Teen Wrinkles: Is Botox Appropriate for Teen Agers?

A recent article on abc.com concerning Botox use in teen age girls was somewhat alarming, but not surprising.

As with everything related to teenagers, there is continued pressure to do more, and to do it earlier.

You can fill in the blank here -- from drinking to drugs to sex to alcohol -- for eons teens have been creating a demand for those vices mostly left for adults.

But is Botox a vice?

Let's put aside medical necessity for a moment and focus on just the idea of catering to your teen's wants and desires.

If little Jane wanted something..."really really bad"...would she automatically get it?

Now before anyone here immediately jumps to the conclusion that "none of my girls are getting Botox" let me assure you that it's not that simple.

You only have to hang around my office for a day and see tattoos in 16 year olds, piercings in tongues, noses, and yes, labia's in 15 year olds, and very UVB florescent light bulb induced tanned 14 year olds.

Yes, just so you know, parents have a tendency to say yes.

My suspicion is young teen age girls can be a very convincing lot.  I have one, a young teen age girl that is, and she can create a very good argument on most issues.

Fortunately for now I'm good at holding strong to my opinions too.  The fruit doesn't fall far from the tree.

So you see it's not really a stretch to put Botox in the same category as these other body manipulations or treatments.

As for medical necessity, well that's another matter.

Botox, or botulinum toxin, for those that have missed the craze that has become the most popular cosmetic procedure in America, is a poison that is injected into facial muscles to induce temporary paralysis or weakening.

Sounds bizarre and dangerous, but it's really not.  It's so simple and relatively risk free that most people can have it done over the lunch hour and no one will ever know.

It's painless, most of the time "bruise less", and the results are gradual over a few days to a week.

You just start to get that "rested look" as the week goes on.

The primary use for Botox is for glabellar (between your eyes), forehead, and crow's feet wrinkles.  And it works exceptionally well here.

Cost is minimal compared to many other cosmetic procedures, but its effects are temporary in that you will require another treatment in 3 to 4 months.

How much?

It varies, but a good guess is about a $100 per month per area.  That is, for your forehead and crow's feet it might be about $400 every 3 or 4 months depending on how much medication is required to achieve the result you want.

The use of Botox though has expanded to other "off label" uses including softening of smoker's lines, correction of gummy smile, and treatment of bunny lines. 

So for teenagers you might wonder where is the clinical necessity?  I mean, as a group they don't suffer from glabellar rhytides or smoker's lines.  Right?

But there is another direction that Botox has taken over the last several years, and that is in the realm of "wrinkle prevention."

Now this may sound bizarre, but it actually makes some sense.

Here's how Botox used to work:  a woman would adamantly state that "I'm never having Botox."  At about age 35 there would be some accidental encounter with either an old high school boy friend or a 10x makeup mirror and a dermatology emergency would be created.

"I can't have this!"

"Why do I have this!"

A nice dermatologist in a black t-shirt would show compassion and understanding, "You're 35 dear.  It always happens at 35."

This would not be taken well by the patient.  Just for the record.

So Botox would now become a necessity and not a luxury or something that she "would never do."  It happens every day, read: every day, in our office.

But the story doesn't stop here.  I wish it could be so easy.

For most women, Botox is a miracle drug.  The wrinkles just fade away over a few days and now the old boy friends and makeup mirrors are much easier to face.

But for some, the results are not as dramatic.  As permanent vertical lines or wrinkles are imprinted on your skin, they may be softened but not erased by the cosmetic injection.

They just don't disappear.

This can be an alarming reality for many women who feel that modern medicine can fix anything.  And for many cosmetic problems, we can.  But it may be more complicated than a five minute Botox injection.

So this brings up the whole idea of "wrinkle prevention."

If you intervene early, weaken the muscles that are creating the permanent lines and wrinkles, can you obviate these cosmetic concerns as a person grows older?

This is the million dollar question -- and yes, it is a million dollar question because that is what is spent (hundreds of millions really) on this approach every day.

Women are coming in earlier and earlier even before wrinkles form to treat areas that are potential areas of cosmetic concern.

So this is the driving force for most teens.

It's just a natural course that these procedures have moved from those in their thirties, to the twenties, and now to the teens.

But is it appropriate?

Well for me, I don't think so.  Could you make some sort of credible medical argument?  Maybe.

Can you convince me?  Probably not.

My view of the world is that teenagers need to grow a few wrinkles.

Wrinkles show age and wisdom.  That might help you know you really shouldn't get your tongue pierced.