It occurs most frequently on the upper neck below the ears, and on the lower cheeks. The skin is usually darker and may have a slightly red color. The color is uneven and may also be lighter in places. The skin is thinned. Most often, the skin looks the same on the left and right side. The skin directly under the chin is usually not affected. The rash causes little itching or discomfort, but many are bothered by its appearance.
This is most likely a type of sun damage, i.e. the skin has been affected by sunlight over several decades. Skin aging is a contributing factor. Hormonal conditions may play a role, as it can occur during menopause in women. In addition, for some it will be due to an irritation or allergy to perfume or other skin products.
Sun protection can prevent it from getting worse. Quitting perfume or other skin products can help. Weak cortisone creams or other creams on prescription from a doctor can make it better. Laser treatment can have an effect.