Does preventive Botox work? Here’s what the experts say.

“It’s just something that makes me feel good about myself,” she said.

People in their 20s and 30s, like Huang Wang, are increasingly suffering Botox in hopes of stopping wrinkles. The practice is known as preventive botox. But does it work?

Botulinum toxin is the active ingredient in name-brand treatments such as Botox, Dysport, Xeomin and Jeuveau. While botulinum toxin has been well studied for a variety of uses, there have been no large-scale clinical trials of its long-term use for wrinkle prevention. Evidence to support this is largely anecdotal or based on small studies, often funded by companies that sell the drug.

Even so, many dermatologists and plastic surgeons say that botulinum toxin can temporarily stop some wrinkles from forming. To understand why it can prevent wrinkles, think of youthful skin as a pristine piece of paper, said Ife J. Rodney, a dermatologist in Fulton, Md.

“It’s a lot easier not to wrinkle the paper than it is to make it perfectly flat after it’s already crumpled,” Rodney said.

The treatment is not permanent and will not work for all types of wrinkles. Botox and similar drugs can also be expensive: It can cost anywhere from a few hundred to thousands of dollars for a single treatment, with results lasting a few months.

Although all medications carry some risks and Botox can sometimes lead to unwanted side effects, the treatment generally considered safe. According to American Society of Plastic Surgeonsabout 127,000 people in their 20s and about 1.6 million people in their 30s had the procedure in 2022.

So how does Botox in your 20s or 30s delay wrinkles? And what are the risks? See what dermatologists, plastic surgeons and other medical experts had to say.

How does preventive Botox work?

Its repetitive motion Our facial muscles can cause dynamic wrinkles — those seen in crow’s feet, forehead lines and between the eyebrows. When we are young, these wrinkles tend to appear when we make facial expressions such as grimaces or surprise.

As we age, the body produces less collagen, a protein that serves as the main structural component of the skin — giving it firmness. We also lose elastin – a protein that gives the skin its elasticity. With less collagen and elastin, the skin becomes thinner and less elastic — meaning wrinkle lines can become more visible, said Smita Ramanadham, a plastic surgeon in Montclair, NJ.

Botulinum toxin works by blocking the nerve signals that tell our muscles to move or contract. Injecting the neurotoxin into our facial muscles temporarily paralyzes them. If you can prevent these face By contracting the muscles, you also prevent the skin from folding in ways that cause wrinkles to form or deepen, said Steven Williams, president of the American Society of Plastic Surgeons.

But the treatment doesn’t work for all types of wrinkles, such as those caused by sun damage. It also won’t help with other signs of aging, such as sun spots.

How long does Botox last?

Paralysis from a Botox injection usually lasts three to five months before people need another treatment, Williams said.

But that time frame can vary, and there’s no standard recommended dose for preventative Botox, said Patricia Wexler, a dermatologist at Mount Sinai Hospital and associate clinical professor at the Icahn School of Medicine at Mount Sinai. Some people may need less Botox than others to achieve the same effect, depending on their history of injections, the strength of their facial muscles and how alive they are.

If you stop taking Botox, your muscles start to contract again, causing wrinkles to slowly form. However, you’re likely to have fewer wrinkles than someone your age who has never had Botox, Rodney said.

“If you start at 25 and stop at 40, it’s like you’ve stopped the clock for 15 years,” he said. “You still have the advantage that the whole time you were using it.”

How effective is preventive Botox?

Anecdotal evidence from dermatologists and plastic surgeons shows that Botox delays the appearance of wrinkles.

But there have been no high-quality clinical trials of preventive Botox or the effects of using the neurotoxin for cosmetics decades. Existing studies have limitations, including industry linkages.

A study from 2006 compared two identical twin sisters. One got Botox about two to three times a year for 13 years and the other had Botox twice in total. In a side-by-side comparison of the twins, who are white and were 38 years old at the time, the study’s author noted that forehead lines were visible in the minimally treated twin, but “were not apparent” in the regularly treated twin. treatment.

The twins were reassessed at age 44, and the researchers noticed that the minimally treated twin had wrinkle lines when her face was at rest, but the regularly treated twin did not.

William J. Binder, a facial plastic and reconstructive surgeon in Beverly Hills, Calif., who worked on both studies, said they were unable to control for other factors that could have contributed to the skin’s appearance, such as sun exposure , weight, diet or lifestyle. But in his follow-up study, he noted that both twins reported using sunscreen daily, leading an active lifestyle, eating a relatively healthy diet and not smoking.

In the initial disclosures of the study, Binder is listed as a shareholder and consultant for Allergan, the company that makes Botox. He said he no longer has any financial disclosures regarding the cosmetic use of Botox.

In a 2011 study, researchers followed a group of 45 women, ages 30 to 50, who received botulinum toxin injections at regular intervals for 20 months. About six months after their last treatment, the researchers evaluated the women and found that they had significant reductions in their wrinkles.

Allergan fully funded the study and assisted with the manuscript.

What are the risks of preventive botox?

Reported complications they are rare.

Patients may experience bruising or swelling at the injection site. Another potential risk is eyebrow drooping, which is usually caused by the neurotoxin spreading to the wrong muscles. Although estimates vary, studies show that it can occur approx 1 to 5 percent of cases. This effect is almost always temporary.

But known temporary complications include double vision, dry eyes and droopy eyelids.

To reduce your risk, experts advise getting treatment from a board-certified dermatologist or plastic surgeon. “There are a lot of overlapping muscles, and if you don’t understand the anatomy, it’s easy to inject a muscle you don’t want to,” Ramanadham said.

Patients should also avoid exercising, lying down or touching the treated area for several hours after the injections, Wexler said.

Another possible side effect of Botox is that the muscles in the face can atrophy — that is, they become weaker and weaker — as a result of the paralysis. While some muscle weakness is the intended effect of Botox treatment, it can also be present involuntary muscle atrophy. This could result in an “unsightly, unattractive appearance” as the muscles in the face become thinner, Wexler said.

Several dermatologists and plastic surgeons have said that any muscle atrophy that results from Botox is reversible. However, some health professionals said it is unclear how reversible the effect is.

When should I start preventive botox?

The age at which someone begins to develop dynamic wrinkles can vary depending on their skin tone, genetics and lifestyle. Generally, people start losing collagen and elastin in their skin in their late 20s and early 30s, Ramanadham said. This is the time frame where anyone considering preventative Botox may want to be evaluated by a dermatologist.

Anne Chapas, a Manhattan-based dermatologist, suggested that patients wait until they start to see small wrinkles or lines when their face has a neutral expression. Otherwise, there’s a chance they’ll waste money injecting Botox into an area where a wrinkle wouldn’t have formed anyway.

“It’s hard to heal something you can’t see,” Tsapas said.

What should I expect during a Botox treatment?

The duration of a Botox procedure depends on the amount of targeted areas, but experienced injectors can treat an area in minutes, Williams said. It usually feels like a small pinprick.

To prevent the Botox from spreading to an unwanted area, patients should remain upright and avoid exercise and touching the injection sites for a few hours. after treatment.

Julia Huynh, 23, of San Jose had her first round of Botox injections in December. She said she was surprised by how quick the process was, and although she said her jaw felt a little sore the next day, she was happy with the experience.

“I can definitely feel a difference,” she said. “I can feel that my face is tighter.”

He plans to come back in a few months and reevaluate whether he needs more injections.

What are the alternatives to preventive Botox?

Dermatologists said there are other ways to take care of your skin, such as using sunscreen daily, eating a balanced diet and getting good sleep. Applying retinoids—which are compounds derived from vitamin A—has also been shown to reduce wrinkles.