Botox to Remove Wrinkles: Does It Work?

The Science Behind Botox for Wrinkles

Woman getting Botox
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Injection of Botulinum toxin type A, or Botox, is one of the most common non-surgical cosmetic procedures performed in the United States.

Even with its popularity, there are still many myths and misinformation about this procedure. The most common myth is that people who get Botox are being injected with botulism, which isn't true.

But that myth and other myths persist, as well, which means many people don't understand how Botox works, and more importantly, exactly what it can—and can't—do.

The History of Botox

Botox actually is a toxin produced by a form of bacteria, Clostridium botulinum. Several different types of this toxin are produced by pharmaceutical manufacturers and marketed for different medical indications.

Type A is the most potent and is marketed by Allergan Plc. as Botox. Galderma Laboratories, L.P. makes a similar product from Type A botulism toxin, which it markets under the brand name Dysport. Both have been approved by the U.S. Food and Drug Administration (FDA) to treat wrinkles. Another product, made from Type B botulism toxin, is marketed by Elan Pharmaceuticals as Myobloc, also is FDA-approved to treat wrinkles.

In many cases, people who say they're getting "Botox" actually are getting Dysport or Myobloc. All three products are quite similar, although results may vary, depending on the physician and the patient.

Does Botox Remove Wrinkles?

Botox doesn't actually remove your wrinkles, and none of the marketing literature surrounding the drug (and its competitors) will tell you that it does.

In fact, you should beware of any physician offering Botox who claims it will remove all your wrinkles.

Instead, it's effective in lessening the appearance of wrinkles—specifically, it's approved to treat severe crow's feet and frown lines between the eyebrows.

Studies have shown that people who get Botox are generally satisfied with the results.

However, it's not a miracle treatment—you should expect some noticeable improvement, but not to turn back the clock 20 years on your wrinkles.

How Does Botox Work?

Botox lessens your wrinkles by blocking the nerve signals that tell your muscles to contract. Once you've had an injection of Botox into a specific muscle, that muscle is basically paralyzed, although it's not damaged at all. When Botox is injected into a muscle that causes a wrinkle in your skin when it contracts, paralysis of that muscle prevents the wrinkle from forming.

The effects of Botox are most noticeable in so-called "dynamic wrinkles," or wrinkles that are only present when the muscle contracts. That's why it's approved to treat crow's feet (which are most prominent when we smile) and frown lines (which are most visible when we frown).

As we get older and lose elasticity in the skin, a permanent crease can form in our skin, leaving a wrinkle that is noticeable even without muscle contraction. Botox does not get rid of these wrinkles, but may help to soften them.

Botox isn't reversible once it's been injected, but it does wear off. Its effects begin within 48 hours and become noticeable within five to 10 days. However, the effects only last between three to five months, at which point you'd need to get another Botox treatment to keep the anti-wrinkle effects.


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Rivers JK et al. Subject satisfaction with onabotulinumtoxinA treatment of glabellar and lateral canthal lines using a new patient-reported outcome measure. Dermatologic Surgery. 2015 Aug;41(8):950-9.

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