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What can be the cause of lip lines, and what can be done?

Lip lines and lip wrinkles are vertical lines on the upper white lip or the mustache area, and in the white skin just below the lower lip. These are relatively common in men and women as we age. The causes of lip lines are often attributed to smokers or those who use straws frequently. It certainly can be seen in patients who fit this profile, but these lip wrinkles also affect non-smokers and those who do not use straws frequently. I see both categories of patients in my practice regularly. The primary cause of visible vertical lines is the underlying muscle of the upper lip, which is called the orbicularis oris, contracting. This can happen with pursing the lips, with cigarette smoking, with straws, or with applying lipstick. More often than not, however, blemished skin and wrinkles result from how patients express themselves and move their lips in natural conversation and premature aging. If anything, smoking may lead to the development of more wrinkles, but other lifestyle habits can cause wrinkles like sun damage or signs of aging. Over time, the muscle contracts even when it is at rest, due to its natural tone, thus developing lip wrinkles and fine vertical lines. At this point, hyaluronic acid treatment at the doctor’s office is your best best to prevent wrinkles and achieve younger-looking skin.

Over time these fine lines and wrinkles become visible even during periods of rest. In my practice, the first line of treatment is a low-dose superficial treatment with Botox in the surrounding area. This addresses the root problem, which is muscle contraction. Botox causes a softening of the contraction and resting tone, which often alleviates or dramatically softens lipstick lines, lip wrinkles, and smoker’s lines and often prevents lip wrinkles in the future. For patients with deep wrinkles or stubborn wrinkles that persist after superficial Botox treatment, I use dermal fillers, such as Juvederm, on a limited basis. Injectable fillers are not my first line of treatment because they add volume to the white area surrounding the lips and can cause an upper lip area that is naturally lower or concave to become level or convex. This can look unnatural if not done very carefully. When performed by a reputable healthcare provider, this treatment option can stimulate collagen production, remove dead skin cells, plump lips, combat chronic dryness, prevent lip lines, add moisture, and leave you with a more youthful appearance. While other cosmetic procedures like chemical peels and laser resurfacing can prevent lip wrinkles and increase collagen production, these procedures require more invasive measures and are not suitable for all skin types– especially sensitive skin.

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