Treating Smokers Lines: Options for Perioral Wrinkles

Last updated: 5 March 2026

Perioral wrinkles, the fine vertical lines radiating from the lip borders, are colloquially called smoker’s lines, though they affect non-smokers too. Understanding causes and treatment options helps you develop an effective plan.

What causes perioral lines?

While smoking is a significant risk factor through repetitive pursing and accelerated collagen degradation, perioral wrinkles develop through multiple mechanisms including repetitive muscle movement of the orbicularis oris, collagen and elastin loss, bone resorption of the maxilla and mandible, volume loss in perioral fat pads, chronic sun damage, and genetic predisposition.

The perioral area is particularly challenging because the skin is thin and mobile, the underlying muscle is constantly active, and the complex anatomy limits the amount of product that can be safely used.

Treatment Options

Several approaches effectively address perioral wrinkles:

• Botulinum toxin: Small doses (2-4 units) injected into the orbicularis oris relax the pursing action. Conservative dosing is critical to maintain lip competence and speech.
• Dermal filler: Soft HA fillers like Belotero Balance injected superficially into individual lines. Lip volume restoration also indirectly improves perioral lines through structural support.
• Laser resurfacing: Fractional CO2 or Erbium laser stimulates significant collagen remodelling. Non-ablative fractional options offer improvement with less downtime.
• Chemical peels: Medium-depth TCA peels remove damaged surface layers and trigger collagen production.
• Microneedling: With or without radiofrequency energy, stimulates collagen over a series of treatments.

The most effective approach combines multiple modalities, conservative toxin, lip filler, collagen-stimulating treatments, and retinoid skincare. A clinical team develops individualised combination plans.

Prevention and Maintenance

Prevention is easier than treating established lines. Daily SPF to the perioral area, smoking cessation, regular retinoid use, SPF lip balm, and adequate hydration all help. These measures complement professional treatments for optimal long-term results.

Frequently asked questions

I have never smoked, why do I have these lines?

Perioral wrinkles are primarily caused by ageing, genetics, sun exposure, and repetitive muscle movement. Activities like drinking through straws and playing instruments contribute. Many practitioners prefer the term perioral lines rather than smoker’s lines.

Can lip filler alone fix perioral wrinkles?

Lip filler improves perioral lines indirectly by providing structural support but rarely resolves established wrinkles completely alone. Combining lip volume restoration with direct line treatment achieves the best results.

Will Botox around my mouth affect my smile?

When performed conservatively by an experienced practitioner, perioral botulinum toxin produces subtle relaxation without significantly affecting smile dynamics. Starting with low doses and adjusting at follow-up is the safest approach.

How many laser sessions are needed?

One ablative fractional session produces noticeable improvement. Non-ablative approaches typically require three to six sessions spaced four to six weeks apart. Book a consultation with a clinical team to discuss the best approach for your concerns.

This article is for informational purposes only and does not constitute medical advice. Consult a qualified medical professional for personalised recommendations.