How to get rid of mouth lines: what should you do first?
“Make-up does not even hide the lines around my mouth.” That is true. The mouth moves all day, so foundation settles into the lines and makes them stand out more. But not every line around the mouth is the same line. Let me first sort out which one it is.
The short answer
Fine vertical lines above and below the lips, lines that appear only when you smile, and lines running down from the corners of the mouth are different from one another, so the approach differs too. For the fine vertical lines, the evidence is for hyaluronic acid filler spread thinly over many points. In a randomised trial of 136 people, 72–87% had improved by at least one grade at 6 months. For lines running down from the mouth corners, I look at mouth-corner botox together with volume and lifting. There is little research on botox around the mouth (2 of the 65 trials in a Cochrane review). Smoking keeps turning up as something that makes mouth lines worse. At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700, we first sort out which line it is.
What types of mouth lines are there?
| Type | Where | Considered first |
|---|---|---|
| Vertical lines above and below the lips | Around the lips, deeper when you purse them | Hyaluronic acid filler spread thinly, a very small amount of botox |
| Lines that form when you smile | Beside the mouth corners | Usually left alone — part of your expression |
| Lines running down from the mouth corners | Marionette lines | Mouth-corner botox, volume and lifting |
| Nasolabial folds | From beside the nose to the mouth corners | Volume and lifting (botox changes them very little) |
What smooths the vertical lines above the lips?
These lines form where the skin has thinned after the muscle that purses the lips has folded and unfolded it countless times. That is why most of the research is on filler placed very thinly, spread over many points.
- A trial that randomised 136 people with moderate or worse mouth lines to two hyaluronic acid fillers — at 6 months, 87% and 72% had improved by at least one grade (mean age 58)
- A randomised trial of 225 people given filler in the lips and around the mouth — the share whose mouth lines improved was 65.4% at 3 months and 66.2% at 1 year
- A split-face comparison of mouth filler in 30 people — bruising was half gone by day 7 and all gone by day 14
All of these trials were funded by the companies that make the products. Rather than taking the numbers at face value, please read them as “roughly this range”.
Can I have botox around my mouth?
You can. But the evidence is thin. In a Cochrane review that pooled 65 randomised trials and 14,919 people on botox for facial wrinkles, only 2 trials looked at the area around the mouth. Most were on the frown lines between the brows.
The mouth is where the muscles for speaking, eating and smiling meet, so too much can make it hard to drink through a straw or make your speech sound a little off. That is why I start mouth botox with a very small amount, and mostly think of it alongside filler. Lines running down from the mouth corners are a separate matter.
Does smoking really affect mouth lines?
Yes. In a study of 186 pairs of identical twins, the twin who had smoked longer looked older, and their wrinkles were more visible. These are comparisons between twins with the same genes, so the numbers carry more weight. The mouth is also where the action of holding a cigarette is repeated.
That is why I recommend stopping smoking before any treatment. If you do not stop, what has been put in will also look as if it is breaking down sooner.
Do creams and cosmetics for mouth lines work?
I could not find a cosmetics study that looked at the mouth area on its own. For fine lines across the whole face, prescription retinoids (tretinoin) worked in a 48-week trial, but the skin around the mouth irritates easily, so take care not to apply them close to the lips. And do put sunscreen around your mouth too.
→ More: Types of facial wrinkles: does each need a different fix?
Mouth lines: frequently asked questions
Which is better for mouth lines, filler or botox?
For the fine vertical lines above the lips, there is more research on hyaluronic acid filler spread thinly. Botox is sometimes used alongside it in a very small amount.
Will botox around my mouth make speaking awkward?
Too much can make drinking through a straw or your pronunciation feel off. That is why I start with a very small amount.
How long does bruising from mouth filler last?
In a study of 30 people, it was half gone by day 7 and all gone by day 14.
Where can I get a mouth lines consultation in Daegu?
At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700. Weekdays 11:00–19:00, Saturday 10:00–16:00, closed Sundays and public holidays.
Read next
Product pages
Related treatments: Nasolabial folds · Lifting · Types of facial wrinkles
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, director of Miso Clinic, Daegu. The treatment standards and injection design set out here are the ones we use in practice.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- Randomised trials of filler for mouth lines — Butterwick K et al. Dermatol Surg 2015;41(12):1351-60. PMID 26606435 (136 people, 6 months) / Geronemus RG et al. Dermatol Surg 2017;43(3):396-404. PMID 28157728 (225 people, 1 year) / Moradi A et al. Aesthet Surg J 2015;35(4):443-55. PMID 25908703 (30 people, course of bruising).
- Cochrane review of botulinum toxin — Camargo CP et al. Botulinum toxin type A for facial wrinkles. Cochrane Database Syst Rev 2021;7:CD011301. PMID 34224576. 65 randomised trials, 14,919 people, 2 on the perioral area.
- Twin study — Guyuron B et al. Factors contributing to the facial aging of identical twins. Plast Reconstr Surg 2009;123(4):1321-31. PMID 19337100. 186 pairs of identical twins.
- Topical retinoids — Griffiths CE et al. Arch Dermatol 1995;131(9):1037-44. PMID 7544967. 99 people, 48 weeks.
- Korean medical advertising law — Korean Medical Service Act Article 56(2) (no treatment testimonials, no comparisons with other clinics, no superlatives). This is why this column carries no prices, reviews or before-and-after photos.
- Miso Clinic practice guidelines — for hollow cheeks, dissolvable hyaluronic acid filler is considered first; botox is offered for all areas of the face; no RF treatment that day if there are metal or electronic implants, pregnancy or skin inflammation.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.