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  • Jill Stetson

Botox Injections: Is Botox just for Women Over 40?




A common question I get is can a young woman get botox and usually they are referring to someone under 30. My initial reaction is no, even though I get botox myself around my eyes to soften the wrinkles 3 to 4 times a year. I am comfortable with that because I didn’t start getting botox until I was 53. But I have always been much less comfortable with a person (men use botox too) starting at a young age, so I decided to research this issue. The purpose of this blog is to provide information if you are considering Botox injections.


What is Botox?

Botox is botulinum toxin or neurotoxin used in highly diluted form. In the 1970’s, Dr. Alan Scott, an ophthalmologist in San Francisco, started to use botox for blepharospasm or uncontrollable blinking or therapeutic uses. He branded the new drug with the name “Oculinum”. Around the same time, biochemist Edward Schantz started using botox to treat strabismus, the condition more commonly known as “crossed eyes”. By the 1980’s the toxin was widely used by both ophthalmologists and neurologists as a remedy for crossed eyes, uncontrollable blinking, and other facial, eyelids and limb spasms.


Jean Carruthers, an ophthalmologist, was the first to discover botox’s cosmetic potential. While using botox on a patient, the patient commented on how they would get a beautiful untroubled expression after it was used. This prompted Dr. Carruthers to apply the toxin to a staff member’s brow/glabella area, which took away that angry tired look. After this finding, it took another decade before people were persuaded to use it for cosmetic use. Physicians struggled with the idea of using a poison to paralyze and relax muscles to take away lines - they thought this was foreign and bizarre.


However, the world changed. In 1991 Allergan bought Botox and in 2002 the Food and Drug Administration (FDA) approved it for cosmetic use in the glabellar lines. By 2015 over 11 million people were using Botox. Currently we have about 20 years of experience with Botox’s use for cosmetic purposes.


How is Botox used?

When Botox is injected it blocks signals from your nerves to your muscles. This prevents the targeted muscles from contracting, which can ease certain muscular conditions and improve the appearance of fine lines and wrinkles.

Cosmetically, Botox is typically used to reduce the appearance of wrinkles and fine lines. Botox can relax the muscles that cause:

  • crow’s feet or wrinkles that appear at the outer corner of the eyes

  • frown lines between the eyebrows

  • forehead creases


Therapeutically, Botox is also used to treat underlying muscular conditions such as:

  • amblyopia ( lazy eye)

  • eye twitching

  • chronic migraines

  • cervical dystonia ( neck spams)

  • overactive bladder

  • hyperhidrosis ( excessive sweating)

  • certain neurological conditions like cerebral palsy


Why are women (and men) attracted to Botox?

Advancements in medicine and science now allow humans to live and work longer. The “look better-feel younger” approach using Botox has an immediate visual effect on older people skin, with long term benefits on their state of mind.

There is a social obsession with youthfulness and discrimination against older adults. Older individuals start the use of Botox to provide confidence and satisfaction with their self-image.

Younger people are using Botox to prevent fine lines and wrinkles.


Correcting with Botox Treatments

Your skin gradually ages and everyone’s skin ages differentially. Aging issues can be accelerated with significant sun exposure, genetics and lifestyle issues include alcohol consumption, poor diet and lack of exercise. As you age, facial expressions or wrinkles, pigmentation including dark spots, and collagen and elastin loss results in sagging skin. Botox is an anti-aging treatment for moderate - to - severe wrinkles. Botox is primarily used around the eyes, softening the “crow’s feet”, in the glabellar area - the 11’s in-between your eye brows, on the forehead to soften lines and sometime in the lip area to soften the lip lines above the top lip.


Preventing with Botox

The use of Botox started with individuals showing signs of aging in their faces. It is now used as a preventative treatment for young woman who present no signs of aging. They want it and the sooner the better. The fundamental question for a young person getting Botox is: Will it do more good than harm over the course of the years you receive it?


Young people may be confused with facial expressions and wrinkles. If you have lines around your eyes when smelling and lines on your forehead when rising brows inquisitively, these are lines of facial expression and not wrinkles. Facial expressions are a natural consequence of dynamic movement of the facial muscles and is not related to the aging process. However in areas where you do see facial expression lines, starting in your mid to late 20’s, using a medical grade eye cream and facial serum to soften the expression lines is a good strategy. I remember seeing my first expression lines around my eyes at 27, which motivated me to use an eye cream. That was a great help in keeping the skin under and around my eyes conditioned and softened the lines. Research suggests with the passage of time, wrinkles will develop in the areas of facial expression and using good products can help reduce this effect.


Research also indicates starting Botox between the ages of 30 and 50 can prevent dynamic wrinkles from forming and eliminate existing wrinkles. However, there is little research to support individuals between 18 and 30 using Botox to prevent wrinkles. If you are in the younger age group you need to consider:


  • Starting Botox requires a long term investment without a guaranteed return - the financial price is high because of the need to get injections every 3 to 6 months

  • Are you willing to forfeit facial expressions at an important time of social development in the hopes that Botox will starve off wrinkles later in adult life?

  • On the issue of facial expressions, Botox has been very successful in eliminating the perpetual frown that comes from the facial expression lines between the eyebrows. This improvement decreases the angry look portrayed by frowning. Will this change emotionally enhance your well being?



How people make the decision to use Botox

The use of Botox started with the mid-aged women to maintain her youthfulness. The baby boomer women in particular do not want to age as the generation before them, but on their own terms. They are working longer, more active, and want to maintain a youthfulness in appearance. Botox helps them achieve this goal.

As more and more women use botox, social networks spread the news, and give some comfort in trying Botox. The manufactures are aggressively promoting the preventative aspects of Botox in addition to correction. They are growing their market share.

And does Botox fit with your beauty plan or regular body upkeep? Currently 3 to 5 % of women have Botox injections. Women have many investment choices to make: Hair, nails, skin care, injections…and many other options for their beauty plan and body upkeep.


Potential Side Effects of Botox

With Botox injections for cosmetic use minor side effects are possible and include:

  • pain, swelling or bruising at the injection site

  • headache

  • fever

  • chills


Some side effects are tied to the area of the injection. For example if you get an injection in the eye area, you may experience:

  • drooping eyelids

  • uneven eyebrows

  • dry eyes

  • excessive tearing


Most side effects are temporary and should fade within a few days. But dropping eyelids, drooling and asymmetry of the mouth are all caused by unintentional effects of the toxin on muscles surrounding the target area of the drug. These side effects may take several weeks to improve as the toxin wears off.

If you are considering botox injections be sure to use someone who is a licensed professional with vast experience, preferably with someone who just does injections. Working with someone who is not licensed or experienced may be more affordable or convenient but doing so can increase your risk of complications.


Long term Botox use - is it safe?

Since Botox has only been used for 20 years in the cosmetic world, research is limited on the long term effects. However, the limited research conducted gives pause to starting at a young age. Botox injections usually last 3 to 6 months so to maintain repeated injections are necessary.


Here are findings from several studies on the long term use:

One study concludes that the risk of adverse effects didn’t increase over time. People who received repeated injections also had better treatment success in the long term.

Another study showed that adverse effects may appear after the 10th or 11th injection.

Several studies caution younger women (18-30) about the use of Botox because of the muscle weakness, atrophy and loss of contractile tissue in the non-injected muscles far removed from the injection site. Botox has also shown muscle loss and weakness or atrophy from the non use of the specific muscle injected This could lead to saggy muscles over time.


Alternatives to Botox

The aesthetic world is full of alternatives to Botox. Like any injections, they will not give you an immediate result but they can slow down the aging process. Here are some basics alternatives:

  • Use an eye cream morning and night starting in you 20’s

  • Micro-current lifts and strengthens the facial muscles naturally. (I actually use this in-between my Botox injections to strengthen my facial and eye muscles)

  • Protect your skin including your eyes from the sun. Photo damage accelerates aging and creates wrinkles and fine lines.

  • Look for specific skin care treatments for the eyes and others areas that potentially you use as an alternative to Botox. At SkinTrust we have facials specifically for the eyes, hydrating treatments and micro-current to lift the muscles.


Key Findings

  • There is no ideal chronological age to start botox injections.

  • Botox is used to address aging issues and primarily used to correct existing wrinkles and lines to prevent further damage. This is very appealing to the aging women who wanted to maintain a youthful appearance.

  • There is inherent risk with using Botox over time because of the potential impact on the muscles injected or surrounding muscles.

  • Some research indicates that cosmetic applications may carry less risk than therapeutic Botox injections because the dose is usually much smaller.


As you can see from these findings, more research necessary. Twenty years, and primarily older women receiving the injections, is just not enough time or diverse sample to assess the complete impact, both benefits and risks.



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