What Are Nasolabial Folds? Causes, Prevention, and Treatment Options
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What Are Nasolabial Folds?
Nasolabial folds are facial creases that become more prominent as skin loses elasticity and volume over time. [1] Leading causes include natural aging, sun exposure, smoking and large weight changes, which break down collagen and elastin. [1] Non-surgical options include dermal fillers, botulinum toxin, retinoids and skin tightening, [1] while a cheek lift or facelift offers more significant correction. [1]
What the research says
Hyaluronic acid (HA) fillers hold up well in head-to-head trials. In a 12-month randomized, blinded trial of 390 adults with moderate-to-severe nasolabial folds across 8 hospitals comparing two HA fillers, more than 73% of participants in both groups were rated improved on the Global Aesthetic Improvement Scale throughout the study, and both products were well tolerated (Wu et al., Aesthet Surg J, 2026 [2]).
Faster results and longer results can be a trade-off. In a randomized trial of 100 patients, collagen and HA fillers gave similar improvement at 3 months, but at 6 months HA had maintained significantly greater improvement. The authors suggest collagen may suit people who want quick correction with minimal downtime, and HA people who want longevity (Huang et al., J Cosmet Dermatol, 2026 [3]).
Serious filler complications are rare but time-sensitive. A meta-analysis of 14 studies found that vascular occlusion, a blocked blood vessel, was most often reported in areas such as the glabella, nose, and nasolabial folds. Hyaluronidase gave partial or total recovery in 84.2% of HA-related cases, and delays beyond five days were linked to permanent deficits (Chakhachiro and Waseem, Cureus, 2025 [4]).
Key Takeaways: Nasolabial Folds Facts
Feature | Details |
Common Names | Smile lines, laugh lines [1] |
Location | From the sides of the nose to the corners of the mouth [1] |
Primary Causes | Aging, sun damage, smoking, and significant weight changes [1] |
Key Proteins | Collagen and elastin (loss leads to deeper folds) [1] |
Non-Surgical Options | Dermal fillers, botulinum toxin, retinoids, and skin-tightening procedures [1] |
Surgical Options | Cheek lifts and facelifts [1] |
Understanding Nasolabial Folds
Nasolabial folds are a standard feature of the human face, visible in almost everyone when they smile or laugh. [1] As the body ages, these temporary lines often become static wrinkles that remain visible even when the face is at rest. [1] This change is largely driven by the structural transformation of the skin and underlying tissues.
The prominence of these folds is often linked to the health of the midface. As the cheekbones flatten and the skin loses its structural support, the area around the mouth can appear sunken or heavily creased. [1] While these lines are medically harmless, many people seek treatment to restore a more refreshed appearance.
Causes and Risk Factors
Several biological and environmental factors contribute to the deepening of nasolabial folds. Understanding these causes is useful for both prevention and choosing a treatment.
Factor | Impact on Nasolabial Folds |
Aging | Flattening of the cheekbones, gravity pulling on loose skin, and less collagen and elastin [1] |
Sun Exposure | UV rays break down collagen and elastin, accelerating wrinkle formation [1] |
Smoking | Destroys collagen and elastin, leading to premature aging [1] |
Weight Changes | Significant loss can leave looser skin, while gain can increase cheek volume; both can accentuate the folds [1] |
The loss of collagen and elastin is the most important internal factor. Collagen provides the skin with its strength and structure, while elastin allows it to stretch and snap back into place. [1] When these proteins are reduced, gravity pulls the skin downward, causing the folds to become more pronounced. [1]
Symptoms and Identification
The primary sign of nasolabial folds is visible lines or creases extending from the sides of the nose to the outer edges of the lips. [1] In younger people, these lines are typically "dynamic," meaning they appear only during facial expressions. [1] Over time, they often become "static," remaining visible at all times. [1]
These folds can be symmetrical, appearing equally on both sides of the face, or asymmetrical, where one side is deeper than the other. [1] There are no tests for nasolabial folds: you either see them or you don't. [1] A dermatologist or cosmetic surgeon can assess how pronounced they are and discuss options if you want treatment. [1]
Management and Treatment Options
There are many ways to address nasolabial folds, from simple at-home routines to clinical procedures. The choice depends on the depth of the folds and your personal goals.
Non-Surgical Treatments
Dermal Fillers: Injections of hyaluronic acid or other fillers plump the area and smooth the creases. Effects last roughly six months to a year. [1]
Botulinum Toxin (Botox): Best known for frown lines, but it may be used to weaken and relax a specific muscle that contributes to the folds. Effects last a few months. [1]
Retinoids: Topical forms of vitamin A can promote collagen production and reduce smile lines over time, though results are gradual. [1]
Skin-Tightening: Lasers, radiofrequency, or ultrasound can help firm the skin by stimulating new collagen growth. [1]
Surgical Solutions
For people with significant skin laxity, surgery may be an option. A cheek lift or a facelift can reposition the underlying tissues [1] and remove excess skin [6], giving a longer-lasting reduction in the appearance of nasolabial folds. No treatment stops aging, so the skin will continue to change over time. [1]
Prevention and Lifestyle Habits
You cannot prevent nasolabial folds permanently, but certain habits can delay them and make them less prominent. [1]
Sun Protection: Wear a broad-spectrum sunscreen of at least SPF 30 every day and reapply every two hours outdoors, and avoid tanning beds. [1]
Don't Smoke: Quitting, or never starting, protects the collagen and elastin in your skin. [1]
Skincare Routine: Use a gentle cleanser and moisturizer at least twice a day, and avoid anything that stings or burns unless a clinician prescribed it. [1]
Healthy Living: A healthy diet, regular exercise, and enough sleep support healthier skin. [1]
Sleep Position: Sleeping on your back may help gravity work against the lines. If you sleep on your side, switch sides regularly. [1]
Conclusion
Nasolabial folds are a natural sign of a life filled with expression, but they also reflect the cumulative effects of aging and the environment on the skin. By combining preventive habits with modern cosmetic treatments, it is possible to manage these lines effectively. Whether through consistent sun protection or professional treatments like dermal fillers, you have more options than ever to maintain your preferred appearance.
For more helpful health resources and visual guides, explore our infographic templates.
Frequently Asked Questions
What exactly are nasolabial folds?
They are the creases that run from the sides of the nose to the corners of the mouth, also called smile lines or laugh lines. [1]
Are nasolabial folds the same as marionette lines?
No. Marionette lines run from the corners of the mouth down toward the chin. [6]
At what age do these folds usually appear?
They can be visible in younger people when they smile, and they typically become more noticeable and permanent with age. [1]
Can facial exercises help reduce them?
Some people try targeted exercises, such as gently stretching the corners of the mouth backward and holding for 10 seconds, which Cleveland Clinic describes as a home option. [1] Clinical evidence for lasting results is limited.
Does everyone have nasolabial folds?
Yes, they are a standard part of human facial anatomy and are very common in women and men of all races. [1]
Are nasolabial folds a medical problem?
No. They are medically harmless, and treatment is a personal, cosmetic choice.
Why do my smile lines look deeper on one side?
Folds can be symmetrical or asymmetrical. [1] Sleeping position, dental structure, and the way you naturally smile can all contribute.
Is smoking a major factor in their development?
Yes, smoking destroys collagen and elastin in the skin, which can deepen the folds. [1]
Can weight loss make them more visible?
Yes. Losing a lot of weight can leave extra, looser skin, and gaining weight can increase cheek fullness. Both can accentuate the folds. [1]
How do dermal fillers work for these lines?
They add volume beneath the skin to plump the area and smooth the crease. [1]
Is Botox effective for nasolabial folds?
Botulinum toxin is best known for frown lines, but it may be used to relax a specific muscle that contributes to the folds. Effects last a few months, [1] and fillers are more commonly used for this area.
How long do fillers last?
Cleveland Clinic cites six months to a year, [1] and duration varies with the product and the person.
Are there any natural ways to reduce them?
Sun protection, not smoking, a healthy diet, enough sleep, and regular moisturizing help delay the folds and keep skin healthy, but they cannot remove established folds.
Can dehydration make the lines look worse?
Dry skin tends to show lines more prominently, so regular moisturizing helps skin look smoother.
Are nasolabial folds genetic?
Your bone structure and skin type, which influence how folds look, are partly inherited.
What is the best sunscreen for prevention?
A broad-spectrum sunscreen of at least SPF 30, applied daily and reapplied every two hours when outdoors, more often if sweating or swimming. [1]
Can side-sleeping cause permanent lines?
Sleeping on your back may help gravity work against the lines. If you sleep on your side, try to switch sides regularly. [1]
Do retinoids really work?
Topical retinoids can promote collagen production and reduce smile lines over time, [1] but results are gradual and more modest for deeper folds.
What is a cheek lift?
A surgical procedure that repositions the tissues of the cheek to soften the nasolabial area.
Are there risks to dermal fillers?
Common effects include swelling and bruising. [5] Rarely, a filler can block a blood vessel (vascular occlusion), which is an emergency that needs prompt treatment. [4]
Can lasers tighten the skin in this area?
Lasers, radiofrequency, and ultrasound can stimulate collagen production and make loose skin tauter. [1]
Does sugar intake affect facial wrinkles?
A healthy diet supports skin health, but the evidence linking sugar to nasolabial folds specifically is limited.
How often should I moisturize?
Cleveland Clinic suggests a gentle cleanser and moisturizer at least twice a day. [1]
Can drinking water fix deep folds?
No, it will not fix structural folds, though staying hydrated supports overall skin health.
Is there a permanent fix for smile lines?
No treatment stops aging. Surgery usually gives the longest-lasting results, but the skin continues to age afterward.
What is hyaluronic acid?
A natural substance in the skin that holds moisture and is the most commonly used filler material.
Can microneedling help?
Microneedling creates tiny injuries that prompt the skin to produce more collagen [6] and may improve skin texture, though it is less effective for deep folds.
Is a facelift the same as a cheek lift?
No. A facelift is more comprehensive and addresses more of the lower face and neck.
Can makeup hide nasolabial folds?
Primers and light-reflecting concealers can help minimize their appearance.
Do chemical peels help?
They can improve skin texture but are less effective for deep structural folds.
What are the first signs of deepening folds?
Lines that remain visible for a few seconds after you stop smiling.
Is vitamin C good for these lines?
Vitamin C is an antioxidant that helps protect skin from damage, but it will not remove established folds.
Can stress cause facial lines?
Chronic stress is linked to skin aging, but evidence of a direct effect on nasolabial folds is limited.
How much do treatments usually cost?
Costs vary widely depending on the procedure, the product, and the location.
Are treatments painful?
Most injections cause minimal discomfort, and numbing agents are often used.
Is there any downtime for fillers?
Downtime is usually minimal, with some possible swelling or bruising. [5]
Can young people get fillers for smile lines?
A provider may consider it if someone has naturally deep folds or early volume loss, but it is a decision to discuss with a qualified clinician.
What is the difference between a fold and a wrinkle?
A fold usually involves deeper tissue sagging, while a wrinkle is a more superficial line in the skin.
Does facial massage work?
It can improve circulation and temporary puffiness but does not change the underlying structure.
Are there specific creams for smile lines?
Look for ingredients such as retinoids, peptides, and hyaluronic acid, and ask a dermatologist for recommendations for your skin type.
Can dental changes affect nasolabial folds?
Possibly. Loss of dental support can change how the lower face looks, so a dentist or surgeon may take it into account.
Is radiofrequency safe for the face?
It is a commonly used non-invasive skin-tightening method, and a qualified provider can advise whether it suits you.
What is the Wrinkle Severity Rating Scale?
A grading scale clinicians use to rate how severe nasolabial folds are before and after treatment. [2] [3]
Can allergies make the folds look deeper?
Frequent rubbing of the face because of allergies can irritate the skin, and irritation can enhance the signs of aging.
How does gravity affect the face?
As cheekbones flatten and skin loosens, gravity pulls the tissues downward against the fixed crease line. [1]
Can nasolabial folds be prevented permanently?
No. Healthy habits can delay them and make them less prominent, but you cannot completely stop the signs of aging. [1]
Can ultrasound treatments lift the skin?
Ultrasound-based treatments can stimulate collagen and help tighten loose skin. [1]
Is it better to prevent or treat?
Prevention, such as sun protection and not smoking, is easier and less costly than treatment.
Can a healthy diet really help?
A healthy diet, exercise, and enough sleep support overall skin health, although they cannot erase established folds.
Should I consult a doctor?
If you are concerned about the appearance of your folds, a dermatologist or cosmetic surgeon is the best resource.
Related Reading
References
Cleveland Clinic. Nasolabial Folds (Smile Lines): Causes & Treatment, Prevention. Cleveland Clinic. Last updated May 18, 2022. https://my.clevelandclinic.org/health/diseases/23027-nasolabial-folds
Wu Y, Ascher B, Yang Z, et al. Effectiveness and safety of a cross-linked hyaluronic acid plus mannitol filler for the correction of nasolabial folds in Chinese subjects: a randomized, blinded, controlled study. Aesthet Surg J. 2026;46(5):466-477. PMID 40997110. https://doi.org/10.1093/asj/sjaf186
Huang C, Liu J, Guo L, et al. A prospective study comparing the efficacy of hyaluronic acid and collagen in the treatment of nasolabial folds. J Cosmet Dermatol. 2026;25(1):e70630. PMID 41454456. https://doi.org/10.1111/jocd.70630
Chakhachiro A, Waseem M. Risk factor analysis for vascular occlusions after dermal filler injections: a systematic review and meta-analysis. Cureus. 2025;17(4):e82800. PMID 40406769. https://doi.org/10.7759/cureus.82800
American Academy of Dermatology Association. Fillers: FAQs. American Academy of Dermatology. https://www.aad.org/public/cosmetic/wrinkles/fillers-faqs
Cleveland Clinic. Marionette Lines: What They Are, Causes, Filler, & Treatments. Cleveland Clinic. Last updated May 18, 2022. https://my.clevelandclinic.org/health/diseases/23028-marionette-lines
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always seek the counsel of a qualified healthcare professional regarding any medical condition or cosmetic procedure.
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