Does Side Sleeping Cause Wrinkles? What the Evidence Actually Says

If you regularly wake up with a crease across one cheek, you may have wondered whether sleeping on your side is contributing to wrinkles.

The short answer is: side sleeping can expose the face to compression, shear and mechanical distortion against the pillow, but the evidence does not show that everyone who sleeps on their side will inevitably develop wrinkles because of it.

Skin ageing is complex. Sleep position is only one potential factor, so the more useful question is what actually happens to the face overnight and what can realistically be changed.

Why Does Side Sleeping Affect Your Face?

When you sleep on your back, most of your face remains free from direct contact with the pillow. Turn onto your side and the relationship changes.

The weight and position of your head can press the cheek and surrounding facial tissue against the sleeping surface. Depending on your exact position, the skin can be compressed, stretched or folded.

A 2016 review published in Aesthetic Surgery Journal describes compression, shear and stress forces acting on the face during lateral and prone sleeping positions. The authors distinguish these mechanically produced sleep wrinkles from wrinkles associated with repeated facial expressions.

Does Side Sleeping Cause Wrinkles? What the Research Says

Research has documented facial distortion when the face is pressed against a sleeping surface.

In a small 2012 study involving 15 adults, researchers used a transparent sleep surface to observe what happened to the face in sleeping positions. They documented deformation around areas including the eyes, mouth, forehead and nasolabial region when the face was subjected to pillow pressure.

Earlier published work also described characteristic facial lines associated with sleeping with the face against a pillow.

However, that is not the same as proving that side sleeping automatically causes permanent wrinkles.

One study examining sleep position and perceived facial ageing found no statistically significant association between a person's preferred sleeping side and the side of the face with more wrinkles or facial descent.

The most accurate conclusion is therefore that side sleeping creates the mechanical conditions for facial compression and sleep creasing, while the long-term relationship between sleep position and permanent facial ageing is more complex.

What Are Sleep Wrinkles?

Sleep wrinkles, sometimes called sleep lines, are facial lines associated with the way the skin is mechanically distorted during sleep.

They differ from expression lines, which develop in areas repeatedly affected by muscle movement such as smiling, squinting or frowning. Sleep lines are associated instead with external forces acting on the face while it rests against a surface.

You may recognise the temporary version: a diagonal crease across the cheek when you first wake up.

For a fuller explanation, read our guide to sleep lines, their causes and how to reduce them.

Why Can Sleep Creases Become More Noticeable With Age?

A temporary pillow mark does not automatically become a permanent wrinkle, and not everyone's skin responds to overnight pressure in the same way.

A study of 542 middle-aged women investigating risk factors for sleep lines found that age and genetic factors were associated with their presence. That reinforces the point that sleep lines are not simply a question of which side you sleep on.

Wrinkles are influenced by many factors, including intrinsic ageing, ultraviolet exposure, genetics and repeated facial movement.

Do You Need to Stop Sleeping on Your Side?

Not necessarily.

Back sleeping generally creates less direct face-to-pillow contact, but if you naturally sleep comfortably on your side, forcing yourself to maintain a completely different position all night may not be realistic.

A more practical question is: can you reduce unnecessary facial compression without completely changing the way you naturally sleep?

That brings the sleeping surface itself into the conversation.

Where Pillow Shape Comes In

A traditional pillow generally presents one continuous surface beneath the side of the face. When you turn onto your side, the cheek can press directly into that surface.

A contoured beauty pillow changes the geometry of that surface by creating additional space around parts of the face while continuing to support the head.

It is not about claiming that a pillow can stop skin ageing. It is about changing one specific physical variable: how much of your face is pressed against the pillow while you sleep.

That is the principle behind the Serene SKN Co Beauty Pillow. Its contoured shape is designed to give the face more space when resting on the side.

What About a Silk Pillowcase?

Silk pillowcases and contoured beauty pillows address different parts of the sleep environment.

A silk or smooth pillowcase changes the surface material touching the skin and hair. A contoured pillow changes the physical shape the face rests against.

Changing the pillowcase does not change the geometry of the pillow underneath it, while changing pillow shape does not make surface material irrelevant.

For more on the distinction, see What Is a Beauty Pillow?

How Can Side Sleepers Reduce Overnight Facial Compression?

If sleep lines concern you, the goal does not need to be avoiding side sleeping altogether. A more realistic approach is to reduce unnecessary facial pressure where practical.

• Consider your sleeping position. Back sleeping generally creates less direct facial contact with the pillow, but comfort and sleep quality matter too.
• Consider your pillow shape. A contoured design can change where the face meets the sleeping surface.
• Think about the surface material. Pillowcase material and pillow geometry address different aspects of the sleep environment.
• Keep the bigger picture in perspective. Sun protection and an appropriate skincare routine remain more established considerations for maintaining skin health than trying to control every sleeping position.

The Bottom Line

Side sleeping can compress and distort facial skin against a pillow, and researchers have documented the mechanical forces involved in sleep lines.

What the evidence does not justify is the stronger claim that everyone who sleeps on their side will develop permanent wrinkles because of it.

If you naturally side sleep, the useful takeaway is simply to consider the sleeping surface your face spends those hours against, rather than assuming you need to stop side sleeping altogether.

References

Anson G, Kane MAC, Lambros V. Sleep Wrinkles: Facial Aging and Facial Distortion During Sleep. Aesthetic Surgery Journal. 2016;36(8):931-940.

Poljsak B, Godic A, Lampe T, Dahmane R. The Influence of the Sleeping on the Formation of Facial Wrinkles. Journal of Cosmetic and Laser Therapy. 2012;14(3):133-138.

Kotlus BS. Effect of Sleep Position on Perceived Facial Aging. Dermatologic Surgery. 2013;39(9):1360-1362.

Sarifakioglu N, Terzioglu A, Ates L, Aslan G. A New Phenomenon: “Sleep Lines” on the Face. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. 2004.

Jdid R et al. MC1R Major Variants Are a Risk Factor of Sleep Lines in Caucasian Women. Journal of the European Academy of Dermatology and Venereology. 2014;28(6):805-809.

This article is for general educational purposes and should not be considered medical or dermatological advice. Individual skin concerns should be discussed with an appropriately qualified healthcare professional.