Facial Botox is less taboo than it once was. Botox injection is the most popular non-surgical cosmetic procedure, and is talked about among friends, on television, and glamorized in the public eye. Although it’s been used by ophthalmologists since the 1970s, it wasn’t until 2002 that demand for it skyrocketed because it began to be sought for cosmetic support in keeping young-looking skin.

With medical spas in every city, it’s estimated there are more than 11 million aging men and women having Botox injections every year. The procedure is most common in women ages 40-54. If this is something you do or are considering doing, then here are some tips to get the most out of your experience and to promote long-term skin health. 

What is Botox and who gets it?

Botox is a prescription-only drug made from the botulinum toxin produced by the bacterium Clostridium botulinum. In large amounts, and when not sterilized and diluted as the drug is, botulinum toxin can cause botulism, a well-known type of food poisoning.

Although there are seven types of botulinum neurotoxins, only types A and B are used clinically. Botulinum toxin type A is also known by brand names like Botox Cosmetic, Dysport, Xeomin, and Jeuveau. It is a well-established treatment, providing muscular relaxation when injected into specific sites. It inhibits acetylcholine release at autonomic nerve terminals and is used in both aesthetic and therapeutic cases.1 It has been well studied and has effects that last 3-6 months.2 

The most common use of Botox injections is facial cosmetics in areas that show signs of aging: crow’s feet around the eyes, forehead wrinkles, or lines around the mouth. After being injected, the toxin blocks specific chemical signals that cause muscles to contract, allowing relaxation of muscle tone and less movement for a temporary youthful-looking facial rejuvenation.  

Botox is also used as a medical treatment for numerous clinical conditions. Conducted by a licensed medical professional it’s used for:

  1. Cervical dystonia
  2. Lazy eye or eye twitching
  3. Hyperhidrosis
  4. Chronic migraine
  5. Overactive bladder
  6. Muscle, joint, or nerve pain
  7. Osteoarthritis pain
  8. Muscular contracture conditions

Safety of Botox

When conducted by a trained medical professional, Botox is relatively safe, although it is not without potential side effects. Precise placing of the needle is essential to avoid side effects, which dictates the importance of having a trained professional conduct the procedure. In addition to injection-site swelling and bruising, other possible side effects include eye dryness, excessive tearing, crooked smile, droopy eyelid, and headache or flu-like symptoms.3 Systemic effects rarely occur, but include trouble breathing or swallowing, loss of bladder control, muscle weakness, vision problems, or difficulty speaking, all of which require immediate medical attention.3

Botox is contraindicated in individuals with a cow milk allergy.3 The milk protein albumin is used to make Botox. Note: lactose intolerance is not the same as a cow milk allergy.

Preparing for Botox

Before the procedure, consult with the medical professional who will conduct the procedure. Be sure to discuss over-the-counter and prescription medications, because some are contraindicated 3-5 days prior to injection. Most notably, these include blood thinners and non-steroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of bruising at the injection site. Alcohol should be avoided 24 hours prior to the injection, as well as excessive sun exposure. 

Regarding nutritional supplements, for several days prior you might be asked to avoid supplements that can impact blood thinning, such as fish oil, vitamin E, ginseng, and ginkgo. It's always best to review your current regimen before each visit: what you take, how much, and for how long. 

Although there is no need to fast before a visit, you should arrive well hydrated, having drunk plenty of water. Although the evidence is scarce, one small, double-blind, placebo-controlled crossover study suggests that 50 mg of zinc supplementation one week prior to a Botox injection helps the toxin’s effect in the skin.4

What to do after the treatment

Post-treatment has fewer restrictions and allows for additional opportunities to ensure the best outcomes in skin firmness, elasticity, and moisture. 

Skip exercising and pass on saunas and hot tubs for at least one day to minimize sweat and bacteria exposure to the inflamed skin and injection sites. For the same reasons, limit for at least one day extra spicy foods that make you sweat.

It’s important to keep your skin hydrated while you can’t touch it, so consume water and electrolyte beverages and avoid excessive caffeine to stay hydrated from the inside out. 

Moving forward, focus on an antioxidant-rich diet to prevent further premature signs of aging. Load up on vegetables, fruits, whole grains, healthy fats (like olive oil and fish) – all important components of the beneficial and easy-to-follow Mediterranean style diet. 

Supplements that support skin health

Although the injection uses tiny needles and the injection site is small, side effects can differ among individuals, and swelling in the face can be uncomfortable and noticeable. Thorne’s Phytoprofen® is a botanical formula that contains curcumin and Boswellia to support inflammatory balance, as well as bromelain, a mixture of protein-digesting enzymes from the pineapple plant.* Bromelain promotes healing and reduces minor swelling and bruising.* You might see bromelain in topical skin-care formulations because it is also known to help with exfoliation and damaged skin tissue.5 

As you age, your body produces less collagen, an important structural component of skin elasticity, the loss of which can lead to more wrinkles. Collagen content in the skin is influenced by puberty, pregnancy, menopause, andropause, genetics, ethnicity, and the environment.6 Collagen supplementation promotes skin elasticity, strength, and hydration,* something that can be more challenging in winter and summer weather. Thorne’s Collagen Plus formula helps reduce fine lines and wrinkles, and can lighten and brighten skin pigmentation in as soon as four weeks.* Consider this option between treatments to extend the fine-line reduction timeline.

Inflammation triggers a cascade of adverse events throughout the body, one of which can lead to collagen and elastin damage in the skin. EPA and DHA are omega-3 fatty acids that help down-regulate oxidative stress by supporting the body’s production of antioxidant enzymes, thus helping maintain a normal inflammatory response in the skin.* Thorne has eight fish oil products to choose from, depending on what other health concerns you have.

Environmental factors like sun exposure, pollution, heavy metal content in cosmetics, and other things you encounter can increase free radicals and cytokines – precursors to inflammation.7 Cytokine production can change the body’s microbiome, which in turn can affect skin structure and worsen fine lines and wrinkles. An important supplement to consider if this is a concern is Thorne’s Curcumin Phytosome, an antioxidant flavonoid that helps maintain the body's normal inflammatory response by optimizing cytokine production.* Note: The gut microbiome plays a significant role in skin health.

Whether or not Botox is for you, the tips in this article can help you maintain your skin health and keep strangers guessing how old you really are!

References

  1. Field M, Splevins A, Picaut P, et al. AbobotulinumtoxinA (Dysport®), OnabotulinumtoxinA (Botox®), and IncobotulinumtoxinA (Xeomin®) neurotoxin content and potential implications for duration of response in patients. Toxins 2018;10(12). doi:10.3390/toxins10120535.
  2. Satriyasa BK. Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol 2019;12:223-228.
  3. Botox injections. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/botox/about/pac-20384658 [Accessed Nov. 7, 2022]
  4. Koshy JC, Sharabi SE, Feldman EM, et al. Effect of dietary zinc and phytase supplementation on botulinum toxin treatments. J Drugs Dermatol 2012;11(4):507-512.
  5. Schulz A, Fuchs PC, Oplaender C, et al. Effect of bromelain-based enzymatic debridement on skin cells. J Burn Care Res 2018;39(4):527-535.
  6. Reilly DM, Lozano J. Skin collagen through the life stages: importance for skin health and beauty. Plast Aesthet Res 2021;2021. doi:10.20517/2347-9264.2020.153.
  7. Chen J, Liu Y, Zhao Z, Qiu J. Oxidative stress in the skin: Impact and related protection. Int J Cosmet Sci 2021;43(5):495-509.