aging skin, mid life skin, botox or notDo you “do it?”

When I was a teenager, “it” usually meant sex. Or drinking. Or drugs. These days, when people ask if I “do it,” they usually mean Botox. A sure sign of aging.

Actually, I think it would be better to ask, “why not do it?” Botox is safe, easy, very effective for certain lines, causes no scarring, is widely available, has no down time, can be modified to produce great results as we age, works well in combination with other anti-aging treatments, and can actually slow the development of some lines and wrinkles. Most of us feel better when we look better, and most people like the way they look after having a Botox treatment. Most of us don’t give a second thought to dyeing our hair. So why doesn’t everyone try Botox?

Well, it’s expensive, for starters. It’s a treatment that works best when it’s repeated, and it only lasts 3 to 4 months to begin with, so it does require some investment of time and money, as well as patience.

Although research into topical forms is ongoing, for now Botox must be injected, so it isn’t ideal for needle averse people. It works best in the hands of skilled injectors, so it may require trial and error to find the right provider.

Botox works very well for some lines: frown lines, forehead lines, crow’s feet, and some lip lines, but doesn’t help with others, such as nasolabial folds  (those lines that run from the nose to the corners of the mouth).

There are medical reasons not to inject Botox. It should not be used during pregnancy, or while nursing, for example.

And, there are philosophical reasons. Some people are not comfortable with the idea of injecting material into their faces to look younger. This seems too far to go for the sake of vanity.

Others just aren’t ready–they think they’re too young, or aren’t bothered enough by wrinkles to take the next step.

Then there is the fear factor–I don’t want to look too “done” or fake.

The answers are varied, and all valid. Botox isn’t for everyone.

It’s also not worth rushing to try it. I’ve never encountered a beauty emergency. Botox, or any one of a number of similar products, will be there when and if you decide that you’re ready.

So what is a Botox abstainer to do? There are, luckily, topical treatments that can improve the appearance of the skin. The most important step to take is to apply sunscreen, SPF 15 or higher every day. I recommend SPF 30 or higher in the summer. Make sure to choose a broad spectrum sunscreen to protect against both UVB and UVA.

Topical antioxidants such as vitamin C can help to minimize damage from the UV rays that manage to get through your sunscreen.

To minimize the appearance of fine lines, apply tretinoin (the active ingredient in Renova or RetinA) every night, along with a moisturizer containing glycolic acid. There are also laser treatments, such as Fraxel, that can stimulate collagen formation and help to reduce the appearance of some lines.

When I have this discussion with my patients, they all want to know if I “do it.”

My answer: only on a regular basis.


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