Nasolabial Folds
Nasolabial Folds — the two lines that run from the sides of the nose down to the corners of the mouth, sometimes called smile lines. They are a normal part of facial anatomy that can deepen with age as skin loses collagen, volume, and elasticity.
Key points
- They are natural anatomical folds present in most faces, becoming more pronounced with age and volume loss.
- Descending cheek fat and reduced skin elasticity contribute to their deepening over time.
- Sun protection and collagen-supporting ingredients like retinoids and vitamin C may help slow their progression.
- Because they are partly structural, topical skincare tends to soften rather than eliminate deeper folds.
Folds, creases and the lines nearby
| Type | What it looks like | What it responds to |
|---|---|---|
| Nasolabial line in a young face | Appears on smiling, absent at rest | Nothing — baseline anatomy, present from infancy |
| Superficial crease | Fine etched line inside the fold, faint at rest | Sunscreen, retinoids, steady hydration — modest softening |
| True fold from volume descent | Deep shadowed groove at rest, cheek sitting lower | Clinician-administered volume replacement; topicals change little |
| Fold with overlying laxity | Loose upper-cheek skin draping over the crease | Energy-based tightening — gradual, partial, not permanent |
| Marionette lines | Grooves from the mouth corners toward the jawline | The same structural approaches; a separate groove |
| Perioral lines | Fine vertical lines above the upper lip border | Retinoids, clinician-led resurfacing; unrelated mechanism |
Why the fold exists at all
A nasolabial fold is not a wrinkle, and not primarily a skin problem. It is an anatomical boundary — where muscles of the upper lip anchor into the skin, dividing the mobile cheek from the mobile lip. It exists in everyone, infants included, which is why a baby's face creases there the moment it smiles.
What deepens it is the tissue above the boundary, not the boundary itself. Midface fat compartments lose volume and drift downward, the ligaments suspending the cheek lengthen, and the facial skeleton remodels beneath, so the cheek settles onto a line that has not moved. That happens millimetres below the surface, which is why no cream meaningfully changes a deep fold, and why claims that one does deserve scepticism.
What softens them, and by how much
Topical skincare has a real but bounded role. Daily broad-spectrum sunscreen is the best-evidenced measure, slowing the photoageing that thins and creases the overlying skin. Retinoids used consistently can improve the fine etched crease over three to six months. Humectant moisturisers soften the surface line within days, for as long as the hydration lasts.
The approaches that reach the structure are clinician-administered. Soft-tissue fillers replace lost midface volume so the cheek is supported higher; the effect is temporary, and this region carries a genuine risk of vascular complications. Radiofrequency and microfocused ultrasound heat the deeper dermis to provoke collagen remodelling, giving gradual, partial tightening. Facial exercises are marketed heavily on weak evidence.
Where a clinician fits in
The fold itself is not a medical concern, so the thresholds involve other things appearing in the same place. Sudden flattening or loss of one nasolabial fold — particularly with a drooping mouth or eyelid, arm weakness or slurred speech — is a recognised sign of facial nerve weakness and can indicate a stroke. It needs immediate emergency care.
The nose and the skin beside the fold are common sites for basal cell carcinoma, so any lump, scaly patch or sore that grows, bleeds, crusts or has not healed in a few weeks should be seen promptly. Injectable and energy-based procedures belong with a qualified, regulated practitioner. After any injection here, blanching of the skin, severe pain or any change in vision needs urgent same-day attention.
Frequently asked
Are nasolabial folds a sign of aging?
They exist to some degree in most faces at any age, but they typically become deeper and more noticeable as collagen, elasticity, and facial volume decrease over time.
Can skincare get rid of nasolabial folds?
Skincare can improve skin firmness and hydration to soften their appearance, but because these folds are partly structural, topical products generally cannot fully remove them.
Why do they look so much deeper in photographs?
Overhead lighting drops a shadow into the groove, which reads as depth, and a close-held phone lens exaggerates midface projection. A photograph often shows a deeper fold than other people see.
Do face yoga or facial exercises help?
The evidence is weak, mostly small studies with subjective outcomes. Repeatedly contracting the muscles that pull on the fold is, if anything, more likely to emphasise it.
Why did mine get deeper after I lost weight?
The midface holds discrete fat compartments that give the cheek its projection, and they shrink along with fat elsewhere. Losing that support lets the cheek sit lower against a fixed boundary.
Do fillers get rid of them permanently?
No. Hyaluronic acid fillers break down over months to a couple of years. They are a clinician-administered procedure with real risks here, so they belong in a consultation rather than a shopping decision.
Related topics
This is a foundational entry in the SYNC Skin Encyclopedia and is expanded over time. Educational information only — not medical advice.
