Fine lines: which treatment options are there?

First, identify the type of line

What we call “fine lines” can have quite different causes, and that cause is what determines which method will work. At the consultation I ask you to make a few expressions, then look at your face at rest. This simple observation often settles half the plan.

• Dynamic lines: lines that appear when you smile, raise or knit your brows, and disappear or fade noticeably when your face relaxes. Their source is muscle movement.
• Dehydration lines: superficial, closely spaced lines that look like crumpled paper, especially on the cheeks and around the eyes. They show up more when the skin is dry.
• Skin-quality lines: lines that appear as the skin loses elasticity with age and sun exposure, alongside thinner, laxer tissue.
• Static (etched-in) lines: lines that, after years of repeated expression, are now visible even at rest. Both muscle movement and skin quality need to be addressed.

A simple check at home can also give you an idea. Take a photo in daylight with your face completely relaxed, then repeat from the same angle while smiling and raising your eyebrows. Lines that only appear in the second photo are largely expression-related. Lines visible in both — especially fine, closely spaced lines on the cheeks — have more to do with skin quality. This isn't a diagnosis, but it can help you clarify what you'd like to discuss at your consultation. If you live abroad, photos like these are also a useful starting point for an online consultation before you travel to Istanbul.

For expression lines: botulinum toxin

Forehead lines, frown lines between the brows and crow's feet at the corners of the eyes are the areas where botulinum toxin (Botox) is most often considered. The toxin temporarily reduces movement in the relevant muscle; when the muscle contracts less, the skin folds less. The effect usually starts within a few days, settles in about two weeks and lasts on average 3–4 months for most people. A measured dose matters for keeping your expression. Treating early, before lines become etched in, may help slow how quickly they deepen.

Options for dehydration and skin-quality lines

Skin booster

For crêpey lines on the cheeks, around the eyes and on the neck, placing micro-doses of hyaluronic acid into the skin with a skin booster may be considered. The aim is not to “fill” the line, but to help the surface look smoother by supporting the skin's ability to hold water and its elasticity. Most plans involve a few sessions a few weeks apart.

Salmon DNA (polynucleotides)

Polynucleotide-based treatments, known as salmon DNA, may be considered to support skin quality, particularly in thin, tired-looking skin and in delicate areas such as around the eyes. Results develop gradually and vary from person to person.

Microneedling and chemical peels

If the lines come with rough texture, visible pores or sun-related differences in tone, microneedling or a suitable chemical peel may be added to the plan. These methods target the skin's surface and texture; they don't replace treatment for expression lines.

With skin-quality treatments, results appear not in a few days as with toxin, but over weeks and as sessions progress. So it makes more sense to think of them not as a one-off fix but as a process that supports the overall condition of your skin.

When is filler considered for fine lines?

Filler is designed for volume loss and deep folds; it isn't the first choice for superficial fine lines. Injecting dense filler into a fine line can create an uneven look. That said, for some etched-in lines or in selected areas such as around the mouth, very soft products may be considered with a careful technique. We explain the difference between toxin and filler in Botox vs fillers.

Around the eyes and mouth: two areas that need extra care

The skin around the eyes is among the thinnest on the face. Fine lines here deepen both with smiling and with dehydration. For crow's feet, the toxin dose is carefully adjusted so it doesn't take the naturalness out of your smile; for fine creasing on the lower eyelid, skin-quality treatments come to the fore.

Vertical lines around the mouth can develop from frequent lip pursing, smoking and sun exposure. Here, very small doses of toxin, skin-quality treatments and, in selected cases, a soft filler may be considered together. Because speaking, eating and expression are directly affected in this area, the approach should always be measured.

How do these fit together in a plan?

Take someone in their 40s with prominent laughter lines at the corners of the eyes and fine, dehydration-related creases on the cheeks. Their plan might be botulinum toxin for the eye area, a few sessions of skin booster for skin quality on the cheeks and around the eyes, and daily sun protection. For someone else, hydration support alone might be enough. That's why there's no single answer to “what's the best treatment for fine lines?” that applies to everyone.

When is a different assessment needed?

If the lines come with redness, scaling, itching or new spots that are changing shape, a dermatology assessment matters before any aesthetic treatment. If lines around the eyes come with marked puffiness or dark circles, that area needs to be addressed separately; we summarise these distinctions on our fine lines page.