The Positive and Negative Long-Term Effects of Botox You Should Know

We take a deep dive into the long-term effects of the anti-aging needle.

Discover the Surprising Long-Term Effects of Botox You Need to Know! Join Dr. Noreen Galaria and a panel of experts as they delve into the positive and negative impacts of Botox treatment.

With its rising popularity, it can be hard to figure out if Botox bad for you or not. The advent of this treatment pretty much revolutionized the anti-aging industry. By simply enduring a handful of tiny pinpricks, you can erase fine lines and deep wrinkles for a smooth, younger-than-your-actual-years visage

We’re all familiar with the amazing short-term results, but have you ever been curious about the long-term effects of Botox and other neuromodulators? Ahead, we’re diving into both the positives and potential negatives, according to doctors.

MEET THE EXPERT

• Noreen Galaria, MD FAAD, board-certified dermatologist and founder of Inner Glow Vitamins
• Jeffrey G. Lind II, MD, double board-certified plastic surgeon
• Kimberly Lee, MD, celebrity facial plastic surgeon
• Blair Murphy Rose, MD, FAAD, board-certified dermatologist

What Is Botox?

Botox is a type of injectable neuromodulator that temporarily weakens or paralyzes muscles. Similar to the way we refer to any tissue as a Kleenex, Botox has become a sort of catch-all phrase for neuromodulators. Other examples include Dysport, Xeomin, and Jeuveau, and they all work similarly.

generally tell my patients that they will begin to see some results within the first week but it takes two weeks to obtain full results,” notes Noreen Galaria, MD FAAD. “Within two weeks patients notice a relaxing of their fine lines and active wrinkles. They will also notice a smoother appearance to the skin with diminished pore size and sweating.”

Positive Long-Term Effects

Neuromodulators have been heavily researched and studied, are FDA-approved, and are considered safe for use. However, every person will have their own experience with this anti-aging injectable, and a customized approach and clear communication with your practitioner are a must. Botox specifically is known for smoothing out the look of existing wrinkles, but this injectable has some other notable long-term benefits.

Helps Prevent Future Wrinkles

Along with smoothing existing lines, Botox may help prevent the formation of new wrinkles. Long story short, there are two types of wrinkles: dynamic—which are visible only while making a facial expression—and static wrinkles, which are always there.

"Dynamic wrinkles, as a result of repetitive muscle contraction, become static wrinkles over time, especially after the skin starts losing its elasticity due to things like excess unprotected sun exposure,” explains Jeffrey G. Lind II, MD. “If [you] start using Botox at a much earlier age, it will dramatically slow down the progression to static wrinkles in the treated area.”

Generally speaking, consistent neuromodulator injections can help you look more youthful even as the clock continues ticking. “A great study was done several years ago on twins where one had regular Botox, and the other didn’t,” says Galleria.2 “At the end of 13 years, the twin that was treated not only had less wrinkles at rest even when her Botox had worn off but also had better skin quality and smoothness in the treated areas.

Doses May Decrease

Another potential long-term benefit of Botox and other neuromodulators is that, with continued use, you may find you need fewer visits and smaller doses. Galaria says this occurs because the muscle has weakened and is less apt to wrinkle.

Can Minimize Headaches

For some, one of the tell-tale signs their Botox is wearing off is when they get headaches or notice more tension in their face. Because neuromodulators relax the muscles in your face, they can help ward off clenching, headaches, and even migraines.

“Botox has been approved for the treatment of chronic migraines and has been shown to reduce the frequency and severity of migraines in some individuals,” notes celebrity facial plastic surgeon Kimberly Lee, MD. With consistent ongoing usage, you may find relief from those painful headaches.

Can Reduce Sweating

While not all Botox injections target sweat glands, Botox is sometimes used as a treatment to target the body's sweaty spots. In fact, it's considered an effective, FDA-approved treatment for Hyperhidrosis, a medical condition characterized by excessive sweating (beyond what's necessary to regulate body temperature).

"Botox for Excessive Sweating." Baylor Medicine, Healthcare: Dermatology.

Negative Long-Term Effects

Neuromodulators have been studied in depth for over 20 years and are considered safe for ongoing use. As such, there aren't many significant negative long-term effects of Botox; short-term negative effects are more likely.

These short-term effects are either the result of poor injection skills, not following post-care advice, or, in rare instances, an allergic reaction. Because Botox and other neuromodulators are temporary—meaning they wear off within three to six months—these short-term effects should also disappear. That said, here are a few of the potential long-term effects that may not be viewed as a positive.

May Require Higher Dosing

One potential “long-term negative effect” of Botox is that over time you may find you need more frequent appointments or higher amounts of Botox to maintain your results, which can get expensive. (Some experience the opposite effect where they need less over time, as mentioned above. Every patient is different.)

“Very rarely, ‘tolerance’ to Botox can develop over longer-term use. That is, patients can become resistant to the effects of Botox,” says board-certified dermatologist Blair Murphy Rose, MD, FAAD. “This is thought to be caused by the development of neutralizing antibodies in the body. Antibodies can be thought of as molecules of the immune system that bind to and, in this case, deactivate another protein or stop it from functioning.”

Galaria adds that this could also be the result of simply aging and having more wrinkles to contend with over time. In other words: You’ve got way more wrinkles at age 40 or 50 than you would at age 20 or 30.

Weakens and Atrophies Muscles

On the opposite side of the coin, some people experience notable muscle weakening when using Botox over time. This occurs because the muscle is being underused. For many practitioners and their patients, this is considered a positive since it means fewer wrinkles.

However, Galaria says, “In some women, this atrophy or weakening of the muscle might make the underlying veins in your face more visible.” Galaria adds that this may be accompanied by unnatural motion limitations.

Can Have a Subtle Flattening Effect

Another potential side effect worth mentioning is that over time, as facial muscles change, “relaxing muscles further with Botox can actually lead to a subtle flattening effect of the brows,” Galara says.7 If you get Botox in other parts of the phase—like the masseters (cheek/jaws) for clenching, then you may notice a slimmer face or more angled appearance over time. This is considered a pro for some and a con for others.

May Cause Pain or Discomfort

While Botox is not a very invasive procedure—and it's generally pretty quick—it may cause pain or discomfort for some patients. You may notice some swelling or light bruising around the injection sites, as well. In rare cases, Botox can spread beyond the target area, which can cause unintended muscle paralysis and lead to drooping eyelids (ptosis), asymmetry in facial expressions, or difficulty swallowing or breathing.8 These effects tend to be more short-term than long-term.