Q: Will Botox injections in my 20s or 30s mean smoother skin and
fewer wrinkles down the line?
A: Although most people who use
botulinum toxin, the neurotoxic protein known by its brand name Botox, are
women over 40, there has been chatter on social media about how starting it
when you’re young can help stall the signs of aging — before they even start.
اضافة اعلان
The basic premise: If you start using Botox, which freezes
wrinkles, when you’re young, you won’t form the grooves people try to “correct”
later in life.
In 2020, about 811,000 Botox procedures were performed on people
in their 30s, which was approximately 18% of the national total, according to a
recent report from the American Society of Plastic Surgeons. This
“prejuvenation” trend seems especially persistent on social media, with
testimonials from influencers on YouTube and TikTok.
Although most dermatologists agree that this approach works,
some worry that patients are making interventions too early, or warn against
the long-term financial cost of repeated injections.
“You do it to slow down the aging process, not to stop it,” said
Shereene Idriss, a dermatologist and founder of Idriss Dermatology in New York
City.
We talked to more than a dozen experts to find out whether
“preventive Botox” is a wise investment.
What’s the claim?
Botox limits movement by blocking acetylcholine, the chief
neurotransmitter. Over time, the theory goes, a repeat user of Botox weakens
her facial muscles, slowing the process in which dynamic lines (those that form
when she is making an expression) settle into static lines (those visible when
her face is at rest).
“Basically, you’re inhibiting the muscle contractions and
decreasing the facial movement,” said Dr. Kristen Broderick, an assistant
professor of plastic and reconstructive surgery at Johns Hopkins Medicine. “And
then, therefore, you’re preventing or slowing the formation of wrinkles over
time.”
Doctors stress that the wrinkles are postponed, not prevented.
(“Mother Nature always wins,” said Dr. Mathew Avram, director of the
Dermatology Laser & Cosmetic Center and director of dermatologic surgery at
Mass General Hospital in Boston.)
Even if you start Botox young, you’re still going to have
emotions. Unless you’re frozen solid, you’re going to show those feelings on
your face — and eventually wrinkle.
The good news is that doctors are no longer serving up the
“Botox-face” — think, eyebrows frozen in perpetual surprise, foreheads
unwrinkled but not exactly youthful. Now, dermatologists try to smooth while
still allowing for movement.
Movement, Idriss said, is essential. “That’s what makes you you.”
What’s the evidence?
Most dermatologists agree that Botox is safe and reliable.
Millions of procedures are performed each year, with almost no reports of
serious side effects.
But long-term use has been little studied, and the evidence is
overwhelmingly anecdotal. Many dermatologists point to their own smooth
foreheads as proof of concept.
“I need very little Botox now,” said Dr. Debra Jaliman, an
assistant clinical professor in dermatology at the Icahn School of Medicine at
Mount Sinai and the author of the book “Skin Rules,” who said she began
injecting herself in 1991. “My muscles have given up.”
There are no large scale clinical or observational studies of
preventive Botox. A 2006 study looked at one set of identical twins over the
course of 13 years. One received regular Botox injections. The other did not.
The researchers found that lines were “not evident in the regularly treated
twin” where she had received injections, but did appear in her sister. The
untreated areas of both their faces showed “comparable aging.” In a follow-up,
when the twins were 44, the twin who received treatments did not have static
lines at rest; her sister did.
A 2011 study looked at whether the effects of repeated
injections reduce or eliminate forehead wrinkles long term. Every four months,
a group of 45 women, ages 30-50, received small amounts of botulinum toxin in
their foreheads. Doctors assessed them two years after they began treatment,
once the last treatment would have worn off, and found that the neurotoxin
significantly reduced their wrinkles.
What if you stop treatment?
You’re not going to reverse your progress if you stop treatment
— you’ll just get your full mobility back, slowly creating wrinkles.
The effect of pausing treatment is hard to track, though, since
few people stop injections once they begin. Even though botulinum toxin itself
does not form chemical dependence, many people become “addicted” to how their
face looks, said Dana Berkowitz, an associate professor of sociology at
Louisiana State University.
Berkowitz, author of “Botox Nation: Changing the Face of
America,” has interviewed dozens of people who used Botox for her book. Only
one — a man — had ever paused treatment, she said.
Your face without Botox “looks ugly to you,” Berkowitz said,
adding, “This wrinkle-free, ageless face becomes totally normalized. We expect
it and then we view that as beautiful.”
Are there downsides to using Botox when you’re young?
Botox is expensive, and repeated procedures add up. The average
cost of a treatment is $466, according to the report.
“Neurotoxin injections are a huge cash cow for dermatology
offices,” said Valerie Monroe, the former beauty director at O, The Oprah
Magazine and the author of a Substack newsletter on beauty.
Alternatives do exist. Many doctors pointed to sunscreen or
retinols, which can increase collagen in the skin and work to counteract the
visible effects of aging.
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