Most people think Botox is the ultimate fix for wrinkles, but that’s only true for some of them. As a board-certified dermatologist, I want to share the truth: Botox can help with expression lines from muscle contraction, but not so much with vertical lines caused by sleeping on your side. We call these “sleep lines”.

In this post, I’ll explain the difference between wrinkle types, why Botox doesn’t work on sleep lines, and what actually worked for me to erase them (spoiler: it wasn’t a needle).

What Are Vertical Wrinkles?

Vertical wrinkles (also known as sleep lines or wrinkles) form from repeated compression of the skin, usually from side or stomach sleeping. These lines appear primarily around the eyes and on the cheeks, forehead, and chin, following the folds that happen when your face is pressed into a pillow for hours every night.

Unlike expression lines caused by facial movement, vertical wrinkles are caused by mechanical pressure over time. That means Botox, which works by relaxing muscles, won’t help.

My Story: The Day They Didn’t Fade

For a while, I noticed vertical wrinkles on my face each morning from exactly where my skin was compressed all night from sleeping on my side. But they would fade a few hours later so I never worried too much about it. Then one day… I was doing my nighttime skincare routine and was taken aback when I noticed they were still there.. That was the moment I knew I needed to change my sleeping habits.

I tried training myself to sleep on my back (free and effective if you can do it), but I just couldn’t get comfortable. I’m a side sleeper through and through!

So I went looking for a “side-sleeper” pillow that I had seen advertised in the past. I figured this would be a solution that could work WITH my sleep habits, NOT against them.

What Actually Worked: The Sleep & Glow Pillow

I got THIS pillow to try and it actually worked to erase my vertical wrinkles.

This pillow has a specially designed side cradle that supports your head and neck while relieving pressure from your face. Instead of smashing your skin into a traditional pillow (which causes and worsens sleep wrinkles), this cradle keeps your skin free from compression.

Here’s what I noticed after switching:

• No more creases or pillow lines in the morning
• Vertical wrinkles began to fade with consistent use
• My neck and spine alignment improved (bonus for anyone with back or shoulder tension)

I recently upgraded to the copper-infused pillowcase option for its antimicrobial benefits, and I love the smooth texture against my skin.

Note: This pillow takes a little getting used to!! It took me a few weeks (maybe even a month or so??) to adjust, but once I did, it became a permanent part of my routine. I even bring it with me when I travel!

Why Botox Won’t Help These Wrinkles

Botox is incredible for horizontal expression lines like crow’s feet and forehead lines that are caused by muscle movement. It works by temporarily paralyzing the underlying muscles so they can’t contract.

But with sleep wrinkles, there’s no muscle movement to block. These are formed by external pressure, not internal expression. That’s why even perfect Botox won’t erase those vertical creases down your cheeks.

A Back-Friendly Bonus

As a skin cancer surgeon, I spend a lot of time bent over operating on patients’ skin. My neck and shoulders get tight, fast. Switching to the Sleep & Glow pillow also helped realign my posture at night, and that alone made it worth it for me.

Final Thoughts: Is It Worth It?

If vertical wrinkles are starting to stick around, and you want a realistic, non-invasive solution, the Sleep & Glow pillow is one I recommend. It’s not cheap, but it is a long-term solution that actually works. 

Want to try it? You can shop the Sleep & Glow pillow here. 

🎥 Want to WATCH my full take on the pillow?Click here to watch the video on YouTube

📲 Let me know in the comments or on Instagram (@thebudgetdermatologist) if you’ve tried it or if you have other wrinkle solutions that worked for you.

All images used in this blog are sourced from the Sleep & Glow website.