Smoker Lines: Upper Lip Wrinkles and Treatment Options

Lipstick that seeps into thin lines, fine lines you see mostly up close, above the upper lip: these are wrinkles around the mouth, also known as smoker lines, and they are not all treated the same way. Some are related to the muscle, others to skin marked by the sun, others to volume loss. CARE MD, in Sainte-Thérèse, on the North Shore, starts by distinguishing between these causes, then discusses, after an assessment, injections, fractional CO2 laser, ablative CO2 laser resurfacing or focused ultrasound, without presenting any one of them as the solution. These treatments fall within facial rejuvenation, of which they are only one part.

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Three-quarter view of a man's lower face, with fine wrinkles above the upper lip and a fold at the corner of the mouth.

At a glance

Six things to know before deciding

Location and names: fine lines above the upper lip and around the mouth; they are called perioral wrinkles and, sometimes, "barcode" lines or smoker lines, a name that does not mean you smoke.
What deepens them: the muscle that surrounds the mouth and contracts constantly, the sun, tobacco and the loss of volume that comes with age; on examination, the doctor also looks at the teeth and their support.
Remedies and exercises: a moisturizer and sun protection help the skin's surface and limit aging; no remedy, oil or exercise is promised to erase these wrinkles.
The options: injections, fractional CO2 laser, ablative CO2 laser resurfacing and focused ultrasound; each meets a different need, none is the solution and none guarantees that wrinkles will be erased.
Before any treatment: an assessment, during which the doctor also considers what each treatment can offer around the mouth, and which can lead to postponing or changing a treatment, or deciding not to perform it.
Warning after filler injections: unusual pain or a change in vision during or shortly after the injection requires immediate medical attention.

What Are These Wrinkles Called, and Where Are They?

The medical name is perioral wrinkles: small wrinkles in the skin around the mouth and lips. Above the upper lip, they are sometimes called "barcode" lines, the name many people use when they search for these lines. "Smoker lines" is another common name. Tobacco contributes to these wrinkles, but having them does not mean you smoke.

Front view of a woman's mouth and cheeks, showing fine lines above the lip and folds between the nose and the corners of the mouth.

To understand these wrinkles, look at when they appear and where they run. Some lines change with movement: they appear only when you talk, smile or purse your lips, while others stay visible when the face is at rest. The first are expression wrinkles, or dynamic wrinkles; the second are set-in, or static, wrinkles, and the two often occur together. Where the folds run also helps distinguish them. The nasolabial fold runs from the side of the nose to the edge of the mouth, and the marionette line descends from the corner of the mouth toward the chin. These folds do not follow the path of the fine lines of the lip, and they are approached differently, like the nasolabial fold, where the main aim is to restore volume. A darker spot on the lip is not a wrinkle either: a wrinkle is a fold, a spot is a colour, and the doctor tells them apart on examination.

Not all wrinkles on the face form in the same way: the relative contribution of movement, surface and volume varies by area, from the forehead to the neck.

Why They Appear: Muscle, Sun, Tobacco, Volume and Teeth

No single cause explains them, and the contribution of each varies from person to person.

The muscle: A circular muscle surrounds the mouth. It contracts every time you talk, eat or smile, and these repeated contractions contribute to wrinkles around the mouth. Over time, a line that appeared only with movement can stay visible at rest.
The sun: It plays a major role in premature skin aging, including the skin of the upper lip. Protecting yourself from it limits this aging; it does not erase wrinkles that have already set in.
Tobacco: It speeds up skin aging and deepens wrinkles. It is one factor among others; your wrinkles do not reveal whether you smoke.
Volume: With age, the area around the mouth loses volume, which contributes to established wrinkles visible at rest. The skin's surface, its volume and its support are three distinct things, which do not call for the same treatments.
The teeth: During the examination, the doctor looks at your teeth and their support. A skin treatment does not correct a dental problem.

Skin Care and Natural Remedies: What to Expect From Them

Two habits help the skin's surface and help prevent aging. A moisturizer keeps water in the skin and can make some fine lines less noticeable. Daily sun protection, using a broad-spectrum sunscreen with an SPF of 30 or higher, limits sun-related aging. Neither fills a set-in fold nor restores volume.

An oil, a home massage or a traditional home remedy does not guarantee that a set-in wrinkle will be erased. Facial exercises do not guarantee it either. Natural does not mean risk-free: a product that irritates the skin makes the signs of aging more visible.

The Options, Depending on What You See

The choice depends on what bothers you: a line deepened by muscle movement, a hollow, changes in the skin's surface or skin that is sagging. Treatments do not all act on the same element.

At CARE MD Line deepened by muscle movement: An injection that relaxes the muscle; it acts on movement.
At CARE MD Hollow or loss of volume: An injection that adds volume.
At CARE MD Skin surface: Fractional CO2 laser or ablative CO2 laser resurfacing.
At CARE MD Deep tissue tightening: Focused ultrasound.
Offered by CARE MD: Injection, fractional CO2 laser, ablative CO2 laser resurfacing and focused ultrasound; whether each is appropriate around the mouth is confirmed during the assessment.

Injections: Relaxing a Muscle or Adding Volume

An injection that relaxes the muscle reduces the contraction that creases the lip. It therefore targets expression wrinkles and, on its own, it is not enough to fully correct those that remain at rest. An injection that adds volume raises areas that have become hollow as volume is lost with age; its result depends on the structure of the tissues, the quantity and the type of gel used. Adding volume to the lips or folds does not automatically treat the fine lines around the mouth: lip injection changes their volume and contour, which does not address the same concern as a fine vertical line.

Among cosmetic injections, these two types have different roles: one reduces movement, the other adds volume. A physician, or a nurse injector supervised by a physician, performs them. A resorbable gel is gradually absorbed by the body, and the effect may call for repeat injections; you and the doctor decide how often.

CO2 Laser: Fractional or Ablative

An ablative laser vaporizes part of the tissue, whereas a non-ablative laser heats it to coagulate it. Ablative fractional CO2 laser has greater benefits and risks than non-ablative fractional laser, but lower benefits and risks than fully ablative resurfacing. "Ablative" describes the action on the tissue; "fractional" describes another characteristic of the treatment. The two terms are not opposites. Mild to moderate wrinkles respond to it more than deep wrinkles, and the maximum benefit requires several sessions. Ablative CO2 laser resurfacing has a greater effect, with a longer recovery. A physician, or a nurse supervised by a physician, performs these laser procedures. Laser treatment of the face can act on the skin in an ablative or non-ablative way; recovery is one of the differences to consider.

Focused Ultrasound

Focused ultrasound delivers energy that turns into heat in the supporting tissues under the skin and in the deep layers of the dermis. It aims to tighten the skin. This tightening has been observed in mild to moderate sagging of the face; what it can offer for fine wrinkles around the mouth remains to be confirmed. An esthetician or a nurse performs this treatment. Focused ultrasound for the face therefore aims to support the skin, rather than adding volume with a gel.

What Remains to Be Confirmed Around the Mouth

Before choosing a treatment around the mouth, you need to check whether it is indicated for this area and for what you want to change. A device's licence covers specific uses; the availability of a treatment is not enough to establish that it suits you. For injections too, the doctor checks their use area by area. This check can lead to postponing the treatment or to not intervening.

What to Expect: Effects, Duration, Recovery

The result, the time before you see it, how long it lasts and the number of sessions vary from person to person and from one treatment to another; the doctor clarifies them during the assessment for the treatment being considered. No treatment guarantees that a wrinkle will be erased.

Injection that adds volume: Swelling and bruising, mostly early on, which go away within a few days to a few weeks; effects can also appear weeks, months or years later.
Injection that relaxes a muscle: This injection acts on contraction, not on volume; before choosing it for the mouth, ask which after-effects to expect in this area.
Fractional CO2 laser: Pinpoint bleeding, oozing and scabs in the first days, then redness and swelling that last longer.
Ablative CO2 laser resurfacing: Significant downtime, and redness that can last for months.
Focused ultrasound: Moderate pain during the treatment, then temporary redness, with or without swelling.

These treatments are not surgery, which does not mean they come without after-effects or without risk. CARE MD does not offer surgery; if it is appropriate for your situation, the doctor will guide you toward it.

The Risks Specific to This Area

Laser: Pain, redness, swelling, bruising, blisters, burns and infection; the skin can also become lighter or darker, most often temporarily.
Cold sores: Mention recurrent cold sores; the doctor takes them into account during the assessment, before any laser treatment.
Injection that adds volume: Swelling, bruising, and, more rarely, the reactivation of a cold sore. The most worrying risk is the accidental injection of the gel into a blood vessel: it is low, but its consequences can be serious and permanent, with tissue death, vision problems that can include blindness, or stroke.
Injection that relaxes a muscle: The vascular risk of filler does not describe the risks of this procedure. Its precautions specific to the mouth must be clarified before choosing it.
Focused ultrasound: Numbness or hypersensitivity, bruising, tingling, burning sensations along the jaw, streaks and contact dermatitis are possible.

Seek care right away

During or shortly after an injection that adds volume, unusual pain, a change in vision, white, grey or blue skin near the injection site, or a sign of stroke (sudden difficulty speaking, numbness or weakness in the face, arms or legs, difficulty walking, a drooping face, severe headache, dizziness or confusion) require immediate medical attention. Do not wait for a response to a form, and do not put them down to ordinary swelling. Before laser or ultrasound treatment, ask for written instructions that distinguish expected after-effects from complications and specify when to get medical help. The form is not for emergencies.

Why an Assessment Comes Before Treatment

The same fold can have several causes and call for different treatments. CARE MD offers a Global Aesthetic consultation. To prepare for this discussion, note what bothers you at rest and with movement, what you want to change, the treatments you have already had and the recovery time you can accept. You can also ask questions about the lips, the teeth and their support, the skin and volume. An examination of the skin may show that another treatment is more appropriate; a spot, a dental problem and a desire for volume do not automatically call for the same procedure. The discussion is an opportunity to consider the options, including waiting or not treating.

Also tell CARE MD's professionals about any information that can affect the precautions:

Tobacco: Tobacco ages the skin, and the doctor takes it into account.
Cold sores: Especially if they come back, before laser treatment.
Previous injections and procedures: Any cosmetic treatment you have already had, including other injections.
Allergies and healing: Your allergies, skin that becomes irritated easily, healing problems.
Bleeding and medications: Your clotting disorders, all your medications, even those without a prescription, and your vitamins, minerals and herbal products.
Pregnancy and breastfeeding: The safety of filler has not been established in these situations.
Your expectations: What you would like to change and what should stay as it is.

Ask Us About Wrinkles Around the Mouth

Frequently Asked Questions

Natural remedies and exercises for wrinkles around the mouth: what can you expect?

A moisturizer and sun protection can help, without erasing a set-in fold. A moisturizer keeps water in the skin and can make some fine lines less noticeable, and daily sun protection, using a broad-spectrum sunscreen with an SPF of 30 or higher, helps keep the sun from aging the skin of the upper lip further. Quitting smoking also limits what speeds up aging. These habits help prevent aging and improve the skin's surface; they do not fill a set-in fold. Facial exercises do not guarantee that wrinkles will be erased. An oil, a home massage or a traditional home remedy does not guarantee it either, even when forums praise its effect. Natural does not mean risk-free: a product that irritates the skin makes wrinkles more visible. If a set-in wrinkle bothers you, it is better to discuss it during an assessment than to try one product after another.

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