How can I get rid of these lines on my forehead and cheeks? (Photos)

Question

Why does my cheek have these lines when I smile? I moisturize but that doesn't fix it. would Botox? I'm 29.

Tania Hassanzadeh, MD · Answer

Hi there,
Thanks for your question! It looks like you are noticing lines pronounced in the so-called "crow's feet". These are caused by normal, physiologic contraction of the muscle around your eyes. You are at the right age to start considering neuromodulator treatment to smooth these lines. I would start there, but if you continue to notice fine lines, you may benefit from a gentle resurfacing laser treatment, such as fractionated erbium, to maximize your results. And of course, maintaining your skincare regimen with a good daily moisturizer as well as a mineral sunscreen is also important.
Hope this helps!Dr. H

Raffy Karamanoukian, MD, FACS · Answer

Non-surgical options for cosmetic dermatology and plastic surgery continue to improve with time. Botox injections and Volume fillers continue to be at the forefront of cosmetic rejuvenation given their high safety profile and efficacy. Facial fillers are used to volumize areas of premature hollowness or wrinkling, whereas Botox is used to reduce hyperactive facial muscles around the eyes, forehead, and chin.

Understanding the various attributes of each filler and Botox option can be discussed in detail during your consultation in our Beverly Hills or Santa Monica offices. Rest assured that we will provide you with exceptional attention to detail and professionalism. 
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic Skin in Chicago.  Thank you for submitting those pictures.  Botox can help soften those lines up and reduce the appearance of them.  I would recommend you have a consultation in office with one of our amazing providers.  You can call our office at 312-944-0117.

Allan E. Wulc, MD · Answer

Hi Tennis Kid,
Great question&mdash;and I’m going to guess you’re spending a lot of time outdoors on the court, which is a big part of what you’re seeing.
Those lines in your cheeks when you smile are dynamic wrinkles, but at 29, they’re usually not just from aging&mdash;they’re often from a combination of:
sun exposureearly changes in skin elasticityrepetitive facial movement (smiling, squinting in bright light)
Moisturizer alone won’t fix this because it doesn’t address the underlying skin changes.
Here’s how I’d think about it:
1. Sun protection is critical (this is the big one for you)**If you’re playing tennis regularly, daily **broad-spectrum sunscreen** is essential. Without that, nothing else will hold up very well. Consider sunglasses!!
2. Improve skin quality**A more active skincare approach can help:
-Vitamin C serum (morning)**-Retinoid (evening)**-Periodic **chemical peels**
These help restore some of the skin’s resilience and smoothness.
3. Botox?Yes&mdash;**Botox can help, particularly for lines that appear with smiling. It softens the muscle activity so the lines are less pronounced. It won’t replace good skincare, but it’s often part of the solution.
Bottom line:At your age, this is very treatable&mdash;but it usually takes a **combination approach**, not just one product.
I’d suggest seeing a **dermatologist or facial plastic surgeon** who can guide you through this properly and tailor it to your skin and your level of sun exposure.
You’re catching this early, which is a big advantage.
Good luck!
Allan Wulc, MD

Anna Chacon, MD, FAAD · Answer

Hi there—this is such a common concern, especially around your late 20s when you start noticing lines that weren’t there before. I want to reassure you first: what you’re seeing is very normal and often very treatable.

Why you’re noticing these lines

From your description, the lines on your:

Forehead are likely dynamic lines, meaning they appear with movement (like raising your brows)

Cheeks when you smile are usually due to natural facial expressions, skin folding, and sometimes early changes in skin elasticity

At 29, this is often more about how your muscles move and how your skin folds, rather than deep aging or volume loss.

Why moisturizer alone isn’t fixing it

Moisturizer helps with hydration and can make lines look softer temporarily, but it doesn’t:

Relax muscle movement

Change how the skin folds during expressions

So it’s helpful—but not enough on its own for expression lines.

Would Botox help?

Yes—Botox can be very effective, especially for the forehead.

It works by relaxing the muscles that cause repeated folding of the skin

This softens existing lines and helps prevent them from becoming deeper over time

At your age, results can look very natural when done conservatively

For the cheek lines when smiling, Botox is a bit more nuanced:

It can help in certain areas, but too much can affect your smile

So it needs to be done very carefully and selectively

Other options that can help

Often, the best results come from a combination approach:

Lightweight filler (in select cases)
Can support the skin and reduce folding if there’s slight volume loss

Skin-quality treatments
Such as microneedling, lasers, or collagen-stimulating treatments to improve elasticity

Topical retinoids
Help build collagen over time and smooth fine lines

Daily sunscreen
This is key—sun exposure accelerates the formation of fine lines

What I’d recommend thinking about

Forehead lines → Botox is usually very effective

Cheek lines → Start conservatively, focus on skin quality first, then consider subtle treatments if needed

A gentle perspective

Lines that show when you smile are also a reflection of natural, healthy facial movement. The goal isn’t to erase expression—it’s to soften what bothers you while keeping you looking like yourself.

You’re catching this early, which actually puts you in a great position to maintain smooth, natural-looking skin long-term.

Kally Papantoniou, MD, FAAD · Answer

Lines that show when you smile are usually dynamic, meaning they’re caused by movement rather than just dryness, so moisturizer alone won’t really change them.

Botox can help soften lines in the forehead, but it’s not typically used in the cheeks in the same way. For cheek lines, it’s more about skin quality and support than muscle movement.

A combination approach is often considered depending on what’s causing the lines, so it’s best to have a professional evaluate your skin and guide you on what makes sense for you.

Glenn Murray, MBBS · Answer

These are classified as static lines, which develop over time due to repetitive muscle activity—such as smiling—as well as the natural decline in collagen and elastin with age. Treatment with botulinum toxin can help by reducing the underlying muscle movement, thereby softening the appearance of these lines and preventing further deepening as the skin continues to age.

In conjunction with botulinum toxin, I would also recommend incorporating collagen‑stimulating treatments to further improve skin quality and reduce the visibility of these lines. Effective options include microneedling, RF microneedling, laser resurfacing, or biostimulators, all of which support dermal remodeling and enhanced collagen production.

Thank you and Take-Care.

Dr Murray.

How can I get rid of these lines on my forehead and cheeks? (Photos)

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