Marionette Lines: What it is, Causes and Treatment Options

Marionette lines (also called puppet lines or mentolabial folds) are among the facial wrinkles that form naturally with age. They run from the corners of the mouth towards the chin line.

Marionette lines or puppet lines owe their name precisely to this shape: they "separate" the chin area from the rest of the face, which is strongly reminiscent of the characteristic facial features of marionettes.

Marionette lines often appear together with nasolabial folds. These extend down from the wings of the nose to the corners of the mouth and, like marionette lines, belong to the smile or expression lines. 

Wrinkles around the mouth and chin like marionette lines are caused primarily by the effect of gravity on the tissue. They are a result of the natural aging process of the skin, in which the loss of elasticity contributes to the sagging and loss of volume in the tissue.

Pronounced facial expressions can promote the formation of marionette lines. The first facial wrinkles form at the age of 25. Thus, the cause of wrinkles is the continuous aging of the skin, in which less hyaluronic acid is produced and the structural protein collagen is degraded.

Other factors that favor the visibility of marionette lines, chin wrinkles and other face wrinkles are 

• thinning skin, which is a sign of aging after the age of 25,
• age-induced dryness or moisture loss of the skin, which is triggered by both internal and external factors
• inappropriate skin care that is not adjusted to the needs of the skin type, and
• insufficient sun protection. So-called photoaging is one of the most common causes of skin aging. It is triggered by UV rays that dry out the skin and attack skin cells.  

Unfortunately, you can’t have marionette lines removed completely and thus, it is not possible to get rid of them altogether. However, marionette lines can be visibly reduced with the help of dermocosmetic treatments.

Keep in mind that these treatments are often expensive and must be repeated at regular intervals to achieve an even effect. Also keep in mind that cosmetic treatments to reduce marionette lines are often (minimally) invasive and therefore always carry the risk of side effects. 

One of the most common methods of reducing marionette lines is the dermal filler, an injection under the skin. For this purpose, so-called fillers (usually hyaluronic acid) are used. Hyaluronic acid is injected directly into the skin with a thin syringe. The plumping of marionette lines with hyaluronic acid should be performed only by a specialist. To maintain the result, it is necessary to repeat the treatment approximately every 6-12 months. Since it is a minimally invasive method, side effects such as temporary swelling and redness and in rare cases allergic reactions are possible. 

Besides hyaluronic acid, injection can be done with the neurotoxin Botox. Unlike hyaluron, Botox is not a natural substance and can therefore trigger significantly more side effects. Before deciding which injection for marionette lines to choose, you should discuss all options and risks with your dermatologist. 

A chemical peel involves applying an acidic solution to the skin to peel away the top layer of skin. Depending on the acid used, this marionette line treatment can have a light and superficial, a medium or a deep effect. Chemical peels stimulate the skin to regenerate, which leads to the reduction of wrinkles such as marionette lines, as well as skin blemishes and hyperpigmentation like age spots - in short, the entire skin appearance is renewed. Side effects reminiscent of sunburn may occur, such as pain, redness and peeling of the skin. 

Caution: After a chemical peel, the skin is very sensitive. Therefore, consistently protect it from sunlight in the following weeks. 

During laser treatment, light energy is directed through the skin's surface into the deeper layers of the skin. There, the heat causes cell damage. They are not visible from the outside, but inside the skin they stimulate the formation of new cells and thus the production of collagen.

The laser pulses are scattered so that the skin cells are evenly hit by the light energy. Chin lines and wrinkles around the mouth are visibly reduced and the skin looks firmer and more youthful. The advantage is that the laser can be used selectively, which allows for targeted elimination or reduction of marionette lines. Usually, several sessions are required to treat the entire skin. 

Laser treatments, like chemical peels, lead to increased sensitivity to light. Therefore, protect your skin from direct sunlight even after this treatment.  

An alternative or addition to the dermocosmetic treatment of marionette lines is a conscientious skin care with high-quality anti-aging creams and serums.

Special care substances such as hyaluronic acid and other anti-aging ingredients provide a plumping effect when used regularly and supply the skin with moisture down to the deep layers.

Thus, the result achieved by laser treatments or injections under marionette lines can be supported and maintained longer. 

With the Hyaluron-Filler products, Eucerin has developed an anti-age series that helps to soften chin lines and other signs of aging and to give sagging facial skin - e.g., around the mouth - noticeably more volume and elasticity. 

To counteract the formation or deepening of marionette lines as well as other facial wrinkles, there are a few things you can do yourself. Learn here how you can easily delay and reduce skin aging including dryness, wrinkles, and volume loss in the long term by applying these simple steps for prevention:  

Sun protection 

The face is constantly exposed to external environmental influences. UV radiation can damage the skin to a great extent and greatly advance skin aging. Therefore, good protection with appropriate sunscreen is important to delay the formation of marionette lines. Apply a day care product with SPF throughout the whole year. In summer, you should choose products with SPF 30 or 50+. Sun protection with an anti-aging effect is provided by the Eucerin Sun Fluid Photoaging Control SPF 50. 

Healthy lifestyle 

What we eat affects the skin as much as the body. Include plenty of foods rich in antioxidants in your daily diet. Raw fruits and vegetables contain many vitamins and antioxidants that can bind free radicals in the body. The fewer free radicals in the body, the slower skin aging progresses. Getting enough sleep also gives the skin time to regenerate and prevent the development of face wrinkles. 

Daily skin care 

A good skin care routine with suitable products protects the skin from premature aging and thus also from deepening marionette lines. It consists of four steps: cleanse - clarify - care - protect. Eucerin's DermatoCLEAN [HYALURON] skin care range is suitable for all skin types and is enriched with skin-regenerating, moisture-binding hyaluronic acid. Learn more in our article about the daily skin care routine. 

Facial yoga: a natural treatment for marionette lines 

Facial yoga (also known as yotox for short) is a wrinkle prevention trend originating in the United States. Facial yoga is said to reduce wrinkles such as marionette lines, frown lines and crow's feet by stimulating the blood and lymph vessels, thus supplying the facial skin with more oxygen. Since "yotox" is a 100% natural treatment for lines and wrinkles, it is becoming more and more popular. Try out the following exercise against the formation or deepening of marionette lines: 

1. Keep the forehead and eye area completely relaxed. 
2. Smile as wide as possible and at the same time smooth out the lines around the mouth. 
3. Hold the position for about 10 to 15 seconds. 
4. As a countermovement, you can pull your lips together to form a kissing mouth. By alternating the two movements, you exercise the muscles of the mouth and cheeks, as well as the jaw. 
5. Repeat the exercise 5 times. 

You can repeat the exercise against marionette lines several times a day. You can also combine it with other facial skin tightening exercises to train the whole facial skin.