Treatments for Vertical Lines Around The Mouth

Cynthia Bailey, MD|December 8, 2011

The vertical lines around the mouth are challenging to fix but now there are things you can do to improve them. Most people call these lines 'smoker's lines' but they aren't necessarily from smoking.  Everybody will eventually get them as they age, smokers just get them earlier, and so do women. I want to give you a quick overview of how I treat them in my dermatology practice.  To reduce the  appearance of vertical lines around your mouth consider one or more of the following treatments (click on any of the blue links to see more about the options).

The Best Treatments For 'Smoker's Lines'

Using skin care products to brighten the skin. These will lessening the dark, wrinkled textural appearance of this area and it's something you can do with your at-home skin care regimen. The best product options include prescription tretinion, retinol (helpful, but not as effective as prescription tretinoin), and AHA products (the best contain glycolic acid with a concentration over 10% and pH around 4). The tretinoin and AHA products may also stimulate a little collagen formation under your skin to actually build up the area to help permanently diminish the wrinkles too. Doing a series of superficial professional skin treatments that peel, abrade and brighten the skin. These treatments include microdermabrasion treatments, chemical peels and intense pulsed light treatments (called BBL in my office). They lessen the uneven pigment and brighten the skin around your mouth, thus improving the the rough, textural appearance of your perioral skin (the area around the mouth).  Brighter, lighter, more evenly colored skin looks smoother and less wrinkled because it throws more light.  Done right, these superficial treatments may also stimulate a little new collagen formation in the superficial dermis to help structurally reverse wrinkles too. Doing cosmetic procedures that treat the deeper layers of the skin. The perioral lines (wrinkles) are actually due to both collagen thinning and tissue volume loss in the deeper levels of your skin.  To really reverse them, you need treatments that reach these areas. The easiest, quickest gratification treatment for wrinkles around the mouth is dermal filler injection.  Dermal filler injection replaces some of your tissue volume that's lost with age.  My absolute favorite filler is Juvederm. You get instant results that last a long time.  Plus, Juvederm is a very soft hyaluronic acid filler and it may even be biostimulatory meaning that your body may naturally build collagen where we place the filler giving you even longer lasting rejuvenation. Laser resurfacing procedures help you build collagen in the mid to superficial dermis, just above where we place fillers.  When you combine laser resurfacing procedures with fillers you get the best and most comprehensive improvement in this deeper skin layer.  To significantly treat perioral lines the laser procedures need to be pretty deep and you will most definitely down time.  Think of these ablative laser treatments as a 'controlled injury' that stimulates collagen as a part of your body's healing process.  You continue to build collagen for up to 6 months after having a laser treatment.  We usually recommend a series of treatments for optimal collagen stimulation. The laser resurfacing procedures that I've seen give the best results with the fewest risks are the ablative erbium laser treatments. In my office I use the Sciton erbium laser for Tunable Laser Resurfacing, Micro Laser Peel and ProFractional laser treatments. The laser is so flexible and easy for me to use that I can combine treatments in one session for my patients so that we can get a lot done with each treatment. You could also consider deeper chemical acid peels to create a 'controlled injury' sufficient to stimulate collagen formation in the deeper skin layers.  These treatments, like laser resurfacing, will have significant down time and are always done by physicians. What's the best treatment for perioral lines, wrinkles? It's all of the above! For my patients, I build them a skin care regimen that brightens skin, stimulates collagen and slows the aging process.  My 'go-to' products include my Anti-aging Facial Rejuvenation Kits that include glycolic acid (and/or I prescribe tretinoin in place of the glycolic acid). Dermatologist's Anti-Aging Skin Care Kit

Click here to see why I combine these specific products for the most comprehensive anti-aging skin care regimens.

If a patient can handle the down-time, we do a couple of deeper laser resurfacing treatments spaced about 6 weeks apart and then finish with Juvederm dermal filler injection treatment at about 6 weeks after the last laser treatment.  At that time we also begin a program of regular professional skin care treatments with my aestheticians including facials with either microdermabrasion treatments or light chemical peels.  This approach is transformational, taking years off of a person's appearance.  Not only are the perioral lines improved, but their entire facial appearance benefits. Smoker's perioral lines are some of the toughest facial aging issues to treat.  In my dermatology practice I find that they're also one of the things that bother people the most about their appearance - they imply a look of wear and tear and none of us like that.  Happily, we now have some great options to help tame the appearance of 'smoker's lines'. Photo: Thanks and Gratitude to Ronsho

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