Is Preventative Botox a Scam? Dermatologists Weigh In

Preventative Botox promises to give you a wrinkle-free complexion — but does it actually work? And if so, at what cost? Honestly, with all of the anti-aging treatments out there, I can't help but find myself skeptical of the injectable's hype. Still, I figured I'd turn to skincare pros to learn the truth (innocent until proven guilty, right?). Ahead, I talk to a slew of dermatologists to get their industry insight and expert advice regarding preventative Botox, from its proposed benefits to potential side effects — and everything in between.

Keep scrolling for our expert-approved guide to preventative Botox.

What Is Preventative Botox?

Preventative Botox is used to keep fine lines and wrinkles from forming or at least, stop them in their tracks. Many doctors recommend it as a preemptive solution to a problem.

"I usually say that the time to really start preventative Botox is when you see a faint line starting to form when your face is at rest," says Dara Liotta, double board certified cosmetic and reconstructive plastic surgeon in New York City. "Anyone without Botox will have lines when they animate their face, but if you rest your face, and you start to see a faint line in the area, that's the beginning of a wrinkle, and preventative Botox can help before the line becomes more permanent."

The Benefits of Preventative Botox

First and foremost, preventative Botox aims to slow down signs of aging, specifically, the formation of fine lines and wrinkles. Loretta Ciraldo, MD, FAAD, a Miami-based dermatologist and co-founder of Dr. Loretta Skincare, tells us she's seen the muscles weaken around the frown line in some patients she's been treating with Botox for 24 years — although it isn't always obvious.

"When I first started teaching this to resident physicians nearly 25 years ago, I injected some young physicians since they wanted to experience the treatment themselves even though they didn't have wrinkles yet," says Dr. Ciraldo. "Many of these young physicians have wrinkled much less than expected and I do believe this is based on the 'preventative nature,' but there really aren't any studies on this yet, so it is just anecdotal at this point."

Risks and Side Effects of Preventative Botox

Generally, the risks of getting Botox are pretty minimal — common side effects include bruising, or a mild headache immediately following the procedure. The fact that doctors confirm its relative safety probably lends to the low-key attitude millennials have toward getting injectables, and why they're willing to pay the price for the treatment.

However, Botox — preventative or otherwise — can go awry when it's injected incorrectly or the wrong amount is used. A few examples Dr. Ciraldo has seen include droopy eyelids or eyebrows after being injected too close to both areas and an uneven smile after receiving crow's feet injections slightly lower in the cheeks. It can also cause non-cosmetic reactions, including dry mouth from getting too much Botox in the neck, and dry eyes from getting it too close to the orbital area.

"Typically, botulinum toxin injections [like Botox] are started when lines and wrinkles start to form, not prior to the appearance of any symptoms," says Patricia Wexler, M.D., dermatologist and founder of Wexler Dermatology in New York City. "If the toxin is started too early, before any lines or wrinkles exist, the muscles and skin overlying the muscles can eventually become atrophic (thin), and look prematurely aged."

According to Dr. Wexler, this is especially true of the forehead. Injecting Botox for many years can lead to muscle loss in the area that's being treated, and flattening of the forehead muscle — and, importantly, the skin on top of it. This means you can end up with even more wrinkles than you originally had, plus visibly protruding veins. Hers is just one of many professional opinions on the subject — I spoke with numerous dermatologists, and all of them made slightly different arguments for or against preventative Botox.

The Preventative Botox Trend

Even without hard evidence, the interest in preventative Botox is growing. The American Society of Plastic Surgeons reports that Botox procedures, in general, have increased 28% since 2010 among 20- to 29-year-olds. Nicci Levy, founder of Alchemy 43, a chain of medical spas known as the "Drybar of Botox", notes that more than half of her customers are under the age of 35. Alchemy 43 offers an inviting, social-media-friendly space to get "micro treatments," a stark contrast to getting injections in sterile doctors' offices. The locations feature pastel pink furniture, marble tables, and neon signs. It looks like the average millennial's Instagram feed in real life.

InStyle beauty editor Dianna Mazzone, 25, gets preventative Botox to minimize frown lines and considers the injectible part of her skincare routine. "I started to see very faint vertical lines between my brows," she told me. "I think about it like anti-aging skincare — it's easier to be proactive than reactive." However, being proactive can be costly.

The Cost of Preventative Botox

According to the American Society of Plastic Surgeons' 2017 Plastic Surgery Report, the average nationwide cost for Botulinum Type A toxin injections is $385. Considering that Botox's results aren't permanent, years of getting injections don't come cheap. In the case of a cautionary treatment like preventative Botox, you're spending money to maintain the treatment results before the problem truly exists.

"Cost is a factor, but this is actually my only real 'indulgence' or frivolous expense," says Dana, 27, who gets Botox to reduce and prevent the appearance of forehead lines. "The cost isn't too hard to swallow if you think about how much it costs per month based on the frequency I receive the treatment (less than $100). That's not to say it's not a lot of money, but it's worth it for me."

The Final Takeaway

Without any concrete studies that prove preventative Botox stops wrinkles from developing or delays early-stage wrinkles from becoming more noticeable over time, I'm not quite sold on what it's selling. It's not that I'm against preventative Botox because I think that getting injections will make my face look frozen or fake or because I'm scared of needles. Instead, my aversion stems from not knowing what Botox will do over time. But as with any other cosmetic treatment, the choice to commit to the expense, plus the risk of long-term Botox use is totally up to the individual. As for my 30-year-old self, I'm going to stick to my Caudalie serum and Pilates. Maybe I'll reconsider once my wrinkles actually appear.

Frequently Asked Questions

• How often do you need to receive preventative Botox to keep up results?

  "We do see the frown muscles weaken if treated three to four times a year," says Ava Shamban, MD, Beverly Hills dermatologist and founder of SKIN FIVE. "It isn't seen around the eyes or in the forehead. If the treatments with Botox stop, the muscle movement begins again." This means that when the muscles move again, it's possible the wrinkles will return, or fully form if they hadn't before. So, "preventative" Botox only prevents wrinkles as long as it's kept up.

• Is preventative Botox approved by the FDA?

  Although there have been studies on using Botox preventatively, using the toxin this way isn't actually FDA-approved. Botox has FDA approval to be used for existing wrinkles on just three facial areas (crow's feet, forehead lines, and frown lines between the eyebrows) — and this limited approval took almost 15 years. "When companies get things FDA-approved it takes many years, thousands of subjects, and is very expensive," says Levy. "Typically what these companies do with getting cosmetic approval is that they pick one thing to get approval on and add other things later."

• How can I prevent wrinkles naturally?

  Wrinkles are a natural part of the aging process, however, certain lifestyle choices can affect how soon wrinkles appear. For starters, it's recommended to use sunscreen daily, invest in an anti-aging skincare routine, try to reduce your stress level, and avoid smoking.

ncG1vNJzZmivp6x7qrrSrbClnV6YvK57wZ6YrqypZMCstc1op6udppq7ta3Toq2eZZKkwbDE