Botox has changed the way we age—now let’s talk about how the industry has changed how we approach botox.
As a naturopathic doctor and cosmetic injector, I am always learning because there is always new information and studies being released. Most recently, there’s been buzz about the new rules of botox. Now the first two rules don’t surprise me, and if you’ve been coming to me for cosmetic injections for any length of time (or even follow me on socials) they shouldn’t surprise you either. The third rule however, is a newer concept. To fully understand the direction the botox industry is taking, we have to look back at where it started.
Botox’s History + What It Means For Its Future
The history of botox starts with outbreaks of sausage poisoning—yes I know, a far cry from the cosmetic treatment we all know and love today. When I refer to botox in this article, what I am actually referring to is botulinum toxin type A, which could include Botox®, Dysport®, Xeomin® and/or Nuceiva®. If you’d like to learn about my experience with the different brands click here. Throughout the article, when I refer to Botox®, I am referring to the Allergan brand.
Muscle weakness, droopy eyes, vomiting—these were all symptoms of botulism, a rare, life-threatening food poisoning that appeared in the late 1800s due to the consumption of, you guessed it, sausages. After decades of outbreaks of this fatal disease, scientists realized patients with botulism have paralysis of the muscles, but not the sensory system or cognitive abilities. It wasn’t until 1895 that a Belgium scientist by the name of Emile Pierre van Ermengem was able to identify the active ingredient that caused this paralysis as Clostridium botulinum. In 1928, scientists started to isolate botulinum toxin in San Francisco.
Fast forward to 1978 when an ophthalmologist by the name of Alan B Scott began FDA trials for the use of botulinum toxin to treat crossed eyes. At the time of its first FDA approval in 1989, Scott called the drug Oculinum, which successfully proved to treat patients suffering (strabismus) and eye twitching (blepharospasm). A few years later, Allergan acquired Oculinum, renaming the product Botox®.
In Vancouver, botox was already being used for medical purposes by 1987—and would soon be pioneered for cosmetic uses by power couple Dr. Jean Carruthers, MD, FRCSC, a Vancouver ophthalmologist and her husband, Alastair Carruthers, a dermatologist. It was while treating a patient with blepharospasm that Dr. Jean Carruthers first recognized the untapped cosmetic benefits of Botox®. Though her patient didn’t need more units to treat her eye twitching, she asked for them anyway. “The penny drops, simply because this lady had noticed that her frown lines disappeared and she was really happy about it, so I knew that I had a solution,” Dr. Carruthers tells in this exclusive interview with Forbes.
With her husband struggling to find a solution to wrinkles in his work as a dermatologist, Dr. Jean Carruthers brought this idea to him. The pair started testing out the possible wrinkle solution themselves, their secretary, and eventually a small group for the couple’s first small clinic study on the cosmetic use of botulinum toxin A—which would soon after disrupt the beauty industry…and later on, provide me with my livelihood!
With the persistence of the Carruthers who faced many nay-sayers along the way, Botox® was FDA-approved for moderate to severe frown lines in adults on April 15, 2002. This is when we first saw Botox® marketed as Botox® Cosmetic to distinguish its uses beyond the therapeutic treatments it had been used for to date. Since, botox has been approved for more therapeutic uses such as chronic migraines and upper lip spasticity in 2010—all while gaining popularity for its cosmetic purposes. If there are any Real Housewives fans, I think we all shared that equal feeling of curiosity and cringe (the injecting technique has thankfully improved) from botox’s 2006 debut.
Over 7.4 million botulinum toxin type A (Botox, Xeomin, and Dysport) treatments were performed in 2018, according to the American Society of Plastic Surgeons (ASPS). And though the statistics aren’t out for 2022, I think we can all agree when we say the treatment’s popularity has only increased in the last four years (particularly due to “baby botox,” a term that describes the many young twenty-somethings turning to this treatment as a preventative measure). Side note: If you know me, I recommend only starting botox once lines are visible and start to bother you—this usually means starting light botox in late twenties to thirties as a preventive measure.
Millennials have inspired their parents and been followed by Gen Z in making botox a regular part of their wellness routines. Unlike the forever rotating fads and trends of the beauty industry, botox has remained steadfast. Nearly unchanged, except for the attitude towards it. I’ve noticed this twofold: There is less stigma which means there is an increased popularity; and the increased popularity is leading to additional research and better approaches. If you want to fully geek out about the intriguing history of botox, I recommend reading the 2017 academic paper, The history of Botulinum toxin: from poison to beauty because I could go on all day about the history, but we need to get into the new rules of botox.
The New Rules of Botox
So, what have we learned about botox since starting to use it for cosmetic purposes 20 years ago? Providers around the world are constantly refining botox best practices based on the results they achieve in their own practice and the research continuously emerging. Here are the three new rules for botox:
- Prevention is key.
This is what I’ve been saying since beginning my practice over five years ago. When we focus on prevention, we can use less product, lengthen the time between treatments, and maintain results more economically. There is no set age when botox prevention “should” begin. While anyone over the age of 18 is legally allowed to receive botox injections, those are not patients I choose to work with. You’ll often hear the age 30 as a benchmark, but I am of the thinking that you should make your own choice. When the wrinkles start to bother you, begin botox to mellow the muscles and prevent the wrinkles from deepening. Simply put, it is much easier to prevent than correct.
Marketing botox has shifted from relying on celebrities for their ads, to friends talking openly and showing off their results at dinner. The stigma of even 10 years ago is nearly non-existent and that means the majority of us have more access to information on the product. Both men and women are embracing botox as a preventive treatment. If you’re like me, when I hit 30, I remember saying how 30 years old just feels younger than it used to—but it actually looks younger too! Our generations will be the first to watch how preventable use of neuromodulators in your 30s impacts your appearance by the time you’re in your 70s. With the right approach, this will mean aging gracefully on our own terms.
- Never treat just one area.
This is true in certain cases. For example, I will not treat the forehead without treating the 11s (glabellar lines) as the weight of just the forehead could impact how the muscles sit. However, if you’d like to treat only the 11s, this is possible. When we take in consideration the first rule (prevention is key), I recommend opting for treating both areas if you’re starting to see horizontal lines on the forehead. Even the bare minimum units can help prevent these lines from becoming more prominent.
- Switch up brands every second time.
This is the rule that I am most excited to learn more about. As many of you know, I personally love the results I can achieve for my patients (and myself) using Dysport, but not long ago I started to offer my patients Newtox (Nuceiva™). So, why is the new rule to switch up from the brand you already know you love? It’s all about tolerance. When the facial muscles of the treatment area build tolerance to a certain muscle relaxer brand, you’ll require more units to get the same results—in some cases, the muscles can stop responding altogether. The theory is, if you continue to cycle through the brand you use every second time, your muscles will not build tolerance or at least not as quickly.
Depending on your facial muscles and history of cosmetic injections, you may already find that you achieve better results with certain brands over others—this could be due to your tolerance to the certain brand of muscle relaxer you have used most. I must stress, there is more research needed before we can make this a concrete rule, but I am here to keep you updated along the way.
Botox Injections on Vancouver Island
Over the last five plus years of providing botox in the Vancouver and Vancouver Island area, I have stumbled upon a niche: I tend to attract first-time botox patients. While this often means a bit more explaining and hand holding (literally!), I am so proud to have been trusted by so many individuals for their first botox treatment. If you’re new to the treatment and would like to learn a little bit more before diving in, give me a follow on Instagram or TikTok for patient transformation photos, my approach to cosmetic injections and everything you need to know about before and after care. As always, my DMs are open if you have any questions.
To book your botox injections at my Parksville, Nanaimo, Chilliwack or Langley locations, click here.
Recent Comments