Beauty Clinic: Help with 'barcode' lines around the mouth
Q. I’m late middle age and have deep-ish vertical lines above and below my lips. Is there anything I can do to soften them? I would prefer not to have fillers injected.
A. Many of us first notice these pesky little furrows as lipstick ‘bleeds’ into them. Although these ‘barcode’ lines are often linked to current or past smoking, they are also very common in non-smokers, according to medical aesthetics expert Dr. Selena Langdon of Berkshire Aesthetics. (www.berkshireaesthetics.com) They occur as we lose elasticity in the skin (due to a reduction in elastin) and the volume of our lips also tends to diminish. But, says Dr. Langdon, there is a lot you can do to help.
The most effective ingredient to look for in topical products is a form of vitamin A called a retinoid, which supports the formation of collagen and promotes cell turnover. It comes in two main forms: tretinoin, which is more powerful but prescription only, and retinol, which you can buy in a range of skincare products. Dr. Langdon recommends ZO Skin Health Wrinkle + Texture Repair/£109 for 50ml.
For prescription products, Dr. Langdon likes Obagi Medical tretinoin, which comes in varying strengths. Bear in mind that initial side effects (e.g. dryness, redness, flaking) are more likely with higher potency vitamin A, she says. Most cosmetic retinols direct you to use every few days at first, gradually building up to every other day or daily; this is important advice so don't rush it!
Dr Langdon adds: ‘If you are looking for a retinoid-free product, there are some fantastic firming serums now available such as ZO Skin Health Firming Serum/£190 for 47ml, which supports fibroblast activity and contains powerful antioxidants, and also Obagi Medical Elastiderm Facial Serum, £160, which contains minerals to support the three stages of elastin development.’
The products Dr Langdon lists above are only available through her clinic and other aesthetic medical clinics, which you can find online. They are the ones she recommends but of course there are many others available over the counter at a range of prices, including the much-publicised Boots No7 Advanced Retinol 1.5% Complex Night Concentrate, currently £25, (which Sarah is trying now but not for barcode lines).
Beauty expert Alice Hart-Davis, founder of The Tweakments Guide, recommends the Medik8 range, starting with Retinol 3TR/£29 for 15ml. ‘It’s always important to start with a low concentration and work up,’ she says.
For a firming serum, pharmacist Shabir Daya extols the properties of vitamin C, suggesting Garden of Wisdom Vitamin C Serum 23% + Ferulic Acid/£10 for 30ml.
Whatever else you do or don't do, Dr. Langdon - in common with every skin expert we’ve ever talked to - insists on the importance of wearing a daily SPF, especially if you are using a form of vitamin A. ‘Ultra violet light, in particular UVA, is responsible for the majority of skin ageing we experience. I prefer to opt for a broad spectrum, mineral-based sunscreen. One of my favourites is Heliocare 360 Mineral Tolerance Fluid SPF50/£22 for 50ml, which protects against UVA/UVB/HEV/Infrared with no whitening effect.’ (HEV stands for High Energy Visible Light, which is the blue/violet range on the UV spectrum and the most powerful we can see; it also affects your eyes so don't forget to protect them with big, wrap around sun glasses.)
In addition, Dr. Langdon suggests you consider a range of possible aesthetic procedures that don't involve injectables.
PROCEDURES
* Energy-based skin tightening treatments. These use heat to cause collagen contraction and also stimulate collagen production. They are non-invasive and very well tolerated. Examples include:
Exilis Ultra – monopolar radiofrequency
Ultherapy – microfocused ultrasound
* Lumenis M22 ResurFx laser for resurfacing. This fractional non-ablative Erbium glass laser offers far less downtime and fewer side effects compared with a more traditional ablative Erbium or CO2 laser. Fractional lasers fire the laser beam through a grid and promote new skin growth.
* Medical grade chemical peels. TCA (trichloroacetic acid), for instance, can help to effectively soften the appearance of barcode lines. TCA chemical peels are available in various strengths and higher grade TCA peels should always be administered by a trained medical professional. The downtime can vary and certain skin types will need preparation prior to performing the peel.
* Medical microneedling. This stimulates collagen production and the release of growth factors by promoting the wound healing response. I prefer to use the SkinPen Precision, which is the only FDA-cleared and CE Medical marked microneedling pen device available in the UK.
* Morpheus8. This technology uses a combination of both microneedling and delivering fractional bipolar radiofrequency at variable depths to improve skin laxity. It offers a minimally invasive method of skin remodelling. This is the most powerful device of its kind on the market, and now a very popular treatment.
