Ask The Doctor! When Should I Start Having Botox?

Ask the doctor


Hi Doctor Lalloo.

I was wondering if you could tell me Botox. Is it safe and when would be the ideal time to start having the procedure?

I don’t want that ‘frozen face’ look!

Dr Lalloo: 

Here’s how to do it right at 20, 30, and 40.

Firstly there are different rules for different decades.

Anti-wrinkle injections used to be a procedure reserved for Beverly Hills housewives, but now this treatment, hailed for its minimal invasiveness and drastic results, is very commonplace. And these days, 20- and 30-somethings are depending on the injections to treat and prevent lines and wrinkles.

Now that the procedure is less controversial, I’m starting to see young women view it as a preventative measure instead of a means to treat skin that’s already showing signs of aging.

If that’s the case, when should you get started, and what should you know before going under the needle?

For Starters, Here’s How Botulinum Toxin A Works


Botulinum Toxin A is an FDA-approved drug made up of botulinum toxins that, when injected into the correct facial muscles, temporarily blocks local nerve impulses that trigger contractions. This softens wrinkles and prevents even more lines from forming. As the skin ages, it loses its elasticity and collagen breaks down, so constant muscle and skin contractions can create more permanent creases.

While you can technically get anti-wrinkle injections at any age under a doctor’s supervision, the FDA has only approved it for those ages 18 to 65.

How you face changes in your 20’s, 30’s, and 40s’  and what you should know about getting anti-wrinkle injections

In your 20s:

To prevent wrinkles, some doctors may recommend using Anti-Wrinkle Injections as early as your mid-to-late twenties to reduce facial muscle over-expression, a totally genetic thing.


Many women don’t have wrinkles in this decade, and wearing SPF daily can help keep skin line-free. If you’re considering using Anti-Wrinkle Injections in the future, think of your twenties as a training wheel period: It can actually help you train your facial muscles not to move as much to prevent future skin wrinkling.

Just remember, Anti-Wrinkle Injections will affect the way your facial muscles move in general. This means it might feel funny when you try to make a particular expression. Don’t want that frozen face? Your doctor can use a smaller amount of the botulinum toxin and also inject it more superficially, so it doesn’t go as deep into the skin I avoid the frozen effect, which happens when too much is used. Most women I see in their 20’s are more looking for a refreshing treatment to look less tired and perhaps lift the eyebrows into a more seductive shape.

In your 30s:


This is the decade when you normally start noticing somefine lines developing between your brows and around your eye area. “Botulinum Toxin will soften and even erase many of the finer lines around this age, as long as you continue keeping up with this regimen every 4-6 months or so.

If you’re only getting the procedure to look wrinkle-free for a particular event- your wedding, let’s say—or simply as a feel-good booster every now and then, you can space it out to every six to nine months to save yourself the cost of an appointment.

In your 40s:

At this age, your skin is thinning more rapidly, meaning wrinkles are far more obvious. If you’ve not yet used Botox, your muscles have been contracting for a long time and you might have a few static wrinkles.

Lines are more likely to have become etched in your skin even when you’re not moving the muscles underneath—not just dynamic ones that form only when you move your facial muscles.MTIzMDQ5NjY0NTAxMTU1MzQw

There’s also some mid-face volume loss (aka sagging) at this age, which Anti-Wrinkle Injections can help with, but your skin may not be perfectly smooth afterwards because of the changes in its quality and resilience.

Again, you’ll want to keep up injections approximately every 4-6 months and perhaps consider fillers to replace the lost fat and help lift the middle of the face and hollowed front of the face under the eyes.

The bottom line:

You don’t need Anti-Wrinkle Injections. Wrinkles are a part of the natural aging process, after all. But if it’s something that interests you, discuss it with your doctor, I recommend only ever having them done in a doctors office, I find it amazing that people think nothing of going to a salon to have this done to ‘save money’, would you bring a new born for their vaccines to a salon? Of course you wouldn’t you’d be terrified of doing that, but for some unknown reason Irish women don’t see it this way. Talk to your Doctor, in their registered office so that you can come up with a treatment plan that won’t leave your face looking stiff as a board…

Remember you get what you pay for too.

Hope that helps!

Dr Lalloo FRCS(Ed) MICGP

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Please note that Dr Lalloo’s opinions are based on the information given to him. You should always consult your GP if you have concerns. This does not constitute a doctor patient relationship. MCRN No 019510

To submit a question to Dr Lalloo in the strictest confidence, please email and include ‘Ask The Doctor’ in the subject line.

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About Dr Lalloo:

Dr Lalloo is qualified from the Royal College of Surgeons in Dublin, and has a fellowship in surgery from the Royal College of Surgeons Edinburgh. He is a fully qualified GP with an interest in skin surgery and dermatology. His registered qualifications with the Irish Medical Council are MBBCh, FRCS Edinburgh, MICGP. Dr Lalloo is on the specialist register with the Irish Medical Council.

Dr. Lalloo is a recognised expert in medical aesthetics having established Cosmedics Clinic in 2002 when medical aesthetics was in its infancy in Ireland. He is a member of the British College of Aesthetic Medicine and on the committee of the Primary Care Surgical Association.

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