Am I too young for botox?

It’s no secret, more and more men and women are seeking injections for wrinkles at younger ages. In fact, according to the American Society of Plastic Surgery, there has been a 28% increase in patients receiving botox treatments among the 20-29 age group. This phenomenon seems to be due to millennials and genXers more aware of the damaging effects of sun than previous generations and thus, wanting to prevent rather than undo years of sun damage. Also, selfies and one’s image on social media has made outward appearance more of a priority than in previous generations.

But, what is the right age to start botox injections?

20sYou want to prevent wrinkles from occurring in your early 30s
30sYou’ve started to notice a few wrinkles—particularly crow’s feet and brow lines—and you want to stop them from becoming deep-set
40sYou start to notice deeper lines—particularly crow’s feet, forehead and frown lines. Your upper eyelids may also start to appear heavier
50sDeeper lines are appearing more etched in. Lines between your eyes particularly become more pronounced as hormonal changes cause skin dryness and collagen and elastin loss accelerates
60s &
You want to look fresher and rejuvenated but still look like you

While there’s no hard and fast rule on what exact age to start, as a physician, I base my decision to recommend starting neuromodulator treatments on a few factors:

1.  Expression lines.     Once expression lines start to stick around at rest, one should consider preventative measures so these lines don't become permanently etched in.
2.  Genetics.    How are parents/grandparents aging?  The way our parents/grandparents aged is a strong indicator of what to expect for how we will age.  If your family member started showing wrinkles at a young age, more than likely you will do the same.
3.  Skin care.   Having a good skin care routine is paramount.  In the words of Benjamin Franklin, "an ounce of prevention is worth a pound of cure".
4.  Lifestyle.  Lifestyle factors such as alcohol consumption, smoking, sun bathing or using tanning beds cause premature aging and would put one at increased risk of developing wrinkles much earlier.

How ‘preventative botox’ works?

Since lines are formed by the repetitive movements of facial muscles (expression lines), preventative botox works by decreasing muscle movement and thereby preventing these fine lines from forming. Following a good skin care regime, avoiding sun tanning and getting botox injections on a regular basis can therefore, delay the formation of deeper lines. As an added benefit, ‘preventative botox’ generally uses less units so you are saving money while looking your best. It’s a win-win, if you ask me!

Preventative botox injections can help prevent premature wrinkling.


While neuromodulator treatment for cosmetic concerns is approved for ages 18 through 65 due to the original clinical studies being in this age range, there are certainly healthcare practitioners who have injected persons older than 65 years. While I have never injected any person younger than 18 years of age for cosmetic botox, I have certainly injected persons older than 65 with. In general, I recommend considering treatment when you start to notice your expression lines leaving fine lines. In some people this can be in their mid to late 20’s and in others can be in their 30’s or even early 40’s depending on lifestyle, genetics and prevention methods. Trending today, I would say I have seen more individuals in their early 30’s seeking ‘preventative botox’ than ever before.

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