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Best Practices for Expression Lines Prevention and Treatment

As we age, facial volume is lost and expression lines and wrinkles start to appear. Unavoidable habits like sun exposure and stress can contribute to the aging process, however, there are treatments available to reduce the visibility of expression lines.

Learn all about expression lines in this article – from what they are, to the causes and best ways to prevent and treat them. Clear any confusion you may have and take advantage of this opportunity.

But first, understand more about how the aging process works. Check it out.

Dr. Szerman explains wrinkles and expression lines:

What Causes Skin Aging?

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Skin aging, which is the natural process of the passing of time, is reflected primarily in the body’s largest organ: the skin. To properly discuss the prevention and treatment of expression lines, it is important to first understand this process.

As time passes, the production of elastin and collagen (required for skin firmness and elasticity) diminishes, leading to reduced cell renewal. In addition, sweat gland activity also decreases.

As one ages, the skin naturally thins and dries out, causing wrinkles, expression lines, and loss of glow to be more prominent.

Skin ageing can appear due to both internal (age) and external factors (e.g. environmental elements). Symptoms can include tired-looking skin, wrinkles, spots, and a lack of glow.

Premature skin ageing occurs when the skin is aged prematurely due to external factors.

External Factors That Can Accelerate the Aging Process of the Skin

Factors that cause premature skin aging include, but are not limited to:

  • Drinking alcohol in excess: Drinking too much alcohol produces free radicals, which cause premature aging and has a negative impact on a person’s health and wellbeing;
  • UV ray exposure;
  • Smoking: Smoking accelerates wrinkles as it restricts blood flow which reduces tissue oxygenation. This causes more prominent marks on the skin;
  • Pollution;
  • Weight gain;
  • Artificial tanning: Artificial tanning is strongly discouraged by the Brazilian Society of Dermatology due to its detrimental effects, including prematurely aged skin and increased risk of skin cancer;
  • High blood sugar leads to premature aging of facial skin.

It is essential to understand that too much sun exposure has cumulative effects on the skin. It is estimated that 80% of one’s total lifetime sun exposure is received before the age of 18.

Prolonged exposure to the sun accumulates damage over time, and the consequences may not be seen until years later. Therefore, we suggest limiting sun exposure and using sunscreen to protect your skin.


Three Stages of Skin Aging

To effectively address skin aging, it is essential to comprehend its stages.

The human skin ages over time in three distinct stages: early, intermediate, and advanced. In the early stage, fine lines and wrinkles may start to appear, and the skin may appear slightly dull. In the intermediate stage, deeper wrinkles and sagging skin may become more prominent. Finally, in the advanced stage, the skin loses elasticity and moisture, leading to a dry, thinned appearance.

In the early stages of skin aging, expression lines and dullness appear due to a decrease in collagen (a protein essential for skin firmness and elasticity), which causes sagging and wrinkles.

In the intermediate stage, deeper wrinkles and sagging skin may become more prominent due to a sharp decrease in collagen and elastin production. This decrease leads to a greater loss of elasticity and deeper wrinkles.

The advanced stage of aging is characterized by facial contours becoming less defined and skin losing density and becoming dry.

Early Signs of Skin Aging

Though skin aging is usually associated with old age, signs of aging can manifest at a much younger age. Knowing how to recognize and address these signs is essential for maintaining beautiful, youthful looking skin. Common signs of aging skin include:

  • Expression lines: Expression lines usually appear from the age of 30. When left untreated, they develop into wrinkles and tend to get deeper.
  • Freckles: Freckles often emerge before the age of 20, typically around the eyes and nose.
  • Sagging: After age 30, the lack of skin support and elasticity may cause sagging, especially beneath the neck.
  • Skin spots: Sun exposure can lead to skin spots which, if not treated promptly, can become permanent.

What Are Wrinkles?

tratamento para rugas de expressão

Wrinkles represent the skin’s aging process. This is primarily due to a decrease in collagen, a vital component for skin support. As elastin production decreases, the skin begins to sag. 

Another substance linked to the aging process is hyaluronic acid, which is a natural element of our body. Treatment with hyaluronic acid can reduce expression lines and facial wrinkles. It works by filling the skin for support between cells.

Wrinkles, particularly on the forehead and the crows feet around the eyes, are often caused by years of repetition of facial expressions, such as: 

  • Squinting frequently 
  • Frowning frequently
  • Smiling frequently 

Facial wrinkles are caused not only by facial expressions, but also by repeated muscle movements. These muscles crease the skin above them, leading to dynamic wrinkles or expression lines.  

Expression lines deepen with age, resulting in “crow’s feet”, “forehead wrinkles”, “mouth corner marks”, and “neck lines”.

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What Causes Wrinkles?  

Wrinkles come in all types, ranging from lines that form when the skin is stretched by movement or expression, to deeper wrinkles that form even when the face is at rest.  

Wrinkles on the face are commonly caused by the natural aging process and sun exposure without sun protection. But there are also other causes like hormone imbalances, alcohol consumption, smoking, and other factors that can contribute to the appearance of wrinkles on the face, including:

  • Collagen loss
  • High stress levels
  • Poor nutrition
  • Excess sugar consumption

In addition to that, wrinkles can be caused by sun exposure, pollution, and smoking.

Types of Wrinkles

Before exploring treatments for wrinkles, it is important to understand the types. Knowing the type of wrinkle you have will make it simpler to determine the best treatment approach.

Wrinkles can be classified into three distinct types: dynamic, static, and gravitational. Dynamic wrinkles appear due to the facial muscles, static wrinkles result from sun damage and age, and gravitational wrinkles form as a result of the pull of gravity on the skin.

1 – Dynamic Wrinkles

Dynamic wrinkles are the most common and bothersome type of wrinkles. These appear when making expressions such as frowning, looking astonished, or smiling with crow’s feet. People typically start developing them around age 30-40, and they become deeper if not treated.

2 – Static Wrinkles

After the age of 40, static wrinkles commonly appear. According to Dr. Guilherme Szerman:

“A static wrinkle was once a dynamic wrinkle” – Dr. Guilherme Szerman 

Dynamic expression wrinkles should be treated quickly, as they can deepen and become static wrinkles, which are more difficult to treat. Therefore, it is important to address expression wrinkles early to avoid more complex treatments down the line.

Needless to say that one should get treatment from a professional or appropriate clinic as soon as possible – the earlier you start, the quicker the results will be.

3 – Gravitational Wrinkles

Gravitational wrinkles are caused by the loss of facial volume that occurs as we age. These wrinkles are also referred to as smile lines, bulldog lines, and marionette lines. Unlike dynamic and static wrinkles, which can appear at any age, gravitational wrinkles typically start to become noticeable around age 40 or 45.

It’s important to address these wrinkles early on in order to achieve optimal results. Seeking the expertise of a professional or an appropriate clinic is highly recommended. Treating these wrinkles as soon as possible can help minimize their appearance and slow down their progression.

How to Prevent Wrinkles?

Wrinkles are caused by a combination of factors, but there are several practical steps you can take to reduce their appearance. Wrinkles can be prevented with proper skin care, including:

  • Keeping skin hydrated with moisturizer
  • Using a quality, broad-spectrum sunscreen daily
  • Limiting your exposure to the sun
  • Wearing protective clothing when outdoors
  • Eating a healthy, balanced diet
  • Reducing stress levels
  • Avoid smoking

To further support skin health, include antioxidants in your diet, such as vitamin C, ferulic acid, and blueberry extract..

For safe and effective skin care and anti-wrinkle treatment, it is important to consult a dermatologist. Different people may have different results with any given product or routine; hence, medical evaluation is required.

Botox is another effective preventive wrinkle treatment. It can help prevent the formation of wrinkles in the upper third of the face.

Eating a healthy diet is another significant factor to help prevent wrinkles; limit salt and sugar as much as possible.

To keep wrinkles at bay, lead an active lifestyle and avoid a sedentary one. These habits can help delay the appearance of wrinkles, but unfortunately, they will eventually make their way as age increases.

There are many methods available to prevent wrinkles. If you already have wrinkles, treatments such as Botox or dermal fillers can help reduce the appearance of expression lines and wrinkles on the face.

What Is the Best Treatment for Minimizing Expression Lines?

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To treat wrinkles, a dermatologist evaluation is your best bet. They are experts in determining the type (dynamic or static) and cause of wrinkles, as well as deciding the best treatment for your individual case.

Botulinum Toxin Treatment for Expression Lines

Botulinum Toxin is a widely used and effective treatment for both static and dynamic wrinkles, including expression lines.

How Does It Work?

Botox injections work by blocking nerve signals in the injected muscles, reducing muscle contraction and thus preventing expression lines from forming. It is an efficient way to target the cause of wrinkles. Other treatments may also be used to achieve desired results.

Is Botox suitable for the face? We receive this question often. Botox is most commonly used to treat wrinkles on the forehead, but it can also be used to target other areas of the face and neck. In this article, we focus on the use of botox in the upper third of the face, which reduces wrinkles in the forehead by decreasing the strength of the muscles.

Botox provides a natural-looking result, making it an attractive option for addressing expression lines.

Botulinum toxin can be used to temporarily reduce dynamic wrinkles around the eyes, forehead, and between the eyebrows.

How Long Does Botox Treatment for Expression Lines Last?

The treatment for expression lines typically lasts 4-6 months. For best results, reapplication is recommended after this time.

Another benefit of it is that you’ll quickly see results with this treatment; in as little as a few days, your skin will improve.

How Much Does Botox Treatment for Expression Lines Cost?

Botox cost is determined based on the amount and brand of the product required, as well as muscle strength. It is essential for a physician to assess each patient’s individual needs.

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Botox Treatment for Expression Lines Before and After

tratamento para rugas de expressão
Rugas de Expressão na Testa
Forehead wrinkles
rugas de expressão antes e depois
Facial wrinkles, also known as crow’s feet
rugas de expressão antes e depois
Crow’s feet wrinkles



Hear what our past patients experienced when they received Botox treatment for expression lines at Clinica de Pele.


Dermal Filler Treatments for Wrinkles or Expression Lines

The treatment of gravitational wrinkles is performed with facial volume replacement and hyaluronic acid (Md Codes or facial harmonization).

How Does It Work?

This treatment reduces static wrinkles and adds volume to the face, particularly around the cheekbones, chin, eyes, and mouth. It softens static wrinkles, as well as wrinkles caused by facial expressions.

At Clínica de Pele Clínica de Pele in Rio de Janeiro, we use MD Codes to treat static and gravitational wrinkles. This technique injects hyaluronic acid, a naturally-occurring element in the body, into the affected area.

Like botulinum toxin, this treatment for expression lines provides a temporary effect. But unlike it, dermal fillers offer a longer-lasting effect than botulinum toxin, lasting up to several years due to the highly reticulated filler used.

Also known as facial harmonization, this is a procedure that uses hyaluronic acid – a naturally-occurring element in the skin – to restore facial volume lost with age.

Dermal Filler Treatments for Expression Lines Before and After



Hear what our past patients experienced when they received Botox treatment for expression lines at Clinica de Pele.


Pre- and Post-Botulinum Toxin Treatment Recommendations

Before and after receiving botulinum toxin injections, there are certain recommendations that should be followed to ensure a safe and successful procedure.

No pre-treatment skin preparations are needed for the expression lines treatment; a topical anesthetic cream can be applied to the area before treatment.

Skin procedures should only be performed by experienced professionals, following an evaluation in a dermatology clinic. This ensures the safety of the procedure and provides the best results.

After receiving dermal filler or Botox injections, we recommend:

  • Not wearing make-up
  • Refrain from lying down for 6 hours.
  • Avoid touching the treated area

Following the doctor’s advice will ensure successful results for treating facial wrinkles.

To keep your skin healthy, remember to hydrate, drink plenty of water, apply sunscreen even when it’s cloudy, and cleanse and tone regularly.

Take our free online quiz to discover the best expression lines treatment for you.



Treatment Statistics

Botox, a botulinum toxin, is the most commonly performed non-surgical procedure globally, used to reduce the appearance of wrinkles and expression lines.

Botox is the most popular cosmetic procedure among men, with a 400% rise in treatments from 2000 onwards, as reported by the American Society of Plastic Surgeons.

In 2020, the American Society of Plastic Surgeons’ 2020 Plastic Surgery Statistics Report revealed 4 million Botox treatments among women, and over 250,000 for men.

Botulinum toxin is the most commonly performed aesthetic procedure globally, with Brazil second only to the U.S., according to the International Society of Aesthetic Plastic Surgery (ISAPS).


Does Wrinkle Treatment Cause Pain?

Most patients tolerate the treatment well thanks to a local anesthetic cream applied beforehand for increased comfort.

Is Skin Preparation Required?

No skin preparation is required. An anesthetic cream should be applied to the area one hour prior to toxin injection. To ensure maximum results, the area should not be moved, makeup should not be worn, and lying down should be avoided for six hours following treatment. Normal physical activity may be resumed the next day.

What Are the Results of Expression Lines Treatment?

Botulinum toxin results are visible within days of application, peaking at 1–2 weeks. Lasting for 4–6 months, maintenance of effects typically requires reapplication after this period. As more applications are made, the results become longer-lasting.

Our medical practice has been providing advanced dermatology services for more than 50 years and we currently have over 45,000 registered clients. If you’re interested in taking advantage of our treatments, get in touch with us.

We are highly experienced and reliable, and we are renowned for providing training to other professionals in our field who understand the importance of our work.

At our facility, we strive to ensure the best care for our patients. To achieve this, we employ a three-prong approach: skilled physicians, cutting-edge treatments, and patient-centered care.

If you have questions about preventing or treating wrinkles and expression lines, reach out to us. We can help you find the best procedure for your situation. 

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