Nasolabial Folds: Why Creams Alone Cannot Lift Them

Nasolabial folds are the two grooves that run from the sides of the nose down towards the corners of the mouth, and they are the first thing you notice in photographs when you stop recognising yourself. You buy a cream, you use it for months, and the fold is still there. That is not the cream's fault, and it is almost certainly the fault of how the problem was explained to you.

Technically, the nasolabial fold — also called a smile line — is not a wrinkle at all. It is the visible border between two areas of the face that are drifting apart, and the anatomical literature has been clear on this for thirty years. In this guide you will find what actually creates it, what a topical product can and cannot do, and why one of the most repeated pieces of advice — facial exercises — works against you in this specific area.

What nasolabial folds really are

Where the groove runs

The nasolabial groove separates the upper lip from the cheek. Underneath the skin, at that exact point, there is a precise structure: the muscles that elevate the lip insert into the dermis and create a line of anchorage. On one side of that line the tissue is fixed; on the other it is mobile.

The classic work of Yousif in Plastic and Reconstructive Surgery (PMID 8278485) and that of Barton (PMID 9326792) described this anatomy in detail, and a more recent study by Snider (PMID 28508263) revisited the role of the midface musculature. The common thread: the fold is an anatomical structure, present even in a young face. In children you can see it when they smile. It does not appear from nowhere with age — it becomes deep.

Why it is not a wrinkle

A wrinkle starts in the skin: collagen degrades, the fibre buckles, the crease stays. The nasolabial fold, by contrast, deepens because the tissue above it descends. It is not the skin wearing out at the point of the crease: it is the volume of the cheek sliding downwards and piling up against that line of anchorage, creating a step.

The distinction is not academic — it is the whole question. On a true wrinkle, an active that stimulates collagen has a target. On a loss of volume it does not: you can improve skin quality as much as you like, but the tissue that has come down stays where it is. That is why a cream gives modest results in this area even when the formulation is excellent.

The three causes, in order of real weight

The descent of the fat compartments

Facial fat is not a uniform layer: it is organised into compartments separated by fibrous septa, each with its own borders. The anatomical description by Cotofana (PMID 30698919) maps that structure, and the work of Rohrich in Plastic and Reconstructive Surgery (PMID 33347073) showed that the evolution of these compartments makes it possible to predict how a face will age.

Over the years the upper compartments empty out while the lower ones descend and accumulate. The result is that the cheek loses projection at the top and gains weight at the bottom, right above the fold. The review by Ugradar (PMID 36700849) on midface ageing sums up this movement well.

This is the primary cause, and no product applied to the skin reverses it.

Bone resorption

This is the part almost nobody talks about. The facial skeleton is not stable over time: the maxillary bone and the orbital rim are progressively resorbed. The analysis by Levesque (PMID 25921564) on midface anatomy and ageing describes this process.

Less bone underneath means less structure holding up the soft tissues, and therefore more descent. It is like removing the frame from under a mattress: the surface sags even though the mattress itself is intact.

Skin quality

It comes third by weight, and it is the only one a topical acts on. Skin that is denser, better hydrated and richer in collagen does not lift the fold, but it changes how the fold reads: it softens the edge, reduces the shadow, improves the texture of the area.

That sounds like very little, but it is not: the perceived depth of a groove depends heavily on the shadow it casts, and the shadow depends on the quality of the surface. This is where a good product earns its place — provided you know what you are asking of it.

When they appear, and why sooner for some

The fold typically becomes visible at rest between the ages of 30 and 40 years, but individual variation is wide and depends on factors you have little control over.

People with prominent cheekbones and good bony support develop it later. People with a lean face see it sooner, because with less fat every loss of volume shows up more — and it is the reason a substantial weight loss in adulthood ages the face even when it does the rest of the body good. Fair, thin skin makes it more obvious, because it generates a stronger shadow contrast.

Then there is the expressive component: if you smile a lot, the dynamic crease repeats more often and the static component consolidates earlier. The same logic applies that we described for crow's feet and the eye area, with one important difference: there the muscular component dominates, here it is the volumetric one.

What a topical product can actually do

Let us reframe the goal, because it is the only way not to end up disappointed: you are not trying to lift the fold. You are trying to make the surrounding skin denser, better hydrated and more even, so that the step reads less.

Retinoids

They remain the active with the most solid documentation on dermal remodelling. The study by Kafi in Archives of Dermatology (PMID 17515510) tested retinol 0.4% against vehicle for 24 weeks, with significant improvement in fine wrinkles. On the nasolabial area retinol works on skin quality, not on volume — but that is exactly the target you are left with.

Hyaluronic acid and hydration

Topical hyaluronic acid draws water into the superficial layers and smooths the surface. The review by Bravo in Dermatologic Therapy (PMID 36200921) documents real effects on hydration and skin quality. Be careful not to confuse it with injected hyaluronic acid, which is something else entirely: that one adds volume, and on the nasolabial fold it is the reference treatment precisely because the problem is volumetric.

On the difference between the two, and on how to choose a serious formulation, we have written in hyaluronic acid for the skin and in high and low molecular weight hyaluronic acid.

Vitamin C and antioxidants

Vitamin C is a cofactor for the enzymes that stabilise collagen: without it, the fibre does not assemble properly. The double-blind study by Humbert in Experimental Dermatology (PMID 12823436) evaluated topical ascorbic acid on photoaged skin with positive outcomes, and the review by Al-Niaimi (PMID 29104718) summarises its mechanisms and its limits.

Photoageing is the first modifiable factor you can genuinely act on: daily sun protection is worth more than any serum, and that is not a figure of speech.

What does not work, and why it keeps being recommended

Facial exercises

This is the most widespread piece of advice and, on the nasolabial fold, the least sensible. The study by Alam in JAMA Dermatology (PMID 29299598) found an improvement in cheek fullness after twenty weeks of exercises, but the systematic review by Van Borsel (PMID 24327764) judges the overall evidence to be still weak.

On the fold there is an additional problem, and it is mechanical. The levator muscles of the upper lip, when they contract, pull the skin above the anchorage line upwards and accentuate the step. A protocol that has you voluntarily and repeatedly contract exactly those muscles is rehearsing the very movement that marks the crease. It is the same mistake people make when they suggest face yoga for the eye area.

Home remedies

Ice, cold spoons, drainage massage and homemade masks can reduce puffiness and temporarily improve the look of the area. On the loss of volume they have no effect whatsoever, and no study suggests otherwise. They do no harm — they simply are not acting on the problem.

Creams that promise a lifting effect

When you read "immediate lifting effect" on a package, what almost always happens is film-forming tension: polymers that contract as they dry and pull the surface taut. The effect is real, it lasts a few hours and it disappears when you wash your face. It is not a scam, but it is not a lift either: it is an optical trick, and it should be bought knowing what it is.

What genuinely slows the process down

If the dominant cause is structural, the right question is not "what erases it" but "what slows it down". And here, unlike on the cosmetic side, there are levers with real impact.

Photoprotection, above all

Ultraviolet radiation activates matrix metalloproteinases, the enzymes that break down collagen, and reduces the ability of fibroblasts to rebuild it. Photodamaged skin gives way sooner and more markedly: it means the step forms on a tissue that has fewer resources to resist the pull.

Daily sun protection is the single habit with the best cost-benefit ratio across the whole face, and it should be used in winter and in the city too. This is not magazine advice: it is the direct consequence of the mechanism.

Body weight, and why fluctuations matter

The fat compartments of the face empty and refill like every other fat depot, but the skin above them does not recover its elasticity at the same speed. Losing and regaining weight repeatedly subjects the tissue to cycles of stretching and retraction that accelerate the sagging.

A significant weight loss in adulthood, even when it is excellent for your health, tends to age the face for precisely this reason: the volume that was supporting the structure is no longer there. That is not a reason not to lose weight — it is a reason to do it gradually and not to go back and forth.

Smoking

It acts on both fronts: it generates free radicals that degrade the fibres and it reduces cutaneous microcirculation, and therefore the supply of oxygen and nutrients to the dermis. Its effect on the face was documented particularly convincingly in the study by Doshi in Archives of Dermatology (PMID 18087005), carried out on identical twins discordant for smoking: with genetics held constant, the differences in skin ageing were visible and measurable.

Filler and aesthetic medicine: where they fit

We may as well say it plainly. If the problem is volumetric, the solution that acts on volume is injected hyaluronic acid filler, and that is a medical procedure. It is the reference treatment for this area precisely because it gives back what has descended or emptied out.

What the two approaches have in common is more interesting than the way they are usually set against each other: a filler placed under thin, dehydrated, collagen-poor skin shows more and ages worse. Topical and internal work improve the tissue the filler is placed into, and that changes the result you see. They are not alternatives — one prepares the ground for the other, and it is the reason it makes sense to arrive at any eventual treatment with months of anti-wrinkle serum behind you rather than starting from scratch.

And if filler is not in your plans, everything that slows down the modifiable part still holds: photoprotection, skin quality, stable weight.

Our approach

On this area we do not promise to erase the fold, because that is not something a cosmetic can do. What we will tell you is what can be worked on with visible results.

The Filler-Effect Anti-Wrinkle Serum is the most concentrated product in the range and it acts on the component a topical has a say in: apparent density, deep hydration, evenness of the surface. On the nasolabial fold it is applied by patting along the crease, morning and evening, and it should be judged months later.

For daily use across the whole face, the Anti-Age Moisturising Face Cream brings the antioxidant contribution of Moringa oleifera together with the moisturiser component — the rationale is in the article on the moringa face cream with hyaluronic acid.

Because the main cause is structural, work from the inside counts for more here than on other areas of the face. The IN&OUT Anti-Wrinkle Face Treatment puts topical care and supplementation together for exactly that reason. On the internal side, the meta-analyses by de Miranda (PMID 33742704) and Myung (PMID 40324552) show consistent improvements in hydration and elasticity with hydrolysed collagen: that is the rationale behind Collagen, Hyaluronic Acid and Moringa, which we discuss in hydrolysed marine collagen for wrinkles.

The Organic Moringa Oleifera capsules remain the antioxidant base, and on diet you will find the full picture in what to eat to improve your skin.

One last thing about this region: if what bothers you is not the groove running from nose to mouth but the vertical lines on the lip or the creases that descend from the corners of the mouth, you are looking at a different problem, with different causes and — good news — with more room for topicals. We cover it in lip lines and marionette lines.

Frequently asked questions

Can nasolabial folds be eliminated with a cream?

No, and no cream can do it. The nasolabial fold deepens above all because of the descent of the fat compartments of the cheek and the resorption of the bone underneath: these are structural changes, and a product applied to the skin does not reverse them. A good topical improves the density, hydration and evenness of the surrounding skin, which makes the fold look less marked, but it does not lift it.

At what age do nasolabial folds appear?

The fold exists from a young age as an anatomical structure and shows when you smile. It typically becomes visible with the face at rest between 30 and 40 years, sooner in people with a lean face or fair, thin skin, and later in people with prominent cheekbones and good bony support.

Do facial exercises help against the nasolabial fold?

In this area they are probably counterproductive. The levator muscles of the upper lip, as they contract, accentuate the step along the anchorage line: a protocol that makes them work repeatedly rehearses the movement that marks the crease. The available studies on facial exercises concern cheek fullness above all, and the systematic review still judges the evidence to be weak.

Is filler the only genuinely effective solution for nasolabial folds?

On volume, yes: injected hyaluronic acid filler gives back what has descended or emptied out, and it is the reference treatment for this area. It is a medical procedure and it should be assessed with a specialist. Cosmetic care and supplementation act on a different level, skin quality, and the two add up: a filler placed in well-maintained tissue delivers a better result.

Does sleeping on your side make nasolabial folds worse?

Repeated compression of the face against the pillow can contribute to sleep creases, which are a documented phenomenon and tend to affect the cheek and the forehead more. On the nasolabial fold, where the dominant cause is loss of volume, the contribution of your night-time position is marginal. If you want to reduce it anyway, a silk pillowcase and sleeping on your back are the usual measures.

How long does it take to see results from a cosmetic treatment on nasolabial folds?

Collagen renewal is measured in months, not weeks. A serious topical should be judged at twelve weeks of consistent use, photographing your starting point: the change is gradual and it is exactly the kind of variation the eye does not register when you look in the mirror every day.