Causes, Prevention, And Treatment
Thin vermilion is one of the earliest signs of aging. The vermilion is the area, margin, or zone between the lip and the adjacent skin. It is the area where women apply lipsticks.
Cosmetic problems such as loss of normal volume, wrinkles, and fine lines, and dryness usually affect this area in addition to the entire lip. It even can appear early at the age of 28.
Figure 1 – The vermillion (red, fleshy part of the lips), naturally thins with age, but some people are ethnically born with thin lips. As studies show, both men and women prefer large lips on each other so this does affect aesthetics.
Why Does Thin Vermilion Affect Facial Aesthetic?
Thin vermilion is natural and perfect if you like it. However, it can be one of the early signs of aging if you used to have fuller lips. Notice your lips and see your old pictures. You will find that they are getting thinner and losing their full appearance because they start losing collagen and the surrounding muscles start losing their tone. Thin vermilion is usually associated with the formation of fine lines and wrinkles leading to aging the entire face.
What Causes Thin Vermilion?
Decreased Collagen Production
Decreased collagen production is the most common cause of thin vermilion and lip thinning in general. Collagen is responsible for making our skin elastic, which leads to an increase in the support of our lips. As we get older, collagen production starts to deteriorate, which leads to making your vermilion thinner. (1)
Sun Exposure
Exposure to the Sun is great for your overall health. However, too much exposure can make damages your skin. It is why we need to wear sunblock. The same is applied to our lips. When you get exposed to the sun for a long time, the collagen in our lips starts to breakdown. Eventually, your vermilion and lips will become thinner and lose their fullness over time. (2)
B Vitamins Deficiency
B vitamins, especially vitamin B12, play an essential role in the health of our skin and hair, including our lips. When you have a lack of B vitamins, your skin loses its collagen and becomes cracked including your lips. Over time, the vermilion and the entire lip becomes thinner. (3)
Genetics
The shape of your lips is the result of your genes. Some people are born with full lips while others have thinner lips and vermilion by hereditary. (4)
Lifestyle Choices
Certain lifestyle choices such as smoking, lip biting, and drinking beverages through a straw can enhance the aging process of the lips. Smoking worsens the condition significantly since it causes skin inflammations and damages. (5)
Dehydration
Vermilion and lips do not have sebaceous or sweat glands. Sweat glands keep our skin hydrated while sebaceous glands keep it oily. That is why lips become dry faster than any other area of the body. (6)
Actinic Cheilitis
Actinic cheilitis is a serious lip condition resulting from the damage of the epithelium of the lip. It increases the risk of having skin cancer, but it is not a serious condition itself. The condition is associated with vermilion problems. It develops mostly on the lower lip but may also develop on the upper lip too. (7
How To Prevent Thin Vermilion?
Stay Hydrated
Dehydration and drinking too much caffeine put too much stress on your skin and accelerate the breakdown of collagen. Try to keep yourself hydrated all the time and drink enough water.
Stay Away from Harmful Activities
Smoking, too much sun exposure, lip biting, and drinking using straws break down collagen and reduce its production. Also, try to prevent your teeth from wearing down. When your teeth wear down, the lips sink inside the oral cavity, which makes your lips and vermilion thinner.
Increase Your Protein and Vitamin C Intake
Make sure that your diet is full of proteins and vitamin C since they enhance the production of collagen and make it stronger and healthier. Chicken, beans, and nuts are good sources of proteins and green veggies are rich in vitamin C.
Always Hydrate Your Lips
Certain products such as lip ointments and oils can keep your lips hydrated all the time. Coconut oil and sweet almond oil are the best compounds that keep your lips moisturized. Put a layer on your lips before going to sleep to keep them hydrated overnight.
Figure 2 – A 20-year-old female patient with an upper lip hemangioma underwent treatment comprising intralesional pingyangmycin injections at the age of 4 months. Left, Preoperative findings. Upper lip superficial scarring, depression, pigmentation, and notching of the free border are noted on the right side. Right, Results after 3 fat transfers (36 months after the third procedure).
How To Treat Thin Vermilion?
Lip Fillers
Lip fillers are the first choice for treating thin vermilion and thin lips. There are many types of lip fillers such as Voluma, Perlane, Juvederm, and Restylane. Your doctor will assess your lips’ and vermilion condition, take pictures to be able to determine the best shape and symmetry for your lips, and determiner where the fillers will be applied. The procedure takes about 15 to 30 minutes and you will be able to go home immediately after the procedure. It is not a permanent solution, but it can solve an urgent problem such as weddings. (8, 9)
Lip Implants
Lip fillers are temporary and last for 6 to 8 months. The best alternative for lip fillers is lip implants. They last longer than lip fillers. Your doctor will determine the best size of the lip implant. It is a simple procedure that lasts for 30 minutes and you can go home on the same day, but you will need a regular follow-up until the sutures are well-absorbed. (10)
Fat Grafting (Autologous Lip Augmentation)
Fat grafting uses the person’s own tissues for lip augmentation. Autologous lip augmentation is one of the best alternatives to implants and lip fillers since it is more natural. The fat is usually extracted from the abdominal area and transferred into the vermilion and your lips. It is usually performed under local anesthesia and the patient can go home on the same day. Autologous lip augmentation lasts for more than 5 years. (11)
Tissue Grafting
Tissue grafting is another type of autologous lip augmentation. It depends on the use of the person’s own skin or dermis. Skin is usually removed from the lower abdominal wall area. The upper layer of the skin is removed and remaining is implanted in the lips. It is performed under local anesthesia and the person can go home the day of the procedure. It usually lasts for 60 to 90 minutes. Tissue grafting can keep your lips full for more than 5 years. (12)<
Figure 3 –
Fig. 7. Preoperative frontal view of a 31-year-old woman who requested more fullness and projection of her lips.
Fig. 8. Preoperative lateral view of the same woman.
Fig. 9. Three-month postoperative frontal photograph of the same patient demonstrating more fullness and increased mucosal show after augmentation with Alloderm and fat autografts.
Fig. 10. Three-month postoperative lateral photograph. (12)
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Citations:
1.Kim, D.-U., Chung, H.-C., Choi, J., Sakai, Y., & Lee, B.-Y. (2018). Oral Intake of Low-Molecular-Weight Collagen Peptide Improves Hydration, Elasticity, and Wrinkling in Human Skin: A Randomized, Double-Blind, Placebo-Controlled Study. Nutrients, 10(7), 826. doi:10.3390/nu10070826
2. Hoel, D. G., Berwick, M., de Gruijl, F. R., & Holick, M. F. (2016). The risks and benefits of sun exposure 2016. Dermato-Endocrinology, 8(1), e1248325. doi:10.1080/19381980.2016.1248325
3. Kannan, R., & Ng, M. J. (2008). Cutaneous lesions and vitamin B12 deficiency: an often-forgotten link. Canadian family physician Medecin de famille canadien, 54(4), 529–532
4. Cole, J. B., Manyama, M., Larson, J. R., Liberton, D. K., Ferrara, T. M., Riccardi, S. L., … Spritz, R. A. (2016). Human Facial Shape and Size Heritability and Genetic Correlations. Genetics, 205(2), 967–978. doi:10.1534/genetics.116.193185
5. Multani S. (2013). Interrelationship of smoking, lip and gingival melanin pigmentation, and periodontal status. Addiction & health, 5(1-2), 57–65.
6. Hitz Lindenmüller I, Itin PH, Fistarol SK. Dermatology of the lips: inflammatory diseases. Quintessence Int. 2014;45(10):875-883. doi:10.3290/j.qi.a32638
7. Mello, F., Melo, G., Modolo, F., & Rivero, E. (2019). Actinic cheilitis and lip squamous cell carcinoma: Literature review and new data from Brazil. Journal of Clinical and Experimental Dentistry, 0–0. doi:10.4317/jced.55133
8. Luthra A. (2015). Shaping Lips with Fillers. Journal of cutaneous and aesthetic surgery, 8(3), 139–142. https://doi.org/10.4103/0974-2077.167269
9. Vedamurthy, M., & Vedamurthy, A. (2008). Dermal fillers: tips to achieve successful outcomes. Journal of cutaneous and aesthetic surgery, 1(2), 64–67. https://doi.org/10.4103/0974-2077.44161
10. Guida, S., Mandel, V. D., Farnetani, F., Manola, C. M., Rubino, G., Ruzzu, S., … Urtis, G. G. (2017). Permanent implants for lip augmentation: Results from a retrospective study and presentation of tips and tricks. Journal of Plastic, Reconstructive & Aesthetic Surgery, 70(5), 699–704. doi:10.1016/j.bjps.2017.02.005
11. Gatti, J. E. (1999). Permanent Lip Augmentation with Serial Fat Grafting. Annals of Plastic Surgery, 42(4), 376–380. doi:10.1097/00000637-199904000-00005
12. Castor, S. A., To, W. C., & Papay, F. A. (1999). Lip Augmentation with AlloDerm Acellular Allogenic Dermal Graft and Fat Autograft: A Comparison with Autologous Fat Injection Alone. Aesthetic Plastic Surgery, 23(3), 218–223. doi:10.1007/s002669900271
13. Baumann, D., & Robb, G. (2008). Lip reconstruction. Seminars in plastic surgery, 22(4), 269–280. https://doi.org/10.1055/s-0028-1095886
