Sleep might be the most underrated step in your skincare regime. While we can slather on the serums and stick religiously to our SPF routine, if we spend eight hours a night scrunching our face into the pillow, all that effort could be quietly undone. According to leading dermatologists and aestheticians, how we sleep matters just as much as how long we sleep – and the way our face meets the pillow at night could be accelerating facial wrinkles, sleep lines and even fine lines before their time. Nightmare!

But, before you go booking that botox appointment, hear us out: with a few thoughtful tweaks to your sleeping position, bedding, and nighttime skincare, you can help keep those tell-tale creases at bay. Think of it as future-proofing – choosing a pillow that supports your head without squashing your cheeks, swapping to a silk pillowcase that lets your facial skin glide instead of crumple, and layering hydrating and collagen-boosting formulas so your skin can repair as you rest. These small changes don’t just help prevent crease-related skin aging — they can also make your nightly wind-down feel a little more luxurious, and have you waking up looking (and feeling) noticeably more rested.

Meet the experts:

What are sleep wrinkles?

Sleep wrinkles are different from the lines caused by our repeated facial expressions – laughing, frowning, smiling – during the day. Dr Raffaella Gabassi at Dermaclarité explains that “Sleep wrinkles are lines that form when the face is repeatedly pressed against a pillow. Unlike expression wrinkles, they’re caused by pressure and compression, rather than muscle movement.”

Harley Street Dermal‘s Dr Hayder Ria agrees that the way we position our face overnight can subtly shape how our skin ages. “When you repeatedly press one side of your face into the pillow night after night, you’re effectively creasing the skin and putting pressure on delicate structures beneath,” he says. “Over time, this can lead to visible changes such as fine lines across the forehead, volume loss under the eyes, and subtle asymmetry that patients often don’t notice until it’s pointed out.”

While a quick crease from a pillow might disappear within minutes in your twenties, collagen and elastin naturally decline with age, so the skin loses its ability to bounce back. Unfortunately, that means temporary sleep lines can settle into more permanent facial wrinkles.

What causes sleep wrinkles?

According to dermatology expert Dr Gabassi, “Sleep wrinkles are caused by pressure, friction, and skin folding against pillows. When the face is pressed into the pillow, the skin and underlying structures are compressed into unnatural positions, disrupting collagen and elastin. Over time, visible creases will appear. Side or stomach sleeping, thin or delicate skin, reduced collagen with age, and certain pillow fabrics can all increase the chances of sleep wrinkles forming.”

Dr Ria has seen this play out countless times in his clinic. He warns that having your favourite side can be especially impactful: “It’s incredibly common for people to have a ‘sleep side’, and over years it shows.” Repeatedly pressing one side of your face down can cause sleep lines to appear more prominently on that side of your face.

Even your pillowcase fabric can play a role. Coarse cotton can create friction and contribute to wrinkle formation, while smoother fabrics found in a silk pillowcase, a satin pillowcase, or a smooth sateen pillowcase, allow the skin to glide rather than drag.

Can sleep wrinkles be reversed?

Dr Gabassi says, “Early sleep wrinkles can soften with treatments such as skin boosters or microneedling, which encourage collagen renewal. Topical retinoids and peptides can also help, but deeply set sleep lines can be resistant and may require injectable treatments like dermal fillers.”

If you’re not a fan of needles, BeauSkin London‘s Abi Oleck shares her go-to holistic tools for supporting skin while you sleep:

• Silk and satin pillowcases: smooth fabrics reduce tugging, keep your skin hydrated, and help prevent those deep pillow creases.
• Anti-wrinkle pillows: designed to cradle your head and reduce pressure on cheeks and eyes.
• Breathwork and mindset: lowering stress hormones like cortisol can slow collagen breakdown. “Taking five minutes to breathe deeply or journal before bed can make a real difference to sleep quality.”
• Nightly facial massage: helps relax the body and mind. “A simple lymphatic drainage massage before bed reduces puffiness and supports skin repair overnight. Choose a good quality oil to aid skin barrier repair.”

“In clinic we refer to emotion skincare which is not just topical, it is a ritual of restoration. Sleep is where true healing begins — physically, emotionally, and cellularly. The right pillow, the right fabric, and the right mindset all work together to keep your skin lifted, hydrated, and glowing,” says Abi.

How to prevent wrinkles when sleeping

Both dermatologists and facialists agree that prevention is all about removing mechanical pressure from the skin while you sleep.

Dr Gabassi’s advice is clear: “Back sleeping is the most effective way to prevent sleep wrinkles. You can also use a silk or satin pillowcase to minimise friction, and keep your skin well-hydrated with a nourishing night cream or serum to maintain elasticity.”

Dr Ria lists his top five tips for skin-friendly sleep:

• Train yourself to sleep on your back – it’s the gold standard for preventing creases and asymmetry.
• Invest in a silk pillowcase – this helps skin glide against the pillow rather than crumpling.
• Use a supportive pillow – memory foam, wedge or V-shaped pillows can reduce pressure on delicate areas.
• Keep skin hydrated before bed – layer a hydrating serum and barrier cream to support overnight repair.
• Prioritise sleep hygiene – avoid alcohol late at night, reduce screen time, and get 7–9 hours of quality sleep to give your skin the best chance to repair.

What other skincare products can help prevent sleep wrinkles?

Your choice of skincare matters too. “Applying any of these before bed, alongside a deeply hydrating night cream or facial oil, will help to protect the skin,” advises Dr Gabassi:

• Retinoid products stimulate collagen production.
• Peptide-infused creams help to repair the skin.
• Ceramides help to strengthen the skin barrier.
• Hyaluronic acid serums plump the skin.
• Antioxidants like vitamin C protect structural proteins from breakdown.

Abi Oleck stresses that products work best when the skin is clean and ready to absorb them. “Firstly, please never sleep in make up or without washing the daily grime from your skin. When you sleep in your makeup, you trap toxins and free radicals against the skin, speeding up collagen loss and preventing overnight repair. Nighttime is when your skin should be healing, but makeup or the daily grime left on at bedtime disrupts this process, leading to congestion, inflammation, and premature ageing.”

Incorporating a targeted skincare routine before bed gives your skin the raw materials it needs for overnight repair, improving skin elasticity and skin hydration so it’s more resistant to wrinkle formation. Prioritise rich, moisturising night creams and anti-aging masks that do the hard work while you’re giving it Zzzs.

What is the best sleeping position to avoid sleep wrinkles?

We know, we’ve mentioned it a lot — but back sleeping really is best.

Dr Gabassi confirms, “Sleeping on your back is best, as it prevents the face from pressing into the pillow and reduces compression lines.”

Dr Ria goes as far as to call back sleeping the “gold standard” for preventing sleep lines. It eliminates the compression that happens when you sleep face down or as a side sleeper, which creates creases on the side of your face pressed into the pillow.

If you really find back sleeping difficult (we hear you!) it’s worth investing in a top quality memory foam pillow that’s designed to keep your head, neck and shoulders perfectly aligned, meaning that when you do drift off, you’ll be less likely to fidget and find your way back to your default side or stomach position.

The role of sleep in skin health

Beyond mechanics, sleep itself is fundamental to skin health. “As a holistic aesthetician and facialist, I see first-hand how lifestyle, emotional wellbeing, and the simplest daily rituals can transform our skin,” says Abi Oleck. “One of the most underestimated yet powerful treatments I recommend to my clients is sleep. We often chase the latest serum, treatment, or device, but if we’re not giving our skin time to heal while we sleep, we’re working against ourselves. We truly do need our ‘beauty sleep’.”

“When we sleep deeply, our skin goes into repair mode. Collagen and elastin rebuild, inflammation calms, and hydration levels restore. Miss out on good sleep, and your skin will soon tell the story —dullness, puffiness, and lines become more visible. I always remind my clients: your night routine starts long before the products touch your skin — it starts with rest itself.”

In other words, you can’t buy your way to great skin if you’re not getting a good night’s sleep.

The verdict: best sleeping position to prevent wrinkles

Sleep lines might seem harmless, but over the years they can become etched into the skin – especially if you’re a dedicated side sleeper or often sleep face down. (Hello, crow’s feet). While you don’t need to overhaul your whole bedtime routine, being mindful of your sleeping position, pillowcase, skincare habits – and let’s not forget, overall wellness – can protect your skin’s collagen and skin elasticity long-term.

As Dr Ria puts it, “Your sleeping habits are something you do every single night, for years of your life – so it makes sense they leave their mark. By making small adjustments now, you can prevent changes that would otherwise show up later.”

So yes, beauty sleep is real. And the best sleeping position for avoiding sleep wrinkles? Back sleeping – combined with a high-quality silk pillowcase and eye mask, hydrating skincare, and the kind of deep rest your skin will thank you for in the morning.