The truth about Botox

Contemporary evil or life-saving godsend to women on the wrong side of 30? Eve Cameron sorts out the myths from the facts

Botox is a bit like Marmite – you either love the stuff or you hate it (or at least the idea of it.) It has generated more column inches than any other non-surgical cosmetic technique, a good deal of it bad press, yet remains one of the most popular anti-ageing treatments here and in the US.

Botulinum toxin

If you're not familiar with how it works, the toxin (Botox is botulinum toxin) is injected into the facial muscles, weakening them so they can't continue to move and crease the skin – repetitive movement, such as frowning and squinting causes lines to develop over time. Botox works best on horizontal and frown lines on the forehead and also on crow's feet, both softening the lines that are already there and preventing new ones developing. It doesn't work well on older skin where muscle tone is slack. Some doctors are now also injecting it at the sides of the mouth to make downturned mouths turn up, though this is a relatively new technique and, in the wrong hands, comes with a risk of drooling!

Disfigurement

What of those stories of disfigurement and of the toxin migrating to and being stored in the liver? Could they be true?

Permanent disfigurement with Botox is impossible as it leaves the body after to two to four weeks, with the effects on the muscles lasting on average around four months – that's why if you like the effect of the treatment you have to have regular top-ups. However more temporary negative effects, such as droopy brows and a frozen look are possible. This is not about the Botox itself, however, it's about who's administering it. The first time you have it done you should ask for the minimum amount

'You only get droopy brows and a frozen look if your practitioner gives you too much or puts it in the wrong place' says Dr Patrick Bowler, author of 'The Nervous Girl's Guide to Nip & Tuck' (£7.99, Harper Thorsons) and Medical Director of Court House Clinics (0870 850 3456 www.courthouseclinic.com). He's of the 'less is more' school of thought and suggests that the first time you have it done you should ask for the minimum amount. Then, have a top-up a month later if it hasn't softened your lines enough (agree this as part of the initial fee, which start from around £200). Harrowing though it might be, any droopiness around the eyes should wear off after two weeks or so.

Regulations

As things stand in the UK, Botox needs to be prescribed by a doctor, dentist or nurse, but they can then delegate to someone else (trained and experienced one hopes) to inject it. More regulation is due next year, but in the meantime, it can be tricky to know what you're getting. For this reason, if you are interested in having Botox, personal recommendations are best. Always go to a practitioner with plenty of experience too. You can also check out the Healthcare Commission's website www.dh.gov.uk for clinics and individuals who are registered with it, plus pick up a few tips. Another good source is www.cosmeticdoctors.co.uk

There's no doubt that Botox is a quick fix for wrinkles and it has a lot of short-term safety data to back it up. As for its long-term effects, a study in the US found that in subjects who had been having treatments for 10 years, there was no effect on the liver, nor did it, as sometimes reported, cause muscles to wither. Although with recent concerns of the long term side effects on the brain, the jury is definitely out scientifically. Will it do you any good? The choice, dear reader, is entirely yours.