Lip lines aren’t necessarily due to age, and it’s possible to have “smoker’s lines” even if you never partook in this bad habit. Dermatologist Dr. Jennifer Ahdout of The Roxbury Institute in Beverly Hills explains the main causes of wrinkling around the mouth, and five ways to restore smooth, plump skin.

I see countless patients who come to my office because of fine lines and wrinkles around their lips, and many say, “I don’t understand why I have these, I never smoked.” Yes, lip lines are a side effect of smoking, but the root cause is repeated muscle movement, including pursing and puckering the lips, which is also associated with drinking through straws and kissing. Combine decades of making these facial expressions with the loss of collagen and elastin due to UV exposure, environmental skin damage and the natural aging process, and wrinkles become etched into the skin. To make matters worse, many studies have confirmed that the underlying bones around the mouth resorb with time, which has an effect similar to a building losing its foundation. But with all of this said, there are several ways to improve the appearance of lip lines—and prevent them from becoming worse.

Skincare
As the saying goes, “An ounce of prevention is worth a pound of cure,” and a proactive skincare regimen can help preserve the integrity of the skin’s collagen and elastin. A daily antioxidant serum such as SkinCeuticals’ C E Ferulic, a growth factor product like Biocutis Bio-Cream, prescription retinoids and, of course, sunscreen can go a long way for maintaining smooth skin around the lips.

Botox
Botox injections can be used to help reduce movement of the orbicularis oris muscles that surround the mouth, in turn minimizing the appearance of lip lines. However, this is an off-label use of Botox that requires an injector who has extensive experience treating this area. Too much Botox in these muscles or incorrect placement can increase the risk of drooling while drinking, make it difficult to pucker or purse the lips and even affect pronunciation of certain letters like “B” and “P.”

Injectable fillers
Small amounts of filler in the uppermost part of the skin around the lips is highly effective for smoothing these lines and wrinkles, but you can’t just use any product in this spot. Volbella, Belotero and Restylane Silk are ideal because they are less likely to be visible through this thin skin. Again, it’s important to seek an experienced injector because of the increased risk of bruising and expertise required for proper placement.

Microneedling and Fraxel
Any treatment that stimulates the skin’s natural collagen production can be used to smooth fine lines and wrinkles around the lips. Microneedling and Fraxel both achieve this goal, however the best treatment for a specific patient depends on their needs and willingness for downtime. It’s important to keep in mind that microneedling and Fraxel are usually performed as full-face treatments, which makes them ideal for patients who need more comprehensive rejuvenation. Many patients prefer these treatments over Botox and fillers because they don’t “wear off” after a certain number of months or require follow-up visits on a regular basis. Microneeding and Fraxel act as a “reset” for the skin before it starts aging naturally again.

When treating lines around the mouth, it’s important to consider the shape and volume of the actual lips as well. Dermatologists and plastic surgeons generally look at these areas as a single unit, and even if you hadn’t considered lip augmentation, filler injections in the lips themselves can further enhance the appearance of the lips’ borders and the surrounding skin.