Tips for Lips…

Understanding how lip lines (perioral wrinkles, smoker’s lines) develop may help in preventing them. It also may help in successful maintenance of your post-treatment pucker – the rejuvenated, smooth, pillowy one.




The Causes

To begin, the fairer your skin, the less melanin you have. As the primary function of melanin is to protect skin from sun damage, the less melanin you have, the more sun damage you will sustain in comparison to darker skin types. Fairer skin types have higher instances of lip lines caused by sun exposure than darker skin types.

Next is for those who tan, whether intentionally (beach, beds, rooftops, etc.) or not (forgetting sunscreen). Tanning accelerates skin aging faster than smoking does. Neither tanning nor smoking offer health benefits to any part of the body.  As for the toll smoking and tanning takes on skin, both kick the degradation of collagen and elastin into orbit.

Let’s clarify why smoking is hazardous for skin health. Smoking depletes oxygen and slows circulation, wreaking havoc on all organs (by the way, skin is the largest organ – 22 ft and 20 lbs for the average human). Starved of oxygen, skin becomes dull and lifeless, and wrinkles form quickly, particularly around the mouth. Additionally, the repetitive muscle actions of the orbicularis oris around the mouth required to grasp a cigarette, paired with significantly reduced supply of O2, almost always guarantees smoker’s lines.

As a matter of fact, smoking is so bad for skin health, lip lines are called smoker’s lines whether or not they have been caused by smoking!


LIP TIP:  Don’t smoke.


Regarding sun damage:  UV radiation has a profound effect on skin. About 80% of skin aging is caused by sun exposure.

Besides wrinkles, a long list of skin issues and disorders are caused by the sun. This list includes skin cancer, compromised immunity, propensity to bruise and to form spider veins because UV radiation thins and weakens walls of blood vessels. The list continues with sun-induced pigment issues, age spots and freckles, bumps, lumps, moles, wart-like lesions, and those aging and bad habit revealing (smoking, tanning) lip lines!


LIP TIP:  Wearing lipgloss in the sun basically is like holding a magnifying glass to your lips. We all love gloss, just be sure sunscreen is included in the product, or wear sunscreen under the gloss.


Another “cause” of lip lines is aging. As we age, we lose facial volume. Unfortunately, losing facial volume with aging generally does not reveal hidden sharp and chiseled features. Instead, losing facial volume deflates skin (imagine a grape becoming a raisin).

With aging and volume loss, lips flatten and shrivel, Cupids’ bows straighten, definition of lip borders fade, and skin’s ability to hold moisture dries up.  Further, decades of repetitive contraction of the muscles around lips (eating, talking, kissing, etc.) eventually takes a toll on skin’s ability to smooth out. In other words, the action of the orbicularis oris muscles creasing skin around lips is much like folding a piece of paper over and over along the same lines. To stop the muscle’s ability to crease skin, a small dose of our favorite neurotoxin works.


The Remedies

Following is a short list of treatments to smooth, plump and soften lip lines:

1. Sunscreen.

Use sunscreen every single day on any exposed area, including lips. As a matter of fact, wearing sunscreen should be considered as important as brushing your teeth. Studies show wearing sunscreen can reverse skin aging, and certainly can prevent compounding future damage.

Reminder: Wearing gloss in the sun is like holding a magnifying glass to your lips. Use sunscreen first and always.


2. Replace lost volume with dermal fillers. (Think of inflating a raisin back into its original juicy grape form.)

Fillers appropriate for lips and lip lines usually are not the same fillers as those for heavier lifting such as those for cheek augmentation or jawline contouring. Using dense fillers for lips and lip lines almost always is disastrous. A well trained injector with artistic sensibility will know how to restore your natural lip shape and correctly fill lines.

Soft, fluid fillers such as Juvederm or Volbella are best for lips and vertical lip lines. Results are instant, and there is no downtime…unless bruising happens.


*Medications/ supplements to stop about a week before injections to reduce chances of bruising: Aspirin, Ibuprofen, Omega 3, Vitamin E, Ginko Biloba, Chondroitin, Alcohol, Ginseng, Garlic.

*NEVER STOP PRESCRIPTION MEDICATIONS regardless of their effects on increased chances of bruising.


3. Botox.

Botox can reduce movement around your lips to give the appearance of smoother skin around lips. Of course, it may take a few sessions to see significant results, much like softening a permanent crease in pants versus ironing wrinkles; some lines just take a little more work. Botox also can be used as a preventative measure for lip lines.

By the way, Botox is the only solution for those who perpetually purse lips. Eliminate the cause, and the problem usually is alleviated.


4. Phenol/Carbolic Acid.

On the strength/depth spectrum chemical acid peels, Phenol/Carbolic acid weighs down the deep end as the strongest chemical peel. Phenol/Carbolic acid can yield the most dramatic improvement of perioral lines in comparison to any other acid peel and oftentimes, any other treatment.

Phenol/Carbolic acid penetrates skin at a depth needed to effectively address serious lines and wrinkles. It penetrates skin past the epidermis to the top layers of the dermis. Skin is forced to repair and regenerate itself, producing thick, strong collagen to fill in the treated lines.

The list of potential risks and complications, such as permanent scarring, hyperpigmentation, hypopigmentation, infections, misplacement, tissue injury, accidental spillage especially in eyes, toxicity, confirms this acid should only be administered by an experienced professional. In other words, DO NOT TRY THIS AT HOME!


5. SkinPen + TCA or Secret RF

Microneedling also is known as collagen induction therapy. Multiple sterile needles puncture the skin at controlled depths, stimulating skin to produce collagen and elastin to fill the damaged “tunnels.”

To heightened results of microneedling with serious tissue tightening, TCA (trichloroacetic acid) may be used, but must be used with great caution. (see above: The list of potential risks and complications)

Secret RF combines microneedling with radiofrequency (aka RF, electrical energy). Microneedling devices incorporating RF can heat targeted skin depths (that is the dermis where collagen is produced) to temperatures known to induce collagen production at top rates. The micro“needles” not only induce collagen themselves, but also serve as conductors for the RF energy. The ability to focus varying amounts of energy at multiple layers of the dermis results in superb tissue tightening and impressive skin remodeling.



While there are other effective treatments for lip lines (CO2 resurfacing, dermabrasion), the downtime and risks of these treatments are discouraging to most patients. The treatments listed above have minimal to no downtime and carry few risks; however, these treatments may need to be repeated to yield desired results.