Rough and grainy skin on the neck needs to be treated according to the different causes of acanthosis nigricans, sebaceous gland hyperplasia, neurodermatitis, etc. by applying drugs such as isotretinoin, salicylic acid, hormones, antibiotics, etc., or by using different treatments such as freezing and laser. 1. Echinocereus vulgaris: it may be related to vitamin A deficiency, the lesions are flaky dense pinpoint-sized follicular keratotic papules, usually with normal skin color at the base, and each papule is topped with a slender keratin filament, which is rough and prickly to the touch. It can subside naturally and has a good prognosis. Can also withhold taking vitamin A, vitamin E, topical exfoliators such as vitamin A acid ointment, urea ointment. 2. Sebaceous gland hyperplasia: sebaceous gland hyperplasia is usually affected by hormone levels in the body, or caused by chronic inflammation stimulation, there may be a rough skin on the neck with a granular sensation, this disease does not require treatment. This disease does not require treatment. If it significantly affects the appearance, electrocautery, freezing, laser or surgical excision. 3. Neurodermatitis: mental factors and local stimuli are common factors, manifested as rough patches, dry, fine flakes. There may be small flat papules at the edge. Topical glucocorticoids such as chlorohalomethasone cream, compound dexamethasone acetate cream can be used. Oral antihistamines such as loratadine tablets, calcium and other symptomatic itch relief. There may be other reasons for the roughness of the skin on the neck, such as flat warts, and it is recommended that you consult a doctor in a timely manner, improve the relevant examinations to make a clear diagnosis and standardized treatment to avoid delays in the condition. The medication should be used under the guidance of a doctor.