Causes, Prevention, And Treatment
Nasojugal lines refer to the grooves or folds in the infraorbital area. The sunken space in the infraorbital area appears is usually 2 to 3 cm depression, which is characterized by the fatigue appearance due to the dark shadow formed over the nasal lower eyelid.
Figure 1 – Nasojugal lines typically form in conjunction with other undereye cosmetic flaws such as nasojugal fat pads and lower eyelid puffiness.
Why Do Nasojugal lines Affect Facial Aesthetic?
Nasojugal lines result from the deep depression between the eye and nose running from the eyelid’s inner corner passing through the infraorbital space along the infraorbital rim to the lateral corner of the eye. Some people have this depression naturally, while others develop it over time as they age. Cosmetically, Nasojugal lines are distracting and make people older than they are.
What Causes Nasojugal Lines?
Negative Vector Orbit
Negative vector orbit means that the cheekbones are flatter and underdeveloped. The cheekbones are less protruded than the eyeballs, causing negative vector orbit, which leads to the formation of nasojugal lines. (1)
Orbital Fat Prolapse
Orbital fat prolapse or herniation means that fat under the eyes has become moveable. Aging and surgical trauma lead to weakness of the capsule holding this fat mass. Men are more likely to develop nasojugal lines than women due to orbital fat prolapse. (2)
Aging leads to skin atrophy and loss of skin elasticity. The skin loses its ability to hold the subcutaneous fat, which leads to the formation of depressions and bulging in the area between the eyes and the nose. This depression appears over time forming the nasojugal lines, which in this case are indicators of aging. (3)
Some people are born with a difference in the thickness of the skin and soft tissues between the cheek part and the orbital part. If nasojugal lines run in your family, you may develop it over time. Usually, people who have a genetic predisposition to nasojugal lines have more prominent nasojugal lines than others and the condition worsens over time. (4)
Some people use their facial expressions more than others. The collagen in our faces starts to deteriorate as we age. If nasojugal lines run in the family, the condition may become worse. Some people have more tired faces than others. (5)
Smoking and stress can contribute to making your face more exhausted by accelerating the breakdown of the collagen in the face, causing inflammations, and reducing the amount of blood reaching your face. Too much stress is one of the worst things that may happen to your facial features. Insomnia also may develop under-eye bags, which may worsen the appearance of nasojugal lines and make them more prominent. (6)
How To Prevent Nasojugal Lines?
Many home remedies and skin care products can prevent the appearance of nasojugal lines and rejuvenate your face. Try them first and see if the lines will disappear or not before deciding whether your nasojugal lines need surgical intervention or not.
Many facial exercises are recommended for getting rid of facial wrinkles and lines such as nasojugal lines. Some people call these exercises “Facial Yoga” because they can relax your facial muscles and tighten your facial skin. (7)
Preventing facial inflammations makes your face more relaxed and reduce the appearance of aging symptoms. Try to quit smoking, avoid unhealthy food choices, and treat your allergies. (8)
Exfoliate Your Nasojugal Lines Gently
Having dry skin contributes to the appearance of your nasojugal lines. When you exfoliate your skin, you enhance the growth of new cells. Some skincare products specialize in removing the wrinkles beneath your eyes, try to find and use them.
In addition, try to avoid harsh, low-quality products to avoid any damages to your skin. (9)
Keep Your Face Moist
Certain skincare products are highly recommended for getting rid of nasojugal lines. Certain products contain ingredients that can enhance blood circulation and promote new cell growth. Find products containing retinol, peptides, and/or hyaluronic acid. Gels and serums are also the best. (10)
Use Sunscreen, Sunglasses, and A Hat
Sun exposure and UV worsen the appearance of nasojugal lines. It is recommended to wear an SPF (30 at least) when you are exposed to the Sun. to protect your face. In addition, wearing sunglasses and a hat are additional protective measures. (11)
Eat Healthy Foods
Foods rich in vitamins such as vitamin C, vitamin A, and Vitamin E promote the formation of new cells and fight oxidative stress and inflammations. Healthy foods can give you healthy, young, firm skin better than skincare products, especially if you avoid unhealthy foods. (12)
Figure 2 – Nasojugal lines and the significant depression in the preseptal segment were corrected.
How To Treat Nasojugal Lines?
Chemical peels are recommended for nasojugal lines, superficial wrinkles, and sagging skin. They can promote cell growth and remove dead skin cells. Along with preventive measures, your nasojugal lines will disappear gradually. (13)
Dermal fillers can treat nasojugal lines because they are produced by nasojugal depressions and grooves. They plump up the face and the area around the eyes, but they are temporary and last from 6 months to 2 years. Restylane and Juvéderm are the best filler for nasojugal lines and grooves. (14)
Microdermabrasion is a great option for people with mild nasojugal grooves and sensitive skin. It removes dead skin cells and enhances blood circulation rejuvenating your face muscles and tightens its skin. (15)
Nasojugal lines can be removed with lasers. Many types of lasers are available for getting rid of all types of facial wrinkles, but the best option for nasojugal lines is fractional lasers. (16)
Micro-Needling depends on the insertion of tiny needles in the skin to poke it. It is followed by applying certain creams and serums to heal the skin and stimulate the production of collagen. After micro-needling treatment, your nasojugal lines will start to disappear and the texture of your skin will improve significantly. (17)
Botulinum Toxin Injections (Botox)
A small amount of Botulinum toxin is injected in the area between the eyes and nose. The toxin targets certain muscles and relaxes the targeted area, which decreases the appearance of wrinkles over time. Most people see actual results after 3 to 5 days. After 4 months, the lines may disappear completely. (18)
Figure 3 – (A) Normal condition. (B) Appearance of tear trough deformity (TTD) through the atrophy of skin and subcutaneous fat in the suborbital area. (C) Appearance of nasojugal groove in the skin and subcutaneous fat in the suborbital area. (D) Appearance of TTD due to contraction of the orbital part of the orbicularis oculi muscle or squinting. (E) Appearance of TTD due to herniation of intraorbital fat. (F) Appearance of infraorbital hollowness through malar bone resorption with soft tissue atrophy.
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