Botulinum toxin (or more commonly known as “botox”) is probably one of the most done aesthetic procedure around the world. What was once used to treat strabismus (or “crossed eyes”) is now seen as an anti-ageing treatment to eliminate the appearance of wrinkles.

While you may imagine individuals above the age of 40 to go for botulinum toxin injections, as this is the age when wrinkles begin to look more noticeable, you’ll be surprised there’s been a new trend called “preventive Botox”, which sees women go for it as early 20-something years old!

But how early should we be starting Botox? Thanks to an informative video by dermatologists Dr. Maxfield and Dr. Shah, who regularly share their thoughts on skin-related concerns and aesthetic procedures on the Doctorly Youtube channel, we have our answers.

What is botulinum toxin?

What Age Botox 1 - what is botox - Diana Polekhina on Unsplash

Photo source: Diana Polekhina on Unsplash

Botulinum toxin (or “botox”), are neuromodulators. They inhibit the release of the neurotransmitter acetylcholine, which enables your muscles to contract, thereby reducing the appearance of fine lines and wrinkles.

Although we commonly call it “botox”, the term is actually refers to a brand of botulinum toxin in the market. Other brands you can find include Dysport and Xeomin.

To understand how botulinum toxin works, we need to first delve into the difference between “dynamic wrinkles” and “static wrinkles”.

Everyone of any age has what is called “dynamic wrinkles”, which are lines that appear when you are moving your face, for instance, when you’re laughing or frowning.

However, when we get older, these “dynamic wrinkles” may eventually get etched into the skin and become “static wrinkles”, which refer to lines that still exist even when your face remains still.

What about “preventative botox”?

What Age Botox 2 - preventative botox - Malin K. on Unsplash

Photo source: Malin K. on Unsplash

“Preventive botox” is a new term that has been trending online, on social media platforms such as Tiktok.

Doctorly’s Dr. Shah is quick to clarify that the goal of all botulinum toxin treatments are in fact “to stop dynamic wrinkles and therefore stop the formation of static wrinkles.”

In other words, while “preventative Botox” may be a term that is going around, all botulinum toxin treatments are preventative in nature, as they are not meant to reverse wrinkles but prevent them.

That is not to say people with wrinkles can’t use botox injections, as it can certainly reduce the appearance of their fine lines while preventing new ones from forming.

Does this means that the 20-somethings on Tiktok are on to something after all? Well, that brings us to our next question…

At what age should you start using botox?

What Age Botox 3 - what age - XFrame

Photo source: Frame

“It’s the same concept of sunscreen, right. Your goal with sunscreen is largely preventative. You can have benefits if you use it after you have all the sun damage but by far, you’re going to get the most bang for your buck if you start it ahead of time.” – Dr. Maxfield.


Since the objective of botulinum toxin jabs is to prevent wrinkles, we must first look into what cause wrinkles to develop.

Wrinkles are a natural part of ageing and are caused by a combination of factors that are hard to control. These factors may include:

  • Having a lighter skin tone
  • Exposure to pollutants and smoking
  • Exposure to UV light and sun damage
  • Repeated facial expressions
  • Genetics, such as stronger facial muscles

Depending on how many of the factors they are exposed to, most people naturally begin to develop wrinkles around their late 20s, early 30s, or mid-30s. Depending on your condition, this may be the time when you might want to start going for botulinum toxin injections.

“It’s the same concept [as using a] sunscreen.” says Doctorly’s Dr. Maxfield. “Your goal with sunscreen is largely preventative. You can have benefits if you use it after you have all the sun damage but by far, you’re going to get the most bang for your buck if you start it ahead of time,” he explains with an analogy.

The doctors also recommend botulinum toxin injections over other wrinkle-fighting treatments such as lasers and thread-lifting, explaining that that they aren’t only cheaper over time, but also have the fewest side effects. The doctors also disclosed that they have used botulinum toxin injections on themselves.

Featured image: XFrame