What is the Best Method to PREVENT the Worsening of Perioral Lines (I.e. Vertical Lip Lines, Smokers Lines)?

At 31 you are noticing early changes in your skin and that reflect the development of some new lip lines. This is early for most women and disconcerting.You nailed the likely culprits, namely smoking and UV radiation. There are probably other genetic and racial factors too, such as the predisposition of northern Europeans to have thinner skin as well as the role of the upper jaw and teeth in supporting the upper lip. This could have a role in your noticing that your lips are thinning out. It has been pointed out to me by experienced aestheticians, that men don't have perioral lines because they shave. Interestingly, I don't see these on men to the degree that they are found in women. That said, I have a Sciton Laser with fractionated and resurfacing systems. I have done deep resurfacing for deep lipstick lines with very good results averaging roughly 50% improvement per treatment.  Like dermabrasion used previously, erbium Laser resurfacing seems to work better than CO 2 devices for this. I also place small amounts of Botox in the superficial lip which helps but may cause some difficulty with preventing dripping water through the lip. Interestingly, I have seen this help to plump the lip, although it is not a filler. I think fractionated Laser is a good adjunct but resurfacing is the key. Diluted Juviderm also seems to work well for fine lines but very little is used and this may not last more than a few months. Frequent light Laser resurfacing with small doses of Botox are a good way to treat a few lines with minimal down time; you should do both due to the preventative effect of both. Deeper resurfacing will yield more dramatic improvement, but with more downtime. Find an experienced board certified plastic surgeon or dermatologist with this device. I think that it is a great Laser for this application. Also, you need to stop tanning your face, (and everywhere else, I know it makes you look healthier and sexier right?). Seriously, a sunscreen and Retin A or retinols help improve skin turnover; exfoliating may help too. Consider using a good medical grade skin care line for your face as the lips are probaply an indication to what is happening to your facial skin in general. Good luck!!

As far as the prevention of perioral lines the first recommendations are the obvious lifestyle modifications of smoking cessation and sun exposure avoidance.  Treatments with small amount of Botox to this area are helpful in softening these lines and preventing the worsening of the lines.  You should also start on a topical skin care regimen with tretinoin which helps improve sun damage skin and sunscreen.  Additionally, to treat the existing wrinkles, fractionated laser is a great option with minimal downtime.

This is an incredibly common problem in Denver due to the dry climate and intense year-round sun exposure. Botox and dermal filler tend to be highly effective. Laser resurfacing can also be very helpful but in many cases needs to be aggressive to achieve results. The best option is prevention of further damage to this skin. This includes avoiding tanning, wearing sunscreen, using Retin-A and moisturizer. It sounds like you're on the right track. I hope this information is helpful.Stephen Weber MD, FACS