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

Question

I'm 31 and, in general, my skin is still very youthful. But after years of smoking/indoor tanning, I'm noticing volume loss above my lips and the formation of two small lines in the perioral region. Right now the lines are barely noticeable but I know they will only get worse. I'm considering tiny amounts of botox to relax my lip muscles, and profractional laser resurfacing to reduce my lines and increase collagen. Is laser resurfacing every several months a good course of action for me?

David R. Stephens, MD · Answer

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!!

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anthony Bared, MD, FACS · Answer

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.

Stephen Weber MD, FACS · Answer

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

Benjamin Barankin, MD, FRCPC · Answer

The best way to prevent perioral lines is to have dark skin and be a male (thicker skin) who doesn't enunciate as much with their mouth. Not smoking, protecting from the sun with hat, sunscreen and avoidance are very important too, as is not sipping with straws. Helps to have great genetics too. Otherwise, topical retinol or tretinoin or vitamin C can be helpful, but Botox is a great starting point preventatively, and fillers when things are deeper. Laser resurfacing with ProFractional is also a great treatment and preventative option.

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

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

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

Answer: Preventing perioral lines

Answer: Preventing perioral lines

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

Answers (10)

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

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

Answer: Preventing perioral lines

Answer: Preventing perioral lines

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Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.