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What is botulinum toxin for facial wrinkles?

The first signs of aging are often wrinkles around your eyes, forehead, cheeks, and lips. Wrinkles are a normal feature of the human face. But many people feel wrinkles make them look tired or older.

To reduce the appearance of wrinkles, some people choose to have injections (shots) of botulinum toxin. These injections are often called by their brand names, such as Botox®, Dysport®,  Xeomin® or Jeuveau™. The injections relax certain muscles in the face, and certain wrinkles become less noticeable for a period of time.

How does it work?

When botulinum toxin is injected, it blocks certain nerve signals that make muscles contract. The muscles relax, reducing unwanted wrinkles. This effect lasts about 3–6 months. After that, the muscles move again and wrinkles come back.

When will you notice?

Within the first week of your treatment, you should notice your muscles begin to relax and fewer facial lines and wrinkles. This effect wears off in about 3–6 months. You may be asked to come back after two weeks for a review, and possible top up.

Types of wrinkles

There are two types of wrinkles: dynamic wrinkles and very fine lines and wrinkles.

Dynamic wrinkles are caused by facial muscles that move when you smile, laugh, and squint. These are often around the lips, on the forehead and between the eyebrows. They are also the “crows’ feet” at the corner of your eyelids. Everyone is born with dynamic wrinkles. As you age, these wrinkles get deeper and easier to see. Botulinum toxin can be used to make these dynamic wrinkles less noticeable.


Very fine lines and wrinkles are formed when collagen in the skin starts to thin. Collagen is protein just beneath and within deep skin layers. Aging and sun damage cause collagen thinning. It makes the skin on your face stretch and sag, creating fine wrinkles. Botulinum toxin does not erase fine lines and wrinkles. However, there are other ways to reduce their appearance.

Who can get botulinum toxin injections?

You need to be healthy and at least 18 years old before you can get botulinum toxin injections.

Some people should not get botulinum toxin. They include those who:

  • have a neuromuscular disease (such as multiple sclerosis or myasthenia gravis)

  • are pregnant or nursing

  • have weakness in certain facial muscles

  • have ptosis (drooping eyelids), deep facial scars, or uneven facial features (when features are not the same on both sides of the face)

  • have skin problems near the injection area


If you are deciding to get botulinum toxin injections, tell your highly trained therapist about your medical history and all the prescription medicines, vitamins, and herbal supplements you take.

Side Effects:


While botulinum toxin injections may help, they sometimes cause side effects or other health problems. Common side effects include:

  • headache

  • eye rednesstearing, or irritation

  • redness or bruising in the injection area. This is more likely to happen if you take aspirin or blood-thinning medicine. 


Drinking alcohol 24 hours before treatment also increases redness and bruising.


A less common but more serious side effect is ptosis (drooping eyelids). This can make it hard to see.

Ptosis should go away when the botulinum toxin wears off in a couple of months, depending on where the Ptosis is, it may be reversible.

To help reduce the possibility of side effects, your therapist may recommend using eye drops after a botulinum toxin injection. You may also be asked to sit upright (not lie down) and avoid pressing on the treated area for about 4 hours after the injection. No massaging for 3 days.

Also, your therapist may recommend you not exercise for 24 hours after treatment, avoid saunas, steam rooms, sun beds and sun bathing for 3 days.

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