Upper lip lines and wrinkles

Upper lip lines and wrinkles are also identified as perioral rhytids or smoker’s lines. It is a major cosmetic feature of the lower face. But you should know that you don’t have to live with these lines. A dermatologist can do a lot more help than you may have thought possible. But at first you should know what causes this annoying lip lines and wrinkles.

The primary reasons for these wrinkles are sun, cigarettes and straws. Skin around the mouth receives a great deal of ultraviolet light from sun exposure which causes some thinning of the skin and induces elastic and collagen fiber degeneration. Smoking cigarettes and sipping through a straw intensify these features with time. 

The changes around your lips are part of the aging process too. They are first noted early in the thirties and become most apparent in the fifties. Early in life the lips have a full appearance but with time the underlying muscles thin out and the lips flatten.  Lips which were once viewed as full now appear thinner with some degree of drooping.   Studies have shown that the volume of the lips actually stays the same over time, but the length between the corners of the mouth widens, and as a result the volume is spread out over a larger area.

Treatments for troublesome lip lines and wrinkles

It is possible to decrease the contraction of the muscles around the mouth to decrease pouting and frequent folding of the skin. As a result the upper lip becomes smoother, progression of lip lines to greater depth is diminished, and the lips may appear fuller. This may be accomplished by the superficial injection of very small amounts of neuromodulators into the lip margin.  This approach can also be used along with other treatment methods, including microneedling, fractional high intensity focused radiofrequency, chemical peels, and fractional laser resurfacing.

Microneedling is a minimally invasive technique that causes microscopic wounds in the skin which stimulate collagen synthesis.  The procedure is generally well-tolerated after a few minutes of topical numbing cream, is usually repeated monthly for three months and is very helpful in diminishing superficial fine lines.  Other devices have become available in which the microneedles deliver radiofrequency induced heat from within the skin.  This energy is converted to heat, which induces growth factors and improved skin remodeling. 

Fractional laser surfacing can help treat lip lines well.  Treatment with fractional non-ablative lasers such repeated on several occasions, brings about modest improvement in deeper lines but more obvious improvement with very superficial lines.  Treatment with fractional ablative laser such has a higher likelihood of being helpful for deep lines.  These procedures are carried out under topical or local injection anesthesia and have several days to a week of recovery time.

There are many approaches to treat the problem of lip lines and wrinkles, or perioral rhytids. Several are often used as they complement each other.  In most patients, injections of small amounts of neuromodulators are helpful along with the gentle injection of soft tissue filling agents to the area around the margin lip and at times into the upper lip.  As well, microneedling or lasers are used for diminution of lines, wrinkles and textural changes.  Because each of these modalities addresses a separate problem, namely excessive movement, deep lines from collagen degeneration, and loss of fullness due to change in the architecture of the lips, they are often used concurrently to bring about what is often a dramatic improvement in this very common problem.  Discuss with the dermatologist about what would be the best combination of treatments for your lip condition.