March 12, 2024/Aging Well

Does Preventative Botox Really Work?

The cosmetic injection may help train your muscles out of frowning, but there’s no hard data to say for sure

Younger person getting a botox injection in forehead from healthcare professional

If you’ve ever been on social media and seen a 22-year-old influencer rave about their recent Botox® injections, you might be wondering, “Wait… Isn’t that stuff for wrinkles?!”


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Yes. Yes, it is. But while Botox injections used to be sought out primarily by people who already had wrinkles, these days, younger and younger folks are clamoring for it, too. Their reason? Preventing wrinkles.

But does it work? And is it worthwhile? Plastic surgeon James Zins, MD, weighs in on the trend of preventative Botox and whether it’s something you should try.

How does preventative Botox work?

The idea is to use Botox (botulinum toxin) injections to stop wrinkles from occurring in the first place. But to understand how that might work, you need to first understand some things about wrinkles in general and about the science behind Botox injections.

Facial wrinkles happen as a result of muscle contractions and gravity. Your facial muscles contract any time you smile, frown, squint or make other facial expressions. As you get older, the combination of repeated muscle contractions and good old gravity leads to — you guessed it — wrinkles.

But Botox relaxes the muscles that cause wrinkles.

“In very, very low dosage, Botox blocks the neuro-communication between the muscle and nerve,” Dr. Zins explains. “This causes weakening or paralysis of that muscle.”

Think about it: If your nerve can’t communicate to tell your muscle what to do, then your muscle won’t do, well, anything — including making the sort of extreme facial expressions that can contribute to wrinkles.

“With repeated injections, we find that patients don’t frown as much,” Dr. Zins says. “Why that is, we’re not exactly sure, but it’s thought to help you break that habit through behavior modification.”

So, some people get “preventative Botox,” to try to keep their facial muscles from making all of those contractions that would eventually lead to wrinkles.

“The concept is twofold,” Dr. Zins explains. “First, to break the habit of frowning and second, to train, weaken or atrophy those muscles so that they’re not as active and thus, might not lead to wrinkles.”

What about other types of injections?

It’s important to note that Botox is a brand name for just one type of botulinum toxin injection, but there are others, too — and “preventative” injections of any of these neurotoxins work the same way.

Other types are:

  • Dysport® (AbobotulinumtoxinA).
  • Xeomin® (IncobotulinumtoxinA).
  • Jeauveau® (PrabotulinumtoxinA).

While they’re similar, they’re not exactly the same. If you’re considering botulinum toxin injections, a healthcare provider can help you figure out which is best for you.

Are there any downsides of preventative Botox?

Here’s the thing about preventative botulinum toxin injections: There’s not much evidence that they work.

“The idea of it is more theoretic than operational,” Dr. Zins clarifies. “I think it’s a reasonable assumption, but we don’t have hard data to support it.”


Getting injections, whether or not you currently have wrinkles, will indeed relax your facial muscles … but only during the time it’s active.

“Botox is temporary,” Dr. Zins points out, “so, once the treatments have stopped, then the effect goes away.”

The effects of Botox and other neurotoxin injections last only about three to four months, and then, your skin will go back to its usual form. If you continue to get injections, your muscles may train themselves to contract less. But there’s no guarantee that they’ll prevent you from getting wrinkles in the first place.

There’s some hope, though, like in a 2006 study that looked at the effects of long-term Botox on a set of twins: One sister received regular injections for 12 years; the other did not. Even seven months after her last injections had faded, the twin who got regular Botox had less noticeable crow’s feet than her sister.

Who’s a good candidate for preventative Botox?

Facial expressions and gravity aren’t the only factors that play a role in wrinkles. Genetics is in the mix, too.

You may be a good candidate for early neurotoxin injections if you have a family history of very deep wrinkles, especially if your relative(s) developed them fairly young.

But again, there’s no hard evidence that Botox injections will prevent wrinkles — just help lessen their appearance as they develop.

Other anti-aging treatments to try

Injections aren’t the only way to keep your skin looking young. There’s plenty you can (and should!) do to keep your skin healthy, which can help postpone or lessen the overall effect of future wrinkles.

  • Quit smoking: Tobacco slows down your body’s production of collagen, which gives your skin structure, strength and elasticity. Too little collagen can lead to wrinkles.
  • Wear sunscreen: Skin cancer is the most common cancer in the U.S., but wearing sunscreen every day can reduce your risk. It can also help prevent sun damage that leads to wrinkles.
  • Choose the right products: In addition to sunscreen, moisturizer and a topical antioxidant every day is a good place to start. Develop a skin care routine that’s right for your skin.
  • Stay hydrated: Your skin is your body’s largest organ — and like the rest of you, it needs water. Drinking water helps flush out toxins, and certain skin care products and ingredients are also designed to help your skin lock in hydration.
  • See a dermatologist: Dermatologists are experts in diagnosing and treating skin conditions, and they can also help you figure out the right regimen to keep your skin healthy for the long term.

Try to remember that wrinkles are a normal part of aging, and aging is a normal part of life. Starting your 30s, your skin loses about 1% of its collagen each year, and your skin cells also slowly divide, which leads to thinner skin and, yes, wrinkles.

While preventative Botox may help keep your skin looking smoother for longer, there’s no fountain of youth that will stop you from ever developing a wrinkle. Do what you can to feel your best — but don’t let those laugh lines get you down!


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