body with medical-aesthetic treatments has expanded significantly over the last five years.
Can creams and lotions actually treat crepey skin on the body?
Frankly? No, not in a meaningful structural sense. Topical products, however luxurious and however well-formulated, work at the surface of the skin. Generally, they can improve hydration, support the skin barrier, and provide some antioxidant protection against further damage. That is genuinely valuable for overall skin health. But they cannot rebuild structural collagen and elastin loss in the deep dermis because that is not where they reach.
To address crepey skin on the body in a way that makes a real, visible difference, you need treatments that work at the level where the problem actually sits: deep within the dermis. The good news is that those treatments exist, they are clinically-supported, and they are available at our St Albans clinic.
The treatments that can actually change crepey skin on the body
At The Skin to Love Clinic, we have an award-winning suite of non-surgical treatments for skin laxity and crepiness on the body that are backed by clinical studies. Here is an honest overview of what each one does and who it is most suited to.
Sculptra Body: collagen biostimulation
“Sculptra Body is, in our view, one of the most significant advances in body aesthetics in recent years.” says Nurse Jane. “And it is a treatment we frequently recommend for crepey, lax skin on the upper arms, abdomen, thighs, above the knees, and décolletage”.
Sculptra's active ingredient is poly-L-lactic acid (PLLA), a biocompatible, biodegradable substance that has been used safely in medicine for decades (you will find it in absorbable surgical sutures and orthopaedic implants). When injected into the deep dermis, PLLA particles trigger a controlled biological response: they stimulate the fibroblasts which are your skin's own collagen-producing cells, to generate new collagen. Over the weeks and months that follow, the skin genuinely rebuilds its structural foundation from the inside out.
This is not a traditional filler that uses a hyaluronic acid-based gel to instantly plump and re-volumise facial contours or wrinkles temporarily. It is a considered, progressive treatment whose results build naturally as your own biology responds. There is no sudden change, but over the course of treatment, the skin becomes genuinely firmer, tighter, more resilient, and less crepey.
The clinical evidence is robust and growing. A prospective, randomised, blinded trial published in Frontiers in Surgery in 2026 evaluated Sculptra specifically for upper arm skin laxity in 20 adults. By day 90, skin elasticity had increased significantly. By day 120, skin thickness had increased from 1.80mm to 2.70mm; a meaningful structural improvement confirmed by ultrasound.
Separate clinical studies have demonstrated statistically significant improvements for knee laxity, thigh and décolletage wrinkles. An international expert consensus panel, whose review was published in Aesthetic Plastic Surgery in 2024, concluded that current evidence supports a meaningful benefit for PLLA across the upper arms, abdomen, thighs, knees, and décolletage.
“Most patients require two to three sessions, spaced several weeks apart.” Explains Nurse Natalia. “Results are typically longer-lasting that many injectable treatments because they are the product of genuine collagen production, not a temporary substance”.
Sculptra Body treatment programmes at The Skin to Love Clinic are priced from £760 per session (two vials). A consultation is always required before treatment.
Thermage: radiofrequency skin tightening
Thermage uses monopolar radiofrequency energy to heat the deep layers of the skin, doing two things at once: causing an immediate contraction of existing collagen fibres, and triggering the body's natural collagen remodelling process in the months that follow.
Nurse Jane tells us: “It has been used globally for over two decades, with a well-established safety and efficacy record, and it is delivered as a single treatment, one session.”
Thermage is particularly effective for skin laxity on the arms, abdomen, thighs, and knees. In our experience, it also pairs exceptionally well with Sculptra, which is the principle behind our signature facial protocol, SculptLift, developed in-house at The Skin to Love Clinic: Sculptra's deep biostimulation working alongside Thermage's radiofrequency tightening for a comprehensive result that combines the strengths of both. That same complementary logic applies to body treatment. Results develop gradually over two to six months and, in clinical experience, can last up to two years.
HIFU: focused ultrasound for deeper laxity
Where Thermage targets the dermal layer, HIFU (High-Intensity Focused Ultrasound) penetrates to a deeper structural level; the same fascial tissue that a cosmetic surgeon would address in some surgical procedures. “This makes it a genuinely different tool for a different patient requirement” adds Nurse Jane.
Whilst Thermage excels at improving skin texture, collagen density, and surface firmness, HIFU is particularly suited to those where laxity is more advanced and the deeper structural support needs addressing alongside the skin itself.
For the body, including the abdomen, upper arms, thighs, and décolletage, HIFU delivers focused ultrasound energy at precise tissue depths, stimulating collagen production in the layers that underpin the skin’s structure. A clinical trial published in Skin Research and Technology measured skin elasticity objectively before and after HIFU treatment to the abdomen and thigh, finding it to be a safe and effective treatment modality for dermal and subdermal tightening. Unlike Thermage, which is designed as a single treatment, HIFU may require more than one session depending on the degree of laxity being addressed. The two are not interchangeable: they address different depths and suit different patient presentations. Your consultation will establish which, or in some cases which combination, is right for you.
Profhilo Body: injectable moisturiser
Hyaluronic acid is a substance the body produces naturally; its job is to retain water in the skin, keeping it plump, hydrated, and supple. The problem is that, like collagen and elastin, levels decline with age. By your forties, your skin holds considerably less of it than it once did, which is part of why it begins to feel drier, thinner, and less resilient.
Profhilo Body contains one of the highest concentrations of hyaluronic acid available in any injectable product, but it does not work as a filler which also contains hyaluronic acid. Rather than sitting in one place, it spreads through the tissue, delivering intense hydration whilst simultaneously stimulating the production of collagen and elastin.
“It is, in the most literal sense, an injectable moisturiser, one that works at a depth no topical product can reach.” Nurse Natalia tells us. “In our experience, it is better suited to those who want to actively help to prevent skin changes, those who are experiencing very early changes, and or those who wish to achieve plump, radiant-looking skin.”
Treatment involves two sessions, a month apart. Results, improved elasticity; better hydration; and a genuine improvement in overall skin quality; develop naturally and look entirely natural. A 2026 systematic review of nine clinical studies found that Profhilo Body produced statistically significant improvements in skin laxity, hydration, and elasticity across inner arms, abdomen, and knees with a mild and well-tolerated side-effect profile. Profhilo Body is particularly effective on the hands, inner arms, décolletage, and neck, and we’ve seen that it works well alongside the HIFU treatment as part of a longer-term, combined treatment plan.
Fraxel Dual Laser: resurfacing from the top down
Where Sculptra, Thermage, and Profhilo work primarily in the dermis, Fraxel Dual Laser addresses skin quality from the surface downward.
Nurse Jane, former EMEA trainer for Fraxel Dual laser and Thermage says: “Its dual-wavelength system is what makes it distinctive: a 1927nm wavelength targets surface concerns like hyperpigmentation, uneven tone, sun damage, while the 1550nm wavelength penetrates deeper, stimulating collagen production, improving skin texture, solar elastosis and reducing fine wrinkles”.
For crepey skin on the body that is also associated with sun damage, pigmentation, or a fine surface texture rather than significant laxity, particularly on the décolletage, arms, and hands, Fraxel Dual can produce meaningful and visible improvement. Published clinical experience from dermatologists using the 1550/1927 dual system across body areas, including the arms, chest, and abdomen, confirms its safety and efficacy for exactly these presentations. It is a treatment our clinical team have offered for many years, and one which we have significant expertise in.
