Crow's feet, eleven lines, marionette lines — you may have heard these words to describe wrinkles in different parts of the aging face. What if we could prevent them from forming or deepening? Botox has traditionally been used to soften the appearance of wrinkles. Over the past few years, more young adults have been looking to gain the potential benefits of preventative Botox. Join us as we explore in this article, what preventative Botox is, if it actually works, and what side effects to look for.
What is preventative Botox?
While the FDA approves the cosmetic use of Botox for adults over 18, it has traditionally been used for facial rejuvenation once wrinkles start becoming more evident. This often differs between individuals based on genetics and external factors, but a study demonstrated that wrinkles tend to become persistent at around 40 years. The latest plastic surgery statistics from 2023 also show that people aged 40–54 received the most neuromodulator injections.
Preventative Botox has been touted as a form of early intervention for young adults. Individuals as young as in their early 20s into their 30s are now seeking preventative Botox even though they may not have experienced a significant loss of skin collagen or experience deepening facial wrinkles. There are numerous, mostly positive, first-hand accounts of people who received Botox injections for wrinkle prevention on social media. But is there enough evidence to say if Botox can really prevent wrinkles in young people?
Is preventative Botox real?
As we age, wrinkle formation is influenced by internal factors such as decreased collagen and elastin production in the dermal layer of the skin coupled with external influences such as photodamage by UV radiation. Connective tissue in the skin, which consists of collagen, elastin, and the extracellular matrix, maintains the structure and function of the skin and is the main contributor to a youthful appearance. As connective tissue decreases with age, the skin is unable to maintain its smooth appearance. Repetitive movements, such as the movement of facial muscles when smiling, squinting, and frowning, cause creases in the skin called dynamic lines. These lines deepen into dynamic wrinkles in the aging skin and may contribute to static wrinkles seen when the face is at rest, including forehead wrinkles, smile lines, and crow’s feet.
Botox is one of the most popular non-surgical anti-aging treatments. Unlike dermal fillers, Botox is not used to mask the appearance of wrinkles. Small amounts of purified botulinum toxin are injected into the target muscle, where it blocks the receptor needed to be stimulated for muscle contraction. Inhibition of muscle contraction prevents the muscle from moving as it would during changing facial expressions. As the effects of Botox usually last for several months, the muscles of the face remain relaxed, thus preventing dynamic wrinkles from deepening over time and becoming static wrinkles.
As the surge in preventative Botox for younger people is a recent phenomenon, there is a paucity of research on the topic. The currently available research on this age group mostly focuses on millennials who are already in their late 20s and are likely starting to see some mild wrinkle development. The data was also collected using a subjective satisfaction scale rather than objective measures.
There is a common misconception that Botox can prevent all wrinkles. Fine lines and static wrinkles caused by a loss of connective tissue and skin turgor, such as sleep lines, will not improve with the use of Botox.
The opinions of medical professionals who administer Botox are divided. Some suggest that preventative Botox could delay the onset of wrinkles, while others do not believe there is any benefit in early Botox treatment. Based on the mechanism of action and length of effect of Botox, if a young person still has ample collagen to maintain the skin’s structure and integrity in response to repetitive movement, paralyzing facial muscles with Botox may not have any effect until they start experiencing the effects of skin aging.
If you are interested in preventing wrinkles and are not sure if you are a good candidate for Botox, a dermatologist can help determine your individual risk factors for wrinkles to determine when would be the best time for you to start Botox or if there is a better option for your needs.
Are there any benefits of preventative Botox?
Botox is a well-established cosmetic procedure for diminishing and preventing further wrinkles, and there is ample evidence of its efficacy in older people. This suggests that those prone to premature wrinkles due to genetics or exposure to damaging environmental factors may benefit from preventative Botox.
In addition, there is some evidence that Botox administered to specific areas may aid in improving mood and is even researched in the field of depression. This is based on the idea of the feedback loop between facial expression and mood. Botox is indicated for glabellar frown lines (elevens); being unable to frown may prevent feelings of discontent and anxiety. However, more research is needed on this topic.
What are the risks of preventative Botox?
When performed correctly, Botox is a relatively safe procedure with minimal side effects. Preventative Botox shares the side effects of regular Botox.
Common side effects may include:
- Pain
- Bleeding/bruising
- Redness
- Swelling at the injection site
- Headaches
Rare, but more serious side effects may include:
- Infection
- Allergic reaction
- Migration of Botox to neighboring muscles, causing weakness and drooping
- Trouble breathing or swallowing
- Loss of bladder control
- Generalized weakness
In addition, Botox is injected into the masseter muscle, a chewing muscle in the cheeks, to improve facial aesthetics. Inhibiting muscle contraction is thought to weaken the muscle over time and make it thinner. The same could occur in other facial muscles if Botox is consistently used on the same muscles, leading to an undesirable side effect of having the area appear flatter. This effect, however, is temporary and should resolve once Botox is discontinued and wears off.
Alternative ways to prevent wrinkles
As wrinkle formation is multifactorial, a comprehensive approach is ideal for preventing wrinkles. Botox may not be the ideal solution for everyone, but numerous steps can be taken to boost skin health, manage skin aging, and prevent wrinkles.
- Effective skincare routine that includes a gentle cleanser and moisturizer to protect the skin barrier.
- UV protection using broad-spectrum sunscreen and sun-protective clothing.
- Topical treatments, including retinoids, antioxidants, and peptides.
- Minimally and non-invasive cosmetic treatments, such as hyaluronic acid fillers, red light therapy, microneedling, and chemical peels.
- Face taping for temporary improvement.
- Balanced diet rich in ingredients that support skin health, including sufficient protein, antioxidants, omega-3 fatty acids, and vitamins.
- Adequate hydration with water to maintain a healthy skin barrier.
- Good stress management to reduce the levels of hormones that are associated with skin aging.
- Regular exercise to improve circulation to the skin.
- Sufficient sleep to help the skin repair and renew.
- Avoiding smoking and excess alcohol use.
So, is preventative Botox effective?
Generally, Botox is a safe and effective treatment for wrinkles caused by facial movement called dynamic wrinkles. It is a temporary measure that works by blocking the signals from stimulating muscle contraction and usually wears off 3–6 months after injection.
There is an increasing discussion on social media about the idea that early use of Botox may benefit young adults as an anti-aging treatment that would prevent wrinkles. However, most adults in their early 20s and 30s have not yet started facing the effects of skin aging and do not have visible wrinkles. Despite assertions that it will prevent wrinkles, there is not enough scientific evidence to support the use of preventative Botox.
Consult a board-certified dermatologist or plastic surgeon if you are thinking about Botox. They will be able to examine the aging of your skin to determine if you can benefit from the procedure. A dermatologist can also help create a tailored plan to help manage skin aging and prevent wrinkles using alternative treatment options.
FAQ
How old do you have to be to get Botox?
Botox is approved for cosmetic use in adults over 18 in the U.S. Most patients wait until they are able to see the wrinkle of concern at rest, usually in their late 30s and early 40s. However, there has been an increasing number of younger patients in their 20s and early 30s interested in exploring the benefits of Botox.
Does Botox make you look older after it wears off?
Once Botox wears off, the muscle movement will return to normal and its repetitive movement may cause the development of wrinkles. However, facial aging is not accelerated after Botox wears off and it will not make you suddenly look older.
Can Botox treat all wrinkles?
Botox improves the appearance and prevents the worsening of dynamic wrinkles caused by repetitive facial muscle movement as we age. However, as it works by decreasing muscle movement, it does not prevent static wrinkles caused by the decreasing integrity and increasing laxity of the skin.
Does Botox change your face?
Botox is a temporary treatment that inhibits muscle movement for 3–6 months. The effect of the treatment is superficial and limited to the muscle. The most obvious change will be a decrease in facial expressions and improvement in wrinkles. Over time, regular administration of Botox may make the muscle appear smaller due to its disuse. However, once Botox is discontinued and wears off, it should slowly regain its normal size.
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Cosmetic Botox is approved for treating dynamic wrinkles in adults over 18 years old.
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Botox is a generally safe procedure with minimal adverse effects.
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There is insufficient clinical evidence to support the use of preventative Botox in young adults.
11 resources
- US Food and Drug Administration. Botox cosmetic medication guide.
- British Journal of Dermatology. New wrinkles on wrinkling: an 8‐year longitudinal study on the progression of expression lines into persistent wrinkles.
- American Society of Plastic Surgeons. 2023 cosmetic surgery age distribution (40-54).
- FACE. Millennials are interested in botulinum toxin injections for prevention of facial rhytids.
- Journal of Cosmetic Dermatology. Botulinum toxin for cosmetic treatments in young adults: an evidence-based review and survey on current practice among aesthetic practitioners.
- International Journal of Cosmetic Sciences. Facial skin ageing: key concepts and overview of processes.
- Best Practice & Research Clinical Obstetrics & Gynaecology. Skin connective tissue and ageing.
- Toxins. Treatment of depression with botulinum toxin.
- StatPearls. Botulinum toxin.
- Archives of Craniofacial Surgery. Scientific review of the aesthetic uses of botulinum toxin type A.
- Frontiers in Physiology. Skin aging from mechanisms to interventions: focusing on dermal aging.
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