I most commonly treat these lines around the lips and mouth with an injectable filler.  This usually lasts 10-12 months, although some studies suggest that fillers stimulate new collagen formation and can provide a longer result.  It takes approximately 5-10 minutes in the office setting.  For deeper lines of the lips and face, sometimes dermabrasion or laser resurfacing is the better option.

CO2 laser resurfacing is a good form of treatment for deep wrinkles and  acne scarring.  It also lightens the skin and can be very effective in removing areas of hyperpigmentation.  If you have superficial hyperpigmentation and mild wrinkling and/or slightly large skin pores, you may be a good candidate for a TCA peel.  This type of peel has a shorter down time and quicker healing phase than the CO2 laser.  Laser resurfacing will certainly provide a more even complexion.

Laser resurfacing is my treatment of choice for acne scarring.  I use a CO2 laser to accomplish this.  You would be a good candidate as long as your acne is no longer active.  Dermabrasion is another option for skin resurfacing, but I prefer the CO2 laser.  The most important factor in deciding to have this procedure is the healing period.  It takes several weeks for your skin to heal, and you will need to avoid direct sun exposure.  I tell my patients to plan at least 3-4 weeks "down time".

If you have some isolated areas of acne scarring, dermabrasion is a good method of treatment. As I have said before, deeper acne scars need to be removed before dermabrasion will provide the final optimum result. Dermabrasion is the process of removing outer layers of skin with tactile force, like sanding down a surface. A chemical peel removes those outer layers by placing an agent onto the skin that causes the outer layers of skin to peel off, leaving a fresh new layer to resurface. I personally do not perform a deep phenol peel which could help your condition, but I do perform laser skin resurfacing which I feel works well. With both dermabrasion, laser resurfacing, and chemical peels, there is a risk of skin lightening. The deeper you go, the longer it takes for you to heal, but the results are more dramatic.

Posted by William E. O'Mara Jr., M.D.

The procedure that is the best for you depends on your skin quality, the depth of your wrinkles, and your desired "down time". For minor wrinkles and pigmentation of the face, I prefer the 35% TCA peel, which is performed in my office procedure room under oral sedation and takes about 45 minutes. Your skin will peel to its new fresh layer in about a week, and makeup can resume in about 2 weeks. For deeper wrinkles throughout the face, I prefer CO2 laser resurfacing. This is a procedure performed under general anesthesia as an outpatient. The skin is red for a bit longer, but makeup can be applied between two and three weeks after the peel. 

Posted by William E. O'Mara Jr., M.D.

In my opinion, laser resurfacing is a better method of treatment for acne scarring. It can more readily provide a uniform removal of the outer skin layers throughout the entire face. However, dermabrasion is very helpful in treating more isolated areas of concern. For deeper, pitted acne scars, I will often perform surgical excision of these areas several weeks prior to resurfacing to improve the overall result.

Posted by William E. O'Mara Jr., M.D.

I perform laser resurfacing more often than dermabrasion, but it has not completely replaced that procedure. Laser resurfacing is valuable for treating the entire face to improve deep wrinkles and/or acne scarring. I use dermabrasion for more isolated areas, such as scar revision or perioral wrinkles.

Posted by William E. O'Mara Jr., M.D.