It’s been nearly two decades since Botox made its appearance onto the cosmetic scene, but despite the longstanding stigma the drug has in some people’s minds, the culture around it has started to change in recent years. With older generations re-entering the dating scene and younger generations more conscious of their appearance, the demand remains high—but patients should still be careful about where they go to get their injections.
Botox, a brand-name drug manufactured by the pharmaceutical company Allergan, launched in 2002, offering dermatology patients an option for reducing facial wrinkles. When the drug is injected into muscles, it blocks the release of the chemical acetylcholine, the compound responsible for muscle contraction.
This block of acetylcholine paralyzes the muscles, thus relaxing them and reducing the appearance of wrinkles. The injection is done with a needle and usually takes only a few minutes with no anesthesia necessary. Patients will usually see the drug’s full effects within 24 hours to seven days, and the effects last for four to six months, after which time the muscle action will return and wrinkles will reappear unless a repeated dose is administered. After several repeat doses, the facial muscles will be relaxed enough that wrinkles will no longer be as severe.
But it’s not just for cosmetic uses that Botox can be beneficial. Doctors have prescribed Botox as a therapeutic treatment for conditions like chronic migraines and excessive sweating.
In other cases, its cosmetic uses extend beyond simply helping patients look younger. A clinical trial published in a March 2018 edition of Plastic and Reconstructive Surgery, the official journal of the American Society of Plastic Surgeons (ASPS), found that Botox injections can improve the appearance of surgical scars. Member doctors with ASPS surmise this is because the muscle paralysis decreases movement and stress around a wound as it heals, which in turn prevents the scar from widening, getting larger, or getting darker.
Despite its many uses, cosmetics continues to be the primary reason for getting Botox regardless of a patient’s age. Last year, ASPS reported that 50,000 cosmetic procedures had been performed on patients 55 and older. These procedures encompassed not only Botox and fillers but also liposuction, hair transplantation, and breast augmentation. This is likely because divorce rates for Baby Boomers have doubled since the 1990s, and more Baby Boomers are returning to the dating scene and wanting to look younger.
But it’s not just the older generation. ASPS reported in 2017 that selfie culture has made more young people conscious of their image and in turn helped destigmatize cosmetic surgery. That might explain why Botox saw a 28 percent increase among people ages 20 to 29 since 2010.
The popularity of Botox means that many “Botox bars” have started opening up, offering consumers the option of getting injections at a spa rather than in a doctor’s office. Although it is legal for non-physicians to administer Botox, be wary—the Mayo Clinic emphasizes that Botox should be used only under a doctor’s care. Improperly administered Botox can be dangerous. In some cases, the toxins in the injection that paralyze the muscles can spread throughout the body. This could potentially cause muscle weakness, vision problems, trouble speaking or swallowing, vision problems, and loss of bladder control.
