No, preventative Botox cannot wrinkle-proof your face

Is preventative Botox as transformative as the beauty industry claims, or is it just another sensationalised fix for a problem that’s yet to appear? 

Never in history have we, as a society, been this anti- and pro-ageing at the same time. While ageing is gradually shredding its taboo status, a whopping 2,02,749 aesthetic injectable procedures—including Botox and fillers— were performed in India in 2022. 

The much-coveted Instagram face has profoundly influenced how Gen Z and millennials look at themselves; people in their 20s are already agonising over wrinkles, crow’s feet, marionette lines, ‘11 lines’ and more—even before the faintest trace of them has appeared. Driven by this obsession with youthfulness, the $13.2 billion global aesthetic injectables market introduced ‘Preventative Botox’, which, as the name suggests, refers to “starting botox much earlier before lines begin to form,” says New Delhi-based dermatologist Dr Kiran Sethi. But is preventative Botox actually as transformative as the beauty industry endorses it to be, or is it yet another clickbait-y solution for a problem that hasn’t even manifested? 

Preventative Botox 101

The Food & Drug Administration (FDA) approved Botox for cosmetic use in 2002, over a decade after it was introduced in the market in 1989. With the advent of social media and the impact of popular culture,  Botox soon crawled up to the wishlist of every ‘it’ beauty enthusiast. The outcome? An upward surge in the usage of Botox by 2,400 per cent since 1997. 

“Botox is a brand name for the active ingredient botulinum toxin. Other brands available in the country are Dysport, Xeomin and Siax,” begins Mumbai-based celebrity dermatologist Dr Madhuri Agarwal. “Botox blocks the signalling to certain nerve pathways responsible for contracting the facial muscles causing lines and wrinkles. It works by relaxing the muscles that become more contracted with age.” 

Preventative botox, also known as ‘Baby Botox’, is meant to do exactly that, except, people opt for it rather sooner, in their 20s and early 30s. “When Botox restricts the activity of the muscle, the movement reduces and there are lesser chances of lines and wrinkles forming [in the future],” says Dr Jaishree Sharad, a celebrity dermatologist and author of Skin Rules. While Agarwal does find merit in preventative Botox, considering you need smaller dosages and can help in delaying the first signs of ageing, Sethi argues that there isn’t enough data to support its necessity. “You don’t particularly need preventative Botox to prevent lines. Instead, I’d recommend starting when lines are forming, and not when they are deep static grooves in your forehead that don’t go no matter what your facial expression.”

Is preventative Botox worth the shot?

There’s no right or wrong in the case of preventative Botox as the facial geometry, which varies from person to person, is the most influential factor here. “We know where the wrinkles will form because the muscles responsible for them share a similar anatomy. It’s predictable like that,” says Sharad. “However, the number of wrinkles and the depth will differ depending on an individual’s muscle thickness and activity.” If you’re signing up for preventative Botox in the hope of permanently outsmarting signs of ageing, Agarwal suggests rethinking. “Botox could slow down the progression of dynamic lines and wrinkles but it cannot prevent volume loss or treat the skin’s textural changes. In fact, no single treatment can defy signs of ageing.”

One user on Reddit wrote, “A 50-year-old, who had just started Botox and was absolutely raving about her results, told me that I should start now (I’m 35 years old). But like…her results were amazing with no prevention. Why spend an extra 10-15 years on it when I can basically get those results when the time is right?”, another one said, “As someone who started Botox at 46, after one round, I had a smooth forehead. I get Botox thrice a year and 5 years later, in my early 50s, I’m very happy with my skin. I can’t imagine spending [money and time] for 15+ years on Botox to get the same effect.” 

According to the FDA, it is prohibited to administer Botox to an individual below the age of 18. “In my clinic, I do not perform preventative Botox for youngsters; I prefer offering micro-needling, a vampire facial or skin booster injections depending on what the patient requires,” shares Sharad. “However, in those above the age of 30, when wrinkles are visibly formed, the only treatment is Botox. For such people, Botox stops the wrinkles from becoming deeper and more prominent.”

The lesser-known caveat about preventative Botox for the face is that overuse, especially , too early, can actually accelerate the ageing process. “The results of Botox last anywhere between 4-6 months; the longevity of preventative Botox is similar,” begins Agarwal. “When lesser doses are used [in the case of preventative Botox], it may also fade out faster. The life of Botox is also dependent on your lifestyle, metabolism and after-care of the treatment.” Given that preventive Botox requires quarterly visits to your dermatologist, starting early means a considerable amount of Botulinum toxin entering your face. In some cases, this could be counterproductive, leading to an older appearance, due to excessively frozen muscles and restricted facial movement. Instagram and TikTok are filled with dramatic B.B. (before Botox) and A.B. (after Botox) comparisons of individuals under 30.

It’s also key to apprise yourself about the potential side-effects of Botox, points out Sethi. “If you expose yourself earlier and repetitively to Botox, the risks, which although rare, can occur in the form of ptosis, migration, bruising, hypersensitivity and your muscles will become thinner over time.” Sharad further adds, “There is some evidence that frequent Botox use may lead to antibody formation, which can make a person resistant to the effects of Botox over time. If resistance develops, Botox may become less effective, and alternative treatments may be needed. Starting Botox early can sometimes lead to a reliance on the treatment to feel confident or attractive. This dependence can escalate over time, leading to frequent and possibly unnecessary injections.”

PSA: Preventative Botox isn’t the only cure-all

“Botox in a bottle” is a phrase increasingly used by skincare brands to promote their serums and creams. While the claim is debatable, a combination of at-home and in-office skincare practices can definitely help you maintain your skin’s firmness and freshness. Sethi recommends applying topical retinoids and sunblock, changing your sleeping position to sleeping on your back, reducing excessive facial movements and microneedling and laser-based facials in a clinic. “Through production of collagen and elastin and prevention of photodamage, we can prevent and treat some lines.”

Agarwal favours a mix of topical, oral and in-office care. “Add anti-ageing ingredients such as retinol, peptides and vitamin C, and opt for oral supplementation with antioxidants and glutathione. My favourite alternatives are non-invasive treatments such as dermal fillers, thread lifts, skin tightening lasers, high-intensity focused ultrasound and microneedling radiofrequency. Skin boosters for dryness, dullness and other signs of ageing on the face as well as the décolletage, hands and legs, can also be useful.” Sharad highlights the importance of a healthy lifestyle; “a sugar-free diet, no alcohol, no smoking, stress management, exercise and 7-8 hours of good sleep are natural ways to protect your skin from early signs of ageing. Poly deoxyribonucleic acid injections and exosome therapy are other treatments to look out for.” While any aesthetic treatment is elective and driven by personal choice, Sethi emphasises that timing is crucial when considering Botox.

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