Botox for wrinkles - is it harmful?

Botox is injected into your skin to reduce wrinkles. Nowadays, treatment with botulinum toxin A (Botox is a brand name of a supplier of this) seems as normal as a visit to the dentist. Botox parties have even surpassed Tupperware parties in some countries. Partly due to social media, the demand has grown enormously. Also with young people! Which is quite worrying because they often have no idea what they are injecting into their body and what side effects it may have in the short and long term. Unfortunately, in addition to renowned doctors, many botox companies are active without having the right papers. Which increases the risk of complications.

Botox against wrinkles or not?

Personally, I'm hesitant to have a poison (because that's botulinum toxin A) injected into my face. But is this right? What is the latest scientific knowledge about whether or not there are dangers for your body in the long term? You can read all about it in this blog.

What is Botulinum Toxin A?

Botulinum toxin A is a neurotoxic toxin made by Clostridium botulinum, a naturally occurring bacteria responsible for food poisoning (botulism). Of all neurotoxins, this is the most lethal of all known varieties. Just 1 g of pure type A toxin can wipe out a million people, which is why the US military has considered using it as a biological weapon.

Botulinum toxin A as a cosmetic agent

From 1989 botulinum toxin A may be used to treat eye twitching. A Canadian doctor who used it for this purpose found that wrinkles in the forehead also disappeared at the same time. And together with her husband - a dermatologist - offered treatments for this. Plastic surgery 'out of a bottle' was born. As of 2002, botulinum toxin A is an approved agent for cosmetic purposes. For cosmetic applications, a highly diluted version of botulinum toxin is used.

Botox, produced by Allergan Pharmaceuticals, is the patented form of botulinum toxin A and is the most well-known brand on the market. Other well-known brands are Dysport, Azzalure, Vistabel, Bocouture and Xeomin.

Does Botox Work?

Botox certainly works to create a tighter face. It interrupts the release of the neurotransmitter acetylcholine that controls muscle reflexes. Without this neurotransmitter, a muscle is effectively paralyzed. If you can't get muscles to move for a period of time, lines and wrinkles are smoothed out. A botox injection is used against, among other things, front wrinkles, forehead wrinkles, crow's feet (the fine 'smile lines' at the corner of your eye), drooping corners of the mouth and wrinkles on the chin. New (social media inspired) trend is to use botox to make your face look smaller and more oval. The effect of Botox is temporary; between three and eight months. Then the poison has been broken down by your body and the paralyzing effect on a muscle disappears.

Is Botox Safe?

Opinions are divided whether the use of Botox is safe. Experts say only a small amount of poison is injected into the body at a time. Which eventually leaves the body again - which you notice by the fact that the effect of the treatment decreases after a number of weeks or months. The long-term effects of (long-term) use of Botox are not known. It will be used as a cosmetic for 'only' 20 years.

Botox moves around the body

Recent research from the University of Wisconsin-Madison indicates that contrary to the assumption that Botox stays at the injection site, it is able to move between nerve cells - to move around. This study was with mice, but it is quite possible that the same process takes place in humans. Further research should reveal this.

As early as 2009, the U.S. Food and Drug Administration (FDA) issued a safety alert, stating that the toxin "may spread from the area of ​​injection to produce symptoms of botulism," such as muscle weakness and difficulty breathing that may appear hours or weeks after an injection. can occur. Botulinum toxin is a poison that acts on nerve impulses. In the longer term, muscle complaints or muscle relaxation could occur.

What I know from the cosmetics and food market is that it was also thought for a long time that small amounts of synthetic preservatives in cosmetics and food are not harmful to you. It is now known that all those little bits accumulate in the body - do not leave the body - and can indeed cause complaints in the long term.

Side effects and complications

There are also various possible side effects known, which, however, do not occur in everyone. Such as dizziness, itching or the appearance of swelling and hardening. This is because the body reacts to the foreign and toxic substance butulinum toxin, which is introduced. Headaches and possibly a drooping eye (due to anesthesia of a small eye muscle) can also occur. (Part of) these side effects usually disappear over time - just as the Botox injection itself wears off after some time.

Complications can occur if the injection is injected too deeply or in the wrong place. For example, a drooping eyebrow, eyelid or corner of the mouth. Usually this goes away after a while. Long-term use of Botox in the same area can thin the underlying muscle, making the skin appear less thick (and it naturally thins as we age).

Wrinkles from botox

Did you know that you can even cause wrinkles by using Botox? After the treatment against frown lines, other muscles in your face try to make a frown. Doing this repeatedly can cause (new) wrinkles.

Everyone the same face?

Tight skin, full lips and emphatic cheekbones. Women all over the world seem to look the same on social media. Using botox and fillers. The threshold for an intervention is getting lower and lower. This is evident from the fact that the number of cosmetic procedures in the Netherlands has grown by more than 15% between 2016 and 2019! And in 2008, 3.1 percent of young people in the Netherlands were treated with Botox or fillers. In 2017 it was more than double - 8 percent.

Is that ultimately what we want? Everyone the same ideal of beauty? And more and more young people who suffer from 'body shaming'? Fortunately, there are also dissenting voices. The Netherlands' most famous social media star Monica Geuze released the book 'Unreleased' in 2021. In which she very daringly places the perfect Insta photos next to Reality photos. To show the difference between Instagram and the real world.

Cosmetic doctor and researcher Tom Decates advocates raising the age limit for cosmetic procedures from 18 to 21 years. He finds the strong increase among young people of this type of procedure worrying. It is a vulnerable group.

Big Business

The fact is that Botox is big business for the pharmaceutical industry. In 2001 the turnover was 'only' 300 million dollars. Already 1.3 trillion in 2015! Given that cosmetic procedures such as botox and fillers are becoming increasingly popular, this turnover will only have increased. For manufacturer Allergan, the production of botox accounts for half of the total turnover. Given the financial interests, there will therefore certainly be lobbying to nip any negative sounds in the bud.


Because the idea of ​​deliberately injecting poison into your body. And the fact that the treatment is still relatively young - so little is known about possible negative long-term effects - Botox is not my cup of tea. Even though I'd rather have less than more wrinkles. I wouldn't be surprised if botox doesn't just stay in the treated area after injection, but goes further into the body. The mere fact that the toxin has been broken down by your body after a number of months and is eliminated seems to indicate this. Moreover, you are not done with a treatment. For a lasting effect, you must repeat the treatment every three to eight months. So you keep injecting a little poison.

I still prefer Cosmetic Acupuncture or Natural Face Lifting as an alternative rejuvenation treatment method. Even if a treatment takes longer than 'putting an injection'. And the effect of this is less 'instant'. But of course! In the case of Cosmetic Acupuncture based on ancient knowledge of Chinese Medicine. And at Natural Face Lifting on in-depth knowledge of muscle, bone, tendon and connective tissue.

If you go for Botox, do it with a certified and skilled cosmetic doctor (KNMG), dermatologist or plastic surgeon who is affiliated with a professional association such as the NVCG, NVPC or NVCD. The treatment is certainly not without risks. Certain health complaints / symptoms are a contraindication. A well-trained practitioner is not an unnecessary luxury! It is not for nothing that the complication consultation hours at Erasmus University are well attended.

Sources:,,,, rxlistcom,,, medical,, Esthe Jan/Feb 2022, NRC 'everyone the same face' Nov 2021