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Posted 31st May 2022

How To Treat Smoker’s Lines

How To Treat Smoker’s Lines

Part Two of our World No Tobacco Day series explains how to treat smoker’s lines. 

Smoker’s lines, also known as “barcode lines” are the vertical lines that form around the mouth through the repeated action of smoking.

How To Treat Smoker’s Lines

Treating smoker’s lines is a popular request among aesthetics patients so is a skill all injectors would do well to master. If you have a lot of more mature clients, or work in an area with an older demographic of patients, this can be an especially worthwhile treatment to offer.

This is because the effects of smoking on the skin – as Dr Carol Mastropierro expertly outlined in Part One – become increasingly prominent over time. Also, effective treatment of these lip lines can have a significantly rejuvenating effect, bringing great patient satisfaction. 

To help you excel here, we spoke to aesthetic medicine specialist, clinic owner and senior Harley Academy clinical trainer, Natalie Haswell. Nat is a Level 7 graduate, an experienced cosmetic nurse prescriber and Allergan Institute faculty member. These are her insights and tips on how to treat smoker’s lines… (scroll down to watch her video, too!)

Smokers Lines Barcode lines


The essential first step: a face-to-face consultation

“Firstly you need a clinical and medical face-to-face consultation prior to any treatment. This is to make sure your patient is suitable,” notes Nat. 

“Observe their face from every angle and whilst they are talking, to ensure you get a firm understanding of their movements and facial vectors. For example, if the patient has a neutral vector, where their face is fairly flat in profile, they may not be suitable for this treatment. This is because it could make them look over-projected or puffy around the top lip, which would provide an unnatural outcome.”

“When someone has a negative vector to their mouth – where their top lip turns outwards – then they are quite often suitable for a filler treatment. This is because it won’t cause their lip to over-project or look unnatural.”

“Second of all, you will need to determine how to treat smoker’s lines in your patient – with a needle or a cannula, depending on which product you’re going to use.”

“Thirdly, remember when you are outlining your aftercare advice, to explain that using a good SPF 30 or above every day with broad spectrum UVA and UVB protection is required. This is a key anti-ageing skin tool and should be applied in the correct amounts to the face, including around the mouth and to the lips. It should also be reapplied throughout the day as per the directions on their product.”

Learn How to Treat Mature Filler Patients

Determining the best treatment or treatment combination for your patient

“You may wish to offer a combination of treatments. As I’ll explain, efficiant use of lip filler in treating the vermillion border or using toxin to relax the relevant muscles, can pair nicely with smoker’s line filler treatment. You may also consider adding in a skin booster treatment for hydration and plumping of the patient’s skin,” Nat advises.

“When recommending a treatment plan comprising more than one of these, speak to your patient about how much time – and money – are they willing to dedicate to getting the outcome they desire. You can then plan your treatment timelines together or revise your recommendations accordingly.”

Which product do you use to treat smoker’s lines?

“At Harley Academy we teach students using the Juvéderm range of fillers.” Nat specifies, “We generally use Juvéderm Volbella to treat smoker’s lines and to treat the lips.”

botox appointment Aesthetic patient consultations

Needle or cannula for treating smoker’s lines?

“We often recommend using a 25 guage, 38mm cannula for treatments around the mouth. This approach has more evidence than most to suggest it is safer than a needle. Whilst it reduces the risk of vascular occlusion, it does not eliminate it,” Nat confirms.

“Make your insertion points either side of the mouth, use your cannula to wriggle through, then use a retrograde linear thread technique around the perioral area.” You can see her illustrate these areas in the following video.

“Another technique we can use here is micro-droplets,” advises Nat. “Even with a cannula, in Layer 2, under the skin layers. Do lots of little boluses with a cannula. You can use a needle but, obviously, this can be quite uncomfortable for your patient. We do numb the area with a topical numbing agent first and all of our filler products also contain an anaesthetic as well. Juvéderm Volbella contains lidocaine, for example, to make it a more comfortable experience for your patient.”

What are the alternatives to filler for treating barcode lines?

“If you determine that your patient is not suitable for filler treatment, or if they simply don’t want filler, you could consider using botox,” Nat recommends. “By relaxing the muscles that cause these lines, you limit their movement. Reducing this movement, reduces skin folding and, therefore, helps to prevent their smoker’s lines from getting any worse.”

“Lip filler can also be an option worth considering when treating smoker’s lines. By treating the vermillion border around the edge of the lips, you can add definition and structure to the lips. This can be incredibly effective when tackling skin ageing in this area.”

“Another option is a skin booster to deeply hydrate this area and help with the elasticity of the skin,” offers Nat. “This works really well and, although it involves injecting a hyaluronic acid product, it’s not like a filler. Soft tissue filler draws more water to it to really lift and plump the folds, whereas the skin booster is a lot softer and helps to treat the skin.”

Combining Injectables With Skin Treatments

“Other skin treatments worth considering, and which our Cosmetic Dermatology course students and graduates will be familiar with, include chemical peels and microneedling. These can slough off dead skin cells, stimulate collagen and elastin production, helping the structure and the laxity of the skin.”

“As I mentioned previously, you may wish to consider a combination of these treatments,” notes Nat. “It’s really about giving your expert opinion and recommendations to your patient then letting them decide what’s best for them.”


Lip filler training in aesthetic medicine

Our industry-leading Master’s level qualification, the Ofqual-regulated Level 7 Diploma in Botox and Dermal Filler includes a comprehensive education in perioral and lip filler techniques. In addition to patient and product selection and injection techniques, you’ll also learn how to prevent and manage complications arising from the various filler treatments. 

Available as a Combined Level 7 and Cosmetic Dermatology course for healthcare professionals investing in holistic, “skin first” injectables practise. 

We also offer our dedicated Fast Track Level 7 option for medical aesthetics practitioners who are experienced but lack an official qualification. 

Furthermore, for licensed doctors, dentists, nurses and midwives who are qualified aesthetics practitioners and wish to focus solely on improving their approach to the perioral area or lip filler, we offer one-to-one mentoring. Our dedicated 1:1 Training in Perioral and Lip Filler sessions allow you to treat your own patient whilst guided by an expert mentor. 

Mentoring is an excellent way to refresh your knowledge, expedite your learning process and receive unparalleled hands-on support to build your confidence. This is why we include mentoring sessions as part of our flagship Level 7 Diploma course.

If you’d like personal guidance as to which aesthetics training course is right for you, contact our Student Recruitment team. They’ll be happy to discuss your requirements and answer any questions you may have about becoming #HarleyTrained!

Wishing you a happy and healthy World No Tobacco Day.

All information correct at the time of publication.

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