Smoker's lines.

What it is

Smoker's lines (properly, perioral or vertical lip lines) are the fine vertical creases that run from the lip border into the skin above. They are unfortunately named: many of the patients who have them never smoked. Sun damage, pursing, and the thin nature of perioral skin do most of the work.

Treating them well is a careful conversation. The lip area is delicate; over-treating creates a stiff, swollen perioral appearance that reads worse than the lines did. We layer subtle modalities over months, conservatively: small doses of muscle relaxation, gentle skin remodelling, and, for deep set lines, careful resurfacing.

What we look for

• ●Repetitive pursing of the orbicularis oris muscle: sipping, drinking, pursing in concentration
• ●Sun damage to thin perioral skin where SPF is rarely applied
• ●Loss of dermal collagen and elastin around the lip
• ●Smoking history: even years past, the damage to the perioral dermis remains
• ●Volume loss in the upper lip itself, allowing fine lines to run unsupported
• ●Lipstick that no longer stays where it was put

Dr Beiki assesses which of these are at play before recommending a layered approach.