Why are people in their 20s getting preventative Botox? Dermatologist answers
Freeze your muscles now, skip the wrinkles later. It sounds like smart planning, and it's everywhere. On a recent episode of All About Her, Dr Hassan Galadari asked the question few people are asking: what if starting early is the mistake?
The conversation was meant to explore skin longevity for women in their forties, but it quickly turned to the injectables craze among younger adults. His verdict was refreshingly blunt.
The panadol problem
The big promise of "preventative" Botox is simple: freeze the muscles early, and the wrinkles never arrive. Dr Galadari calls this a myth. Starting botulinum toxin in your late teens or early twenties, he says, will not stop lines from showing up later in life.
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His analogy is hard to forget. It's like taking a Panadol on Tuesday because you suspect you might get a headache on Wednesday afternoon. Medicine works when the symptom is there, not days before it.
Why your body prefers the easy route
There's a second concern beyond wasted money: the way our bodies respond to shortcuts. According to Dr Galadari, the body is naturally "lazy." Give it artificial help before it needs any, and you risk dampening its own regenerative processes.
The same logic applies to collagen biostimulators such as poly-L-lactic acid. Young skin already makes plenty of collagen. Injecting stimulators on top of that can lead the body to scale back its own production and lean on outside intervention, which can ultimately produce unnatural results.
So why the bad reputation?
Don't mistake this for an anti-Botox rant. Dr Galadari is clear that Botox and fillers aren't inherently bad products. Their tarnished image comes from how often they're abused.
In a culture of instant gratification, over-injecting is easy to do. The results are familiar: frozen expressions, a face that can't emote naturally, and the dreaded "pillow face." His answer is a better kind of practitioner.
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A responsible dermatologist, he says, should act as an ethical gatekeeper and know exactly when to say no.
The skin health pyramid
Dr Galadari offers a simple framework for deciding where to invest your time and money. Think of it as a five-level pyramid, and start at the bottom.
Level 1: The foundation
Healthy lifestyle choices: good nutrition, regular exercise, quality sleep and managing stress.
Level 2: Daily topicals
Consistent sun protection is your primary anti-ageing shield, supported by actives like retinoids or antioxidants.
Level 3: Skin refreshers
Chemical peels are an effective, cost-efficient way to exfoliate and brighten.
Level 4: Energy devices
Non-invasive options such as microneedling with radiofrequency, or lasers, improve texture and boost collagen.
The peak (Level 5): Injectables
Botox and fillers sit at the top, with surgical options coming last of all.
The point of the shape is that the peak is small for a reason. Jumping straight to injectables in your twenties skips the layers that do the heavy lifting for long-term skin health.
When botox actually makes sense
According to Dr Galadari, botulinum toxin should be reserved for patients who have visible dynamic lines (the creases that appear when you move your face) that genuinely warrant treatment. Not a theoretical future line. A real one, today.
The real goal isn't 25
For women in their forties, he says the aim isn't chasing perfection or looking 25 again. It's supporting your skin so it looks like the healthiest, most natural version of itself.
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That might be the most useful takeaway for readers of any age. Before you book the injections, check your foundations:
- Are you sleeping enough?
- Wearing SPF daily?
- Using products that suit your skin?
Master those, and you may find the pyramid's peak is further away than social media would have you believe.