Is there a 'perfect' age to begin Botox?

Once thought of as a treatment only celebrities used to preserve their look or in many cases look overdone, Botox is now discussed as commonly as getting a facial for anti-aging.

While Botox is now more frequently accepted, a common question I’m asked as a Master Injector & trainer by patients and in social settings: Elisabeth, What age is recommended to start botox treatments?

20’s: There are three factors that determine if you are a candidate for Botox in this age range. Before you instantly start saying, “that’s way too early!” the real determination for when Botox treatments are started does not rely on age; instead there are several other factors to consider.

  1. Hereditary factors & sun damage. Many patients in their 20’s do not have lines at rest, and when I first began as an injector and would see a 20 something year old on my schedule, my first response was hesitation. But, with more experience, I realized just how important it is to consider impact of genetic influence and previous sun damage on skin creasing. I know for myself, I have expressive forehead genes + was a lifeguard for 4 years. This combo = creases in the skin around 25 years old. So I began Botox when the movement lines started to linger after the movement had stopped. ***This is preventative Botox*** Botox at this age does not need to be repeated every 3 to 4 months, instead it can be a once or twice a year treatment, depending on desired results. The benefit of starting at the sign of lines at rest? Those lines are reversible. Another benefit? You do not need to “freeze” the face to reduce these lines. With a conservative treatment, you can create a natural, expressive look while preventing lines at rest. (prevention will make even more sense once you see the 30 year old before and after)

  2. Asymmetry. Most patients who walk through my door have some level of asymmetry. You know what? Asymmetry can absolutely be beautiful. However, when it comes to brow asymmetry, many patients are bothered by this as they spend time each morning penciling in their brow shape to match. In this case, an asymmetric Botox pattern can be used to balance the brows, and this may be started before wrinkles begin. The benefit? Prevention of constant expression worsening the asymmetry over time.

Now the truth is, not every patient in their 20’s is ready for Botox-there are many that do not have static lines/wrinkles at this age and therefore Botox is not the first recommended treatment. Instead, preventative skin care is key. Examples: retinol and consistent use of sunscreen. These will delay the progression of collagen breakdown and therefore slow the aging process.


Top photo: Patient in her 20’s with horizontal forehead lines at rest.

Bottom photo: After one Botox treatment the lines completely resolve.


The guide to this age group is almost identical to the explanation for patients in their 20’s. Overexpressive or sun damaged skin will start to see the advantage of preventative Botox sooner than others.

A common complaint I hear is, “my makeup is caking in my wrinkles.” Although these wrinkles still may not stay at rest at the beginning of the day, patients will notice them by the end of the day. In this case, Botox is like a cast for a broken bone-if you cannot move it, your body has a chance to smooth it out and repair it.


Left photo: 30 Year old patient before treatment with sun damage expediting line formation

Right photo: After Botox with lines softened and a refreshed appearance. Notice, not every line is erased but significantly improved.

Typically in your 40’s-50’s you reach the Botox sweet spot.  It doesn’t matter if you have bathed in sunscreen and taken care of your skin, the effects of repeated expression will begin to pull brows down creating hooding as well as leave wrinkles at rest. After this point the achievement of a reduction of fine lines and movement wrinkles becomes increasingly more difficult. Our cell turnover slows which means lines form more easily. When lines begin to stay at rest as well as become deeper, other procedures may be necessary such as microneedling and chemical peels to reduce these lines.  


Top photo: Patients in her 40’s with horizontal forehead lines and frown lines at rest

Bottom photo: After Botox treatment with softening of lines

When you reach your 60s, many people believe that Botox is no longer an option. This is an incorrect assumption. Sun damage accumulated over the years will become apparent, and lines may be present at rest, but it is possible to prevent the lines from getting worse. At this age, I do not guarantee lines can be erased as each patient’s skin health is different, but I have seen great improvement with diligence and proper skin care procedures.

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Top photo: Patient in her 60’s before Botox treatment with deep frown lines and forehead

Bottom photo: After Botox treatment, slight softening of lines, smoother appearing skin

In general-each face is different. Our sun exposure, skin care routine, and genetics will always play a role in how we age (or how we prevent aging).

The great thing about all of this? You don’t have to be the judge-this is why I offer a FREE facial analysis to determine if Botox is right for you! Call today for your complimentary analysis (615) 267-6300.