- Frown lines are deep wrinkles caused by many factors including aging, genetics, smoking and repeated muscle movement.
- Effective in-office treatments include neurotoxin injections and dermal fillers.
- Frown lines can be minimized by using specially formulated moisturizers, serums and masks.
- Prevent the formation of frown lines by maintaining a healthy diet, staying hydrated and adopting a good skin care routine.
Frown lines, also referred to as wrinkles, forehead furrows, glabellar lines, worry lines or “the 11s,” are deep vertical lines that develop on the forehead, between the eyebrows and around the eyes.
What Causes Frown Lines
Wrinkles fall into two categories: static and dynamic. Static wrinkles are visible when facial muscles are at rest, while dynamic wrinkles appear when facial muscles are in motion or contracting.
“Common facial expressions like raising your eyebrows or furrowing your brow causes temporary wrinkles in your skin,” says Dr. Rafi Fredman, MD, a plastic surgeon specializing in facial rejuvenation procedures.
In young, healthy skin, these temporary wrinkles quickly fade once skin returns to its resting position, however, older skin takes longer to spring back, eventually leading to permanent wrinkling.
While aging is the most significant contributor to wrinkle formation, other factors also play a role. “Skin wrinkling can be worsened by habits and lifestyle choices such as excessive sun exposure, smoking or poor skin care,” explains Dr. Fredman.
Understanding these and additional factors will help in preventing wrinkles and treatment.
Aging is a key cause of frown lines, as the skin loses elasticity and support over time. “This is due to decreasing amounts of elastin and collagen, two important components of youthful skin,” says Dr. Fredman. Reduced elasticity results in visible lines and wrinkles, even when muscles are at rest.
Genes are a part of our DNA, and determine our skin tone and type: normal, dry, oily or combination. Due to their lower melanin and collagen levels, those with lighter skin tones are more prone to lines and wrinkles; darker skin tones are more resilient as skin has higher collagen levels. The presence of oil glands, which tend to be more present and larger in darker skin, also correlates with shallower wrinkles.
For those with lighter skin tones, excessive exposure to sunlight is responsible for 80% of the visible signs of facial aging, including deep facial wrinkles. This damage is caused by ultraviolet (UV) radiation and is aggravated by light skin’s minimal natural defenses to this damage.
Additionally, while damage is less severe for those with darker skin tones, it is still vulnerable to environmental skin aging and wrinkling.
These harmful rays break down the skin’s collagen and elastin, causing facial skin to lose elasticity and form wrinkles. Precautions, such as avoiding sun exposure and applying sunscreen regularly, can help mitigate this damage for people of all skin tones.
Smoking is associated with premature facial wrinkling. Studies demonstrate that smokers experience a higher rate of wrinkles than nonsmokers, due to tobacco’s damaging effects on skin elasticity and texture.
Repeated muscle movement
Wrinkles between the eyebrows become deeper through repeated movement of the muscles used when frowning. Additionally, repetition of facial expressions, such as squinting, smiling, or furrowing the brow can cause deep vertical lines to appear between the eyebrows, and may increase in severity over time.
Sleep and stress
Stress causes tension and this can prompt repeated facial expressions that can lead to frown lines. Lack of sleep also contributes to facial lines. In fact, poor-quality sleepers show increased signs of skin aging, including reduced elasticity and the appearance of fine lines.
How to Treat Frown Lines
A number of effective options are available to help treat frown lines. For finer lines, prevention is key, while neurotoxin injections and at-home skin products are effective at treating existing lines. For deeper moderate-to-severe lines, dermal fillers are successful treatments.
Begin treatment in your 20s
“Treating frown lines early can prevent them from becoming a problem over time,” says Dr. Fredman. While frown lines can develop at any age, most people start noticing them in their early 20s. “Your 20s are a good time to begin treatments to prevent fine lines and wrinkles before they become a problem,” explains Dr. Fredman.
In-office injectable treatments
Injectable treatments offer an effective nonsurgical answer to frown lines, with little to no downtime. Although these treatments are not permanent, neurotoxin injections and dermal fillers offer long-lasting results.
Dr. Fredman typically begins treating wrinkles by advising patients to cease any harmful activities such as smoking or excessive sun exposure, and follows by crafting a proper skin care routine. “After harmful habits are addressed, I usually recommend using a neurotoxin such as Botox to help reduce or eliminate frown lines,” says Dr. Fredman.
Neurotoxin injections, such as Botox, Xeomin and Dysport are FDA-approved neuromodulators that work by blocking nerve signals to the muscles.
When injected into targeted muscles, neurotoxin’s active ingredient, botulinum toxin type A, temporarily blocks muscle contractions.“Since repeated facial muscle movement plays a key role in the development of forehead wrinkles, weakening the muscle with neurotoxin can prevent wrinkles, or if already present, it can reduce their appearance and allow the skin to rejuvenate,” explains Dr. Fredman.
Visible results of these procedures can last 3 to 6 months before a new treatment is needed to maintain results. Treatments are virtually painless and patients can return to normal activities immediately after a session.
For best results, these treatments should be performed by an experienced professional.
Costs of neurotoxin injections vary depending on the number of injections, the brand and the size of the treatment area.
Dermal fillers are safe injectable agents offering a temporary improvement of the appearance of moderate to severe lines. They act by creating support under the skin, which smooths out frown lines and other facial lines and wrinkles.
“The most commonly injected fillers are composed of hyaluronic acid, which is naturally found in the skin,” says Dr. Fredman. “This option not only fills in wrinkles but due to its ability to store moisture, it also provides hydration to the skin.”
Injections are performed with fine needles and patients usually experience only mild discomfort during the session. As this procedure is minimally invasive, patients can return to normal activities immediately after treatment.
Results are typically noticeable 2 to 3 days after injection, and can last 3 to 12 months.
The cost of dermal filler treatments vary depending on the number of injections, scheduled touch-ups, the amount of product used and the size of the treatment area.
How to Treat Frown Lines Without Botox or Fillers
While neurotoxin injections and dermal fillers are the most common in office treatments for frown lines, other options are available. “Professional facial treatments also include chemical peels, microneedling, and laser resurfacing, which can reduce the appearance of fine lines or wrinkles,” says Dr. Fredman. These treatments cause minor controlled injuries to the skin to trigger the natural healing process and stimulate collagen production.
You can also treat frown lines with over-the-counter treatments like facial moisturizers, masks and serums containing various active ingredients.
Superficial chemical peels—the mildest form of peels—can improve shallow to moderate wrinkling with little to no downtime. These procedures use acids, such as glycolic and salicylic acid, to damage the outermost layer of skin in a controlled way, to improve natural collagen production and reduce the appearance of wrinkles.
While superficial chemical peels can be performed at home, working with a dermatologist or other skin care professional can minimize any risk of complications.
Chemical peels are best suited to patients with lighter skin tones, as those with darker skin are at a higher risk of experiencing skin discoloration from this procedure.
Microneedling creates multiple, small injuries to the skin to stimulate collagen production; a wand-like device is passed over the forehead to repeatedly puncture the skin. This process helps improve skin health and increase skin elasticity, reducing the appearance of frown lines.
Prior to the procedure, a topical anesthetic is applied to the skin to minimize any discomfort.
Improvements to the skin gradually appear over the weeks following treatment, however up to four microneedling sessions may be required for ideal results. No downtime is needed, however skin may appear red for several days following each treatment session.
Ablative lasers such as Erbium and CO2 lasers, are used to treat mild to moderate frown lines. Before your treatment, a topical anesthetic or injected local anesthetic is used to help eliminate any pain or discomfort. Concentrated beams of light are then used to remove the outer layer of skin and trigger the collagen production process.
Following this procedure, up to three weeks of downtime may be needed. During this time, the treatment area will appear very red and scabs will form.
As with chemical peels, laser resurfacing can cause hypopigmentation and hyperpigmentation, particularly for those with darker skin tones. As a result, laser resurfacing is better suited to patients with lighter skin.
Moisturizers and masks with hyaluronic acid
To reduce the appearance of frown lines, keep your skin well hydrated by applying moisturizers and face mask formulations. Look for formulas containing ingredients such as hyaluronic acid (HA), which helps skin retain water molecules and decreases frown lines by improving facial volume.
Serums with retinoids and HA
Serums are formulations rapidly absorbed by the skin that deliver concentrated doses of select ingredients. Some of these ingredients, such as topical retinoids, promote cell turnover and combat fine lines. As with cream and lotion facial moisturizers, serums can also contain HA.
Skin care routine
It is best to customize your skin care routine to suit your unique needs, targeting your treatment to fit your skin type and focusing on your specific concerns. A tailored skin care routine should include washing with a mild cleanser.
When washing, drying or applying skin care products, treat your skin gently. Because vigorous scrubbing can irritate skin and increase the appearance of wrinkles, use the pads of your fingers and apply gentle pressure.
To maintain balance and protect your skin, it is important to moisturize and apply sunscreen; choose oil-free and noncomedogenic products.
Lastly, as a form of preventive care, the application of a serum or an eye cream or gel can also be part of your skin care regimen.
Many at-home treatment options can contribute to the reduction of frown lines, such as aloe vera gel supplements and red ginseng extract. Although some may be effective, at-home treatments may not fully address your skin’s needs and they are not a substitute for professional medical advice and diagnosis.
Some skin concerns require advanced medical treatment. Cosmetic dermatologists provide informed medical evaluations, and the safest and most effective methods of treatment to suit specific skin conditions.
Aloe vera gel supplement
Dietary aloe vera gel has anti-aging properties for the skin. By increasing collagen production, aloe gel significantly improves the appearance of wrinkles and increases elasticity in the skin.
Red ginseng extract
Long-term use of fermented red ginseng extract provides anti-aging benefits and can effectively reduce facial wrinkles. Its efficacy is due to its bioactive compounds, which increases collagen synthesis in skin.
Facial exercise, including those that entail puckering and squeezing the cheeks, have not been demonstrated to be effective in reducing facial lines and wrinkles, due to a combination of lack of evidence and poorly controlled studies. Additionally, facial exercises are not professionally accepted treatments.
How to Prevent Frown Lines From Forming
Skin aging is unavoidable, but adopting good habits can contribute to prevent the signs of aging.
“Staying hydrated, avoiding excessive sun exposure, always using sunscreen, and not smoking are key to keeping skin healthy,” states Dr. Fredman. “Healthy skin will maintain its youthful qualities and will develop less wrinkles with age.”
Diet and hydration
A healthy diet and consuming adequate amounts of water are linked to skin thickness and rejuvenation. This impacts how quickly wrinkles may appear.
For example, a diet high in vitamins A, C, B3 and E will have a significant effect on increasing the production of collagen, preventing the appearance of fine lines. On the other hand, insufficient water consumption will impact the density and plumpness of the skin and contribute to the appearance of wrinkles.
The sun’s rays break down skin elasticity, which can accelerate signs of aging. The regular use of sunscreen when outdoors protects the skin from UV rays and subsequent damage.
During sleep, skin works to produce collagen which helps prevent wrinkles. Since increased collagen means plumper skin, good sleep hygiene can prevent frown lines from forming.
Moisturizers replenish water loss and improve skin elasticity. To prevent frown lines, a good skin care regimen should include a moisturizer with ingredients such as HA, retinol and peptides.
There are many effective options available to treat frown lines. Various in-office procedures are safe and effective, such as neurotoxin injections and dermal fillers.
While not as effective, several at-home treatments can also contribute to the reduction of wrinkles, such as the use of facial moisturizers, masks and serums that contain active ingredients such as HA and retinol.
Because wrinkles develop over time, prevention is key and can include the daily use of sunscreen, maintaining an effective skin care regimen, following a proper diet and getting enough sleep.
When considering professional treatments for frown lines, consult an expert to obtain the best advice for your unique needs. A medical practitioner will understand the best approach for your specific issue and provide the best treatment options.
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