What can be done about vertical lines above the top lip?

The most effective way of approaching the vertical lipstick bleeding (bar code) lines above the upper lip is to address both primary causes of this common cosmetically troubling problem. Increasing overactivity of the muscles of facial expression around the mouth are the underlying cause. Repetitive overactivity of these muscles everntually leads to the "etching" of the overlying skin into the characteristic vertical lines you describe. (They similarly and quite commonly also occur below the lower lip, as well). So, in order to most effectively treat these lines, it is wise to both suppress the overactivity (not freeze) of the muscles encircling the mouth, which takes only a few microndroplets of Botox (or Dysport or Xeomin) to achieve. And, filler, can then be used to smooth the "etched-in" lines that have already form. Both procedures are quick and most often performed together in the same treatment session, which should take no more than five minutes or so in experienced hands. The results are typically quite gratifying. Make sure you consult with a board certified aesthetic physician with experience and expertise in treating this region, as this is not an area that should be left to novice injectors accustomed only to treating ordinary smile lines with simple Restylane or Juvederm. Best of luck.

Thank you for your question.It is difficult to know what would be your best option would be without seeing a photo. Juvederm or Volbella can be great options to fill in the lines. There is also the option of microneedling, which can help stimulate collagen and decrease the lines over time.

A combination approach would give the most improvement.  Fractional co2 laser or fractional RF treatments are usually best to this area in combination with fillers and/or botox. I suggest you see a cosmetic dermatologist for a formal evaluation. Best, Dr. Emer