Marionette Lines Treatment And Prevention Options

Written by Donna Hart, MD, Board Certified Dermatologist on December 4, 2017 6 Comments

marionette lines treatments

While commonly referred to as “laugh lines”, marionette lines (also known as nasolabial folds) are no laughing matter!

Marionette lines are creases or folds that run vertically from the corners of the mouth down to the chin. Ironically, marionette lines are not caused by years of laughing. The lines are a common result of the natural aging process that includes a combination of depleting fat (and other facial tissue underneath the skin) with a loss of skin elasticity.

Genetics can also play a key role in the development of marionette lines and how prominent they become. In fact, genetically susceptible individuals can begin to develop some degree of marionette lines during their childhood.

marionette lines example

Example of marionette lines (Source: Radiesse)

Preventing Marionette Lines

While there is no way to absolutely prevent the development of marionette lines, there are a few ways you can slow them down. Follow these simple preventative methods:

Sleep Better

Stomach (face down) and side sleepers are more prone to developing facial wrinkles as their face experiences the pull of gravity all night long. The pressure from the pull of gravity is especially harsh on the nasal-labial fold area of the face. Try to sleep on your back as much as you can. If you simply must sleep on your side try to position your pillow so the lower half of your face doesn’t touch it.

Sun Protection

Excessive UV exposure on the skin can contribute to the loss of collagen and skin elasticity, both of which are essential to preventing marionette lines during natural aging. Always use a high SPF broad-spectrum sunscreen, avoid the sun during peak UV hours, and wear a wide brimmed had when outdoors during a long period of time.


The chemicals found in cigarettes are known to induce early onset aging and damage the skin. Smoking cigarettes causes the deterioration of current collagen in the skin as well as a decrease in future collagen production. Ditch the habit to help your skin (and entire body) look and feel its best.

Skin Care

Another way to prevent marionette lines is to simply take care of your skin by consistently following a daily skin care regimen that suites your skin type. This includes using a daily moisturizer and applying an anti-aging night cream to regenerate the skin. Products containing ingredients like vitamin C, hyaluronic acid, peptides, and other growth factors can work to rebuild lost collagen and restore skin elasticity.


What you eat and drink each day can play a key role in terms of your skin’s resistance to the effects of aging. Dry skin is more prone to forming wrinkle and lines, so staying properly hydrated will ensure that your skin looks and feels its best.

Treating Marionette Lines

If you already have fairly prominent marionette lines, there are several cosmetic treatment options that are both safe and effective:

Dermal Fillers

Fillers are non-surgical, injectable treatments that offer the ability to instantly smooth lines and wrinkles. In the case of marionette lines, a hyaluronic acid-based filler such as Juvederm can be used to restore lost volume for a plump and youthful appearance. Radiesse (another popular filler) instantly adds volume back into the skin while also utilizing an ingredient that stimulates the production of collagen over time.

Laser Treatments

Skin tightening lasers effectively reduce the appearance of lines and wrinkles for a smoother, more youthful appearance. These laser treatments transfer heat and laser light under the surface of the skin. By heating the tissue to lift and tighten the underlying foundation, this strengthens the skin and stimulates the growth of new collagen. Some of these types of skin tightening laser treatments include Thermage and Ultherapy.


Micro-needling (also known as Collagen Induction Therapy) uses controlled damage to spur the skin’s natural creation of new tissue. By creating minor skin injury during the procedure, the skin’s natural healing process initiates the production of new collagen and elastin fibers that thicken the skin and reduce the appearance of wrinkles. Micro-needling can be combined with topical skin rejuvenation treatments like or growth factor gels.


Individuals with deep and prominent marionette lines can benefit from facelift surgery. A facelift is a surgical procedure that makes the face tighter by removing excess skin and tightening any loose underlying facial muscles. While more invasive than all the other above treatment options, a facelift procedure will provide the most dramatic and long-term improvements to the lower face area.


Donna Hart, MD

Donna Hart, MD, a medical, surgical and cosmetic dermatologist, completed her dermatology residency at the John H. Stroger, Jr. Hospital of Cook County in Chicago, where she served as chief resident. Dr. Hart is Board Certified by the American Board of Dermatology, and is a member of the American Academy of Dermatology, American Society for Dermatologic Surgery, and Women’s Dermatologic Society.

6 Responses to “Marionette Lines Treatment And Prevention Options”

  1. Patricia says:

    For treatment of my marionette lines I having been massaging natural oils into my clean, moist, warm face, such as hemp, avocado, almond, aloe, then do a facial steam treatment to open my pores enabling the oils to absorb. Is this an effective treatment, or are there better effective home remedies?

    • WD Staff WD Staff says:

      Hi Patricia,

      Thanks for reading our post and submitting your great question. Those are most of the popular home remedies I’ve heard. Our advice would be if those prove ineffective, you can come in for a free assessment regarding one of the professional treatments described above. We can tailor an effective treatment plan for your specific needs!

      Thanks again,
      WD Staff

  2. MARY says:

    I am 67 years old, very very few wrinkles ..round face, not fat but round, my issue is the marionette lines are getting deeper and my upper lip must be falling because at times i can feel the upper part of the line that has formed….best think is?? what to do..

    • WD Staff WD Staff says:

      Hi Mary,

      Thanks for reading our post and submitting your excellent question! We would definitely recommend getting an in-person consultation with a certified dermatologist or plastic surgeon as it is difficult to provide guidance without assessing the skin in person!

      That said, it sounds like you may benefit from a simple non-surgical filler treatments since you indicate that you have few wrinkles and firm skin. Individuals with more severe symptoms will generally need a surgical procedure.

      We hope that helps!

      WD Staff

  3. Villonell says:

    Saved as a favorite, I love your blog!

  4. Rose says:

    Thanks for this post, very helpful. I’m dealing with the beginnings of marionette lines and want to get started counteracting them. Do you recommend anything for addressing early marionette line formation?

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