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Let’s Talk Lips

Let’s talk lips. These two guys are a huge feature of the face and take many beautiful forms. Our lips are made not only of the portion used for smooches (vermillion lip) but also the skin around it that puckers (cutaneous lip). These days very full lips are all the rage, but there are many ways to enhance this lovely facial feature and also keep the lip skin healthy.


1. Moisturize

I see dry chapped lips year-round as lips are commonly forgotten. Lip licking is a temporary “fix” that not only can eventually lead to excessive dryness but can even cause redness, itch, irritation, and discoloration of lips and surrounding skin. The great thing is lip balm is easy to keep around. I have one in my purse, desk, car, nightstand and many other places around the house. I use lip balm frequently throughout the day to help keep my lips hydrated.

Some of my favorites:

2. Protect

Sunscreen containing lip balms protect lips from burn so these are a good idea when planning on getting sun. Besides pain, sunburns lower the skin’s immune defense and can allow a cold sore to rear its ugly head (in those with the virus). Wide brimmed hats also provide nice protection to not only the lips, but the entire face, as well as the scalp and ears.

Skin cancer on the lips can be serious so protection and prevention are key.

Some lip sunscreens I like:

3. Avoid smoking

Smoking severely damages skin and increases risk of skin and mouth cancer. It destroys collagen, reduces oxygen supply, and slows healing.  The action of smoking also requires puckering of the lips and this repetitive contraction leads to fixed lines around the mouth. These can be treated, but prevention is a much better (and cheaper) option than treatment after the fact. Though treatments like microneedling, radiofrequency, laser resurfacing and topical medications can help, they rely on your body’s ability to produce new “better” skin after controlled intentional heat and/or damage, thus you need good building blocks as a starting point to get the desired results. Think of trying to build a house with brittle or crumbling bricks. Even if you have the best tools and equipment, your end-product will not be the structurally sound and beautiful new house you set out to build when using poor quality bricks. Our skin is constantly recreating itself, but smoking damages the necessary building blocks for healthy skin turnover.

For my patients who smoke but want to improve these lines, quitting is the best first step. Other options besides those mentioned above include certain lip fillers made to address lines around the lips. These nicely improve the skin without requiring the help of new collagen formation. I also use NovaThreads (specialized suture) of which several types can be inserted into the lip border to provide immediate mild plumping with the added benefit of stimulating new collagen formation.

As a former regional coordinator for Oklahoma’s youth tobacco use prevention program (about 20 years ago!), I know quitting smoking is a tough call, but encouragement, support and sometimes pharmaceutical help make this an achievable goal. So if you don’t smoke, please don’t start. If you do smoke, there is never a better time to quit than now.

4. Avoid frequent use of straws

One thing people forget is that it’s not just smokers who get pucker lines. I’ve had patients come with them for all sorts of reasons including frequent whistling! But probably the most common reason that people don’t consider is frequent use of straws. Just like smoking, the frequent pucker action can make fixed lines around the mouth. When the lines are mild or only present when puckering, simply treating with neuromodulators (e.g., Botox/Xeomin/Dysport) can erase them. However once deep/etched and present when relaxed, additional procedures may be required to reduce or get rid of them.

Already have pucker lines? Don’t fret. The good news is I have many tools—some mentioned earlier in this blog—with which to treat etched lines and it is very satisfying to reverse them!  Depending on the depth, location, and other patient specifics these can be addressed with neurotoxins (e.g., Botox/Dysport/Xeomin), lip filler (e.g., Juvederm, Restylane), microneedling, NovaThreads, or laser resurfacing. Topicals, such as retinoids and antioxidants, can also help soften lip lines. See below for our holiday specials!

Wishing you and yours a wonderful season filled with joy and peace.


Kesha Buster, MD FAAD (board-certified dermatologist)

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