We tend to assume most of our facial lines and wrinkles come from expressions. Hence, the so called “smoker’s lines” around the mouth, “crow’s feet” around the eyes, and “bunny lines” around the nose. While it is true many lines on the face are formed as a result of repeated facial movements, often patients will come to our office concerned about a line that doesn’t follow along the path of a muscle.
We regularly see patients with more lines on one side of the face, often the left side, running perpendicular to expression lines. When we see these lines not associated with the movement of a facial muscle, we have to search for a cause. Often, patients see more lines and damage on the left side of the face, since the left side is exposed to more sun while driving in the car. (Studies of people in England who drive on the other side of the road and postal workers who also drive on the opposite side have found these people have more significant lines on their right “driver’s side”).
Another likely culprit is sleep. We spend up to 1/3 of our lives sleeping! While we are resting, our faces are often pressed against pillows, which, over time, can result in sleep lines.
These sleep lines are more difficult to address for a number of reasons. First, they can’t be treated with a neurotoxin such as Botox or Dysport. Since these products work to “freeze” the muscle, if the line isn’t a result of a muscle movement, the procedure will not be effective. Second, it is very difficult, if not impossible, to modify our sleeping position. Research has shown, as we age, we shift positions less often throughout the night. More time spent in each sleep position equals an increased chance of sleep wrinkles forming! While we can try to fall asleep in a certain position, it is unlikely we can maintain that same position throughout the entire night.
So what do we do? We need sleep to maintain our health, but we also want to avoid wrinkles. This is a tough question. As discussed above, injectables tend to have little effect on these lines. Some studies indicate certain pillows might decrease the formation of wrinkles, but the research is still early and not conclusive. Other evidence points to the efficacy of collagen forming treatments such as microneedling. While there is no definitive solution to these rest wrinkles, our patients have seen success with SkinPen microneedling treatments, chemical peels, and Ulthera. All of these procedures increase our body’s collagen making processes. Unfortunately, there is no magic bullet, but we have many tools to help maintain a smooth youthful face, while still resting easy.