Does preventative Botox really work? The pros and cons of starting Botox in your 20s

However, celebrating my 25th year in the middle of social media’s obsession with skincare and beauty meant that my mind had begun to shift more towards concerns about how I would look in the future.

The words “preventative Botox” seemed to be everywhere I looked.

It became one of those “facts” people would tell me, much like the one about my fully formed brain.

These claims usually included mention of a TikTok a person saw about how starting Botox at the age of 25 essentially meant my generation could stay young forever.

The hashtag #preventativebotox has 46.6M views on TikTok alone.

A single search unveils an endless supply of young women in their 20s documenting their “Botox journey” by recording themselves during the days directly after the treatment, to show their diminishing expression lines.

A lot of people — including my mother — would argue that at 25, I should not be thinking about ageing, but I couldn’t help but feel like there must be a reason for this new trend.

I discussed it with friends the same age as me, who were all feeling the same and wondered if preventative Botox is something they too should consider.

Would it be a case of hopping on the bandwagon and regretting it down the line, or was this truly a revolutionary discovery that we were about to miss our window on?

None of them had taken the plunge — yet — but one thing was for sure: The conversation about Botox in your 20s was not unique to my friendship group, or my TikTok “For You” page.

The cause of the craze

“There’s been a big shift in the age group of people getting [Botox] done now. Often, it’s from the mid-20s on,” Dublin-based consultant dermatologist at the Institute of Dermatologists Prof Caitriona Ryan says. 

“Traditionally, it would have been much later that people started doing it.”

Dr Jennifer Owens of The Glow Clinic has also seen an increase in inquiries about preventative Botox in the past couple of years, with many people in their 20s asking when they should start.

“The younger generations are spending less on alcohol, they’re wearing SPF daily, I think it naturally fits in with that that they’d be curious,” she says.

This influx in interest seems to correlate with the covid-19 pandemic and, according to Dr Owens, the time spent in lockdown was a “massive player” in the aesthetic world in general.

The so-called “Zoom Effect” was even studied, and researchers in Australia found that over one-third of participants identified new appearance concerns while on video calls.

During the pandemic, skincare also became a big focus for my friends and me during a time when the consumption of makeup and nice clothes felt pointless with nowhere to go.

Couple that with more time looking at ourselves online, and I guess it’s no surprise that we’ve become so focused on our faces.

It’s all in the genes

To put it simply, Botox is injected into a specific muscle that we don’t want to move and that we want to relax.

It’s not a permanent treatment and lasts for approximately three months.

When it comes to preventative Botox, it’s the same thing — but it’s all about starting earlier.

A common claim online is that you should start before you see any lines on your face, to prevent them from ever appearing. However, as Dr Owens says, the time to start — if you wish to — is when you notice lines that are still there, even when your face is at rest.

“It’s about looking at are we having lines that are starting to sit there on the face? A common one is makeup starts to sit into their lines. That is a good time to look at injectables. It doesn’t always mean it’s the best option for you,” she says.

Prof Ryan and Dr Owens fall into the category of women who got Botox in their 20s. Prof Ryan was 26 when she first got Botox while Dr Owens was 27. They both had “lines at rest” by this point.

Prof Ryan explains how lines at rest, an etched frown and eyelids that have started to sag are “the main pointers” for those considering preventative Botox and often, these are things that run in the family. “I think they’re all acceptable reasons to start earlier,” she says.

According to Dr Khalida Mahar at Thérapie Clinic in Cork, the significance of the age of 25 is down to the reduction in collagen once we reach our mid to late twenties. “When collagen goes down, lines start coming,” she says, adding that diet and health are some of the factors that can affect collagen.

After 25 is the right time to start if you want to, she says, but always reminds clients that ageing is normal and if it doesn’t bother them, it’s fine. So far, the youngest person she has had for preventative Botox was 23 and worked as a social media influencer.

As I settled into the hot seat for my own Botox consultation at Thérapie Clinic in Cork, Dr Mahar explained that her younger clients often point to their parents’ features when they express concerns about ageing.

Family history is usually the first thing she asks them about, and if they have any concerns, such as “sustained lines” that they have noticed on parents or grandparents.

While I awkwardly lay on the consultation chair, Dr Mahar handed me a mirror and directed me to point out my areas of concern. It hit me that I hadn’t really given this too much thought prior to my appointment. In all honesty, I was hoping she would take one look at me and tell me to come back in ten years. But under the bright lights of the consultation room, as I raised my eyebrows, my problem area became obvious — and it was staring right back at me.

I quickly pointed to the lines forming above my eyebrows but explained to Dr Mahar that family history wasn’t much of a concern to me and — as much as I hate to admit it — I breathed an internal sigh of relief when she said that Botox, therefore, probably would not be necessary right now. However, if I did have concerns about family history, I could still get preventative Botox in a “low dosage”.

Does it work?

With all the hype around preventative Botox, I had assumed it was just that: Hype, but there can be benefits — as long as you fit the profile.

“It’s so individual and it’s so important that somebody understands what they’re undertaking. This is a prescription drug it’s not, ‘I’ll try that new blow dry because my friends are getting it’,” Dr Owens says.

How you look after your skin is also important. Prof Ryan says she has had younger clients who want Botox but haven’t been using sunblock and retinol, which are her two “cornerstones of preventative anti-ageing from a skincare perspective”.

“If you start doing Botox earlier and aren’t practicing a simple but scientific skincare regime, you’re still not going to have good skin,” she says.

However, as with anything, there can be risks, according to Dr Mahar.

She says if I, for example, were to start to get Botox very regularly, to achieve what she describes as the “frozen look,” (rather than a natural look) then I may notice heaviness in my brows in years to come.

“When we exercise, we tone the muscles. We are making our muscles strong. If there is a muscle that we are not working on, it gets lean and thin.

“It’s the same way here,” she adds.

Dr Owens also notes the possibility of losing “the idea of what your face actually looks like” with too much Botox too often at a younger age, while Prof Ryan reiterates the importance of keeping your Botox as natural as possible. “Good Botox is the Botox you can’t tell is Botox,” she says.

With that in mind, if you fit the profile for preventive Botox, then there is a benefit with “getting in ahead of time”, says Prof Ryan.

“I think people are trying to get in there ahead of things nowadays, preempt what’s going to happen and actually, the younger somebody starts in that way, it does look more natural. If someone comes to me in their early 30s, it’s much easier to give them a very natural look and keep that natural look with time than if they come to me in their mid-50s,” she says.

Taking my findings back to my friends, there were mixed feelings.

While some found it encouraging to see that preventative Botox can work under the right circumstances, for others it felt like another thing we may have to keep up with in years to come.

As for me, I think I’ll stick to retinol, SPF, and a good skincare routine for now.