Is there an alternative to Botox?

Botulinum toxin injections today are one of the most popular cosmetic procedures in the world. In 2017 alone, more than 3 million injections of botulinum toxin preparations were administered in the United States. However, despite the ever-increasing popularity of the procedure, a huge number of people are looking for alternatives to Botox.

There are many reasons for this. Home - fears of side effects. The active ingredient of Botox (or its analogues, for example, Dysport) is botulinum toxin - a natural poison that temporarily paralyzes the muscles and this ensures the effect of the disappearance of wrinkles. The very idea of ​​voluntarily injecting yourself a poisonous substance scares many.

Further, the cosmetological use of botulinum toxin is associated with a high risk of side effects that can persist for several months.

Finally, the cost of injections is quite high, especially considering the need for regular injections.

It is not surprising that many patients justifiably want to find an alternative that, with greater safety, will provide a similar effect.

On the other hand, it is not always botulinum toxin that is needed to obtain a particular result. Botox is used to eliminate facial wrinkles that appear due to muscle contraction. These are wrinkles on the forehead, between the eyebrows, in the corners of the eyes and lips.

When wrinkles appear, for example, due to sagging skin, fillers with hyaluronic acid and some other fillers are used.

Without understanding these features, many people consider such fillers to be Botox substitutes, which is completely wrong. Indications for both procedures are significantly different, and when one is needed, the other will be ineffective or generally useless. It is the same with other techniques. All means have their own indications, different mechanisms of action and, accordingly, provide different results.

In fact, today botulinum toxin is almost the only remedy that allows you to completely eliminate facial wrinkles. It acts directly on the subcutaneous muscles, while other drugs affect only the skin. Without injections, you can reduce surface wrinkles, but if you need to remove deep folds provoked by constant muscle tension, there are practically no alternatives to Botox.

Let's see in what cases Botox and its analogues are needed, and when it is worth using other methods and drugs.

On a note

Do not confuse the terms Botox and Botulinum Toxin. Botox is a drug of the pharmaceutical company Allergan, the active substance of which is botulinum toxin. In the early 1990s, when the ability of botulinum toxin to eliminate facial wrinkles was revealed, the company significantly increased the production of the drug and made it its brand. As a result, today many people use the word “Botox” to mean all botulinum toxin preparations, as well as injection procedures for introducing these drugs into the muscles. Because of this, such absurdities as phrases such as “Botox Dysport” and the like are often found. Speaking further about alternatives to Botox, we will consider precisely means and methods that have a completely different principle of cosmetological action. Botox analogs - Xeomin, Dysport, Mioblok - as alternatives, we will not discuss here.

 

Why in some cases Botox is practically irreplaceable

Botulinum toxin preparations are used to smooth expression wrinkles.Such wrinkles are formed as a result of contraction of the muscles of the face in the expression of various emotions. When a muscle contracts, the skin covering it contracts and wrinkles appear on it.

At a young age, when the skin is sufficiently elastic, it quickly recovers after such wrinkling. With age, this ability decreases and visible skin defects form in the folds. Moreover, in the early stages, if the muscle is completely relaxed, these defects almost completely disappear. For such relaxation in cosmetology, botulinum toxin preparations are also used.

If wrinkles are severely launched, and even when the muscles are completely relaxed, strips remain in their place, in addition to Botox, various preparations are used to promote skin regeneration and eliminate such defects.

So, in cases where wrinkles are caused by a constant contraction of facial muscles, not a single remedy, except for the botulinum toxin preparation, will allow such wrinkles to be removed. After all, no matter how clean and well-groomed the skin may be, the muscles contracting under it will still form wrinkles. The only way to get rid of these defects is to eliminate their cause, that is, immobilize the muscle and eliminate its contractions. Only Botox and its close analogues can cope with this task.

Botulinum toxin is one of the most powerful neurotropic poisons. In large doses, it causes disturbances in the functioning of the heart and diaphragm, which leads to death from respiratory failure. In cosmetology, very small doses of botulinum toxin that are safe for life are used. During intramuscular injections, the drug enters directly into the muscles of the face, neck or decollete and affects only the nerve cells associated with them, and practically does not enter the blood.

The principle of action of botulinum toxin is that it blocks the transmission of nerve impulses from the brain to muscle fibers, which makes their intentional or involuntary contraction impossible. This leads to temporary muscle paralysis.

After about 6-9 months, the effect of botulinum toxin on the muscles stops due to the appearance of new neuromuscular synapses. Mobility returns to the muscles, and wrinkles reappear on the skin when expressing emotions. Therefore, botulinum therapy should not be considered a panacea, which will permanently get rid of wrinkles. To maintain the effect of the injection will need to be repeated regularly.

 

Cases when botulinum toxin preparations are difficult to manage

Understanding the principle of the action of botulinum toxin, it is easy to figure out in which cases it will be the main means of correcting wrinkles. Such cases include:

• Horizontal and vertical forehead wrinkles;
• "Rabbit" wrinkles appearing on the back of the nose when expressing anger;
• Wrinkles between the eyebrows and on the nose;
• Small wrinkles in the eye area;
• Wrinkles above the lips and chin;
• Wrinkles on the neck and décolleté;
• Defects in the location of the lips when the lower or upper lip is raised;
• “Gummy smile” when, smiling, a person unintentionally exposes the upper gum.

Also, with the help of botulinum toxin, the severity of fresh scars is sometimes corrected (for example, after surgery), but this application is not related to wrinkles.

For medical purposes, botulinum toxin preparations are used to treat serious illnesses. For example, they can be shown with:

• Blepharospasm - drooping eyelids as a result of tension of the circular muscles of the eye;
• Hemifacial spasm - asymmetric curvature of the face due to contraction of large facial muscles;
• Hyperkinesis - sudden involuntary muscle contractions;
• Nerve ticks;
• Spastic crank;
• Hyperhidrosis - increased sweating in the area of ​​the armpits, feet and palms;

• Paralytic strabismus;
• Cerebral palsy;
• Asymmetries of the lips caused by hyperactivity or paresis of the masticatory muscles;
• Migraine.

With blepharospasm, Botox allows you to relax the circular muscle of the eye, the tension of which causes the lowering of the eyelid, but it is important not to completely immobilize it. In this case, the effectiveness of treatment directly depends on the professionalism of the doctor. He must correctly calculate the dosage and the injection site so that the muscle is not completely paralyzed, but relaxes to the right extent.

The use of botulinum toxin with paralytic strabismus allows you to solve the problem without the use of surgical methods.

In patients with frequent migraine attacks, Botox can reduce the symptoms of the disease. The drug prevents muscle strain and blocks receptors that transmit pain signals, thereby reducing the power of attacks. However, Botox migraine does not cure and does not eliminate its causes, but acts only on the symptoms.

 

Individual cases when botulinum therapy can be replaced by other methods and means

At the same time, in some situations, botulinum therapy, indeed, can be replaced by other cosmetic methods. And sometimes it is not at all a suitable solution.

So, with the appearance of gravitational and age-related wrinkles, Botox is ineffective. Gravity wrinkles appear due to sagging skin as a result of sudden weight fluctuations (for example, with rapid weight loss), aging and weakening of the skin tone, due to a hereditary factor, exposure to ultraviolet light or insufficient skin care. An example is nasolabial folds, small wrinkles in the corners of the mouth and eyes.

Similarly, age-related wrinkles that appear as a result of natural physiological processes in the body in any area of ​​the skin cannot be corrected with botulinum toxin: muscle relaxation will not affect the condition of aging skin.

Alternative means should also be sought if necessary to eliminate such defects:

• Dents on the skin caused by thinning of the underlying layers of the dermis - in this case, fillers help, especially biologically active ones, stimulating the reproduction of fibroblasts;
• Change in face shape - contour plastic is required here;

• The appearance of age spots;
• Wrinkles not caused by facial facial muscle contractions. For example, puppet wrinkles, superficial “dry folds” (peeling helps with them), lacrimal groove.

It is important to understand that in some cases, attempts to use alternative methods instead of Botox can not only not give the desired effect, but also exacerbate the situation. For example, if you try to eliminate deep facial wrinkles, for example, fillers, these defects will become even more pronounced, since the skin will be more "luxuriant" and muscle contractions under it will be especially pronounced.

 

Effective Botox Alternatives

So, we found out that talking about alternatives to Botox is almost pointless. Botulinum toxin is used in cases where other means and methods are almost useless and cannot be replaced if wrinkles are caused by facial expression of facial muscles.

Therefore, when talking about alternatives to Botox, means and methods, they mainly understand the technologies that are used when the introduction of botulinum toxin is inappropriate.

The most famous among them are fillers. These are skin fillers that are injected into the skin to reduce the depth of wrinkles caused by age-related changes, loss of skin elasticity, its drying out and lack of certain substances.

Fillers are used in the nasolabial and parotid folds, nasolacrimal groove, earlobe, to eliminate wrinkles around the eyes and on the back of the nose (the so-called crow's feet and rabbit wrinkles), on the neck and in the decollete.

Also, fillers allow you to slightly increase the volume of the lips, adjust their shape, as well as the shape of the chin, cheekbones and the general oval of the face. In cosmetology, fillers based on hyaluronic acid, collagen, L-lactic acid, calcium hydroxyapatite, polymethyl methacrylate microspheres are used.

The effect of filler injections lasts on average as long as it does from Botox injections - 5-9 months, depending on the individual characteristics of the patient. Sometimes botulinum therapy and the introduction of fillers are carried out in parallel, for example, when, you need to eliminate facial wrinkles on thinned skin.

To eliminate superficial wrinkles, the depth of which does not reach the middle and deep layers of the skin, peeling is used. At home, you can conduct surface peeling using scrubbing agents that are easy to buy at the pharmacy. Such scrubs cleanse the skin and improve its appearance, but wrinkles do not remove. To eliminate superficial wrinkles, chemical or laser peeling is used - procedures available only to a cosmetologist.

For chemical peeling, various acids are used, which remove the upper layers of the skin and activate natural regeneration processes, including enhancing the production of collagen and elastin. As a result, wrinkles are reduced due to the renewal of the epidermis and dermis.

A similar effect is provided by laser peeling. Its feature is greater accuracy of exposure and less traumatic.

The most powerful is hardware peeling - dermabrasion. This procedure is painful and requires more time to restore the skin. Apply it to remove tattoos, scars and age spots.

Another method is non-surgical lifting. Depending on the type of procedure, the internal layers of the skin are exposed to light energy, a laser or a high-frequency current. As a result, the production of collagen, elastin and hyaluronic acid increases, which increases the elasticity and firmness of the skin, and also leads to some smoothing of wrinkles. These procedures are painless and not traumatic. To achieve the effect, on average, 4-8 procedures are needed, which are carried out with a frequency of slightly less than a month.

Nanoperforation is carried out on a special apparatus and involves exposure to the skin with a narrow beam of laser radiation. The device scatters a laser beam into many microscopic beams. They create very small lesions in the inner layers of the skin, to eliminate which collagen and other substances responsible for the health and beauty of the dermis begin to be intensely produced. As a result, this procedure reduces the depth of wrinkles and improves the overall condition of the skin.

In some cases, mesothreads are most effective. These are special fibers that, through small incisions, are placed in the epidermis during sagging skin and to correct facial contours. The cosmetologist makes small incisions in the target areas and places mezzanines there, after which he smoothes them with a special device. Threads have a rough surface, so when smoothed, they “cling” to skin cells and pull it up. Incisions are made with the finest needles, and after the procedure, there is no trace of surgical intervention.

Most often, mesothreads are used to eliminate wrinkles in the neck and nasolabial folds.According to cosmetologists, this method in some cases can really replace Botox injections.

Phototherapy is sometimes considered an alternative. It provides for exposure to the deeper layers of the skin with intense flashes of light. This procedure is used both to smooth wrinkles, and to restore skin elasticity, remove age spots and capillary stars. The intensity of the used LED light is much lower than that of a laser, but this technique is not inferior to it in efficiency. The mechanism of action is similar: after the procedure, the regenerative functions of the skin improve.

Finally, surgical plastics can be considered a really alternative way. This concept combines the most radical methods of eliminating skin defects, including deep wrinkles. They are used when other cosmetic procedures are not effective enough. For example, a surgical facelift is done in the case of the formation of deep age wrinkles with severe sagging skin. However, such plastic surgery is more often accompanied by side effects and costs more than botulinum therapy procedures.

 

Pseudo-alternatives, or remedies that certainly do not replace botulinum therapy

There is a lot of information about the methods that supposedly replace botulinum therapy, including the use of folk remedies at home. As if such methods with complete safety provide the same effect as the use of Botox. However, in reality, such products, if they have a positive effect on the skin, for example, moisturize it and saturate it with useful substances, then expression wrinkles will certainly not be smoothed out. And it is precisely in this that Botox’s task lies.

For example, Botox's ineffective alternatives include:

• Ampoule serums, ointments, creams;
• DMAE-based products;
• Homemade masks based on orange oil and other natural remedies;
• Anti-aging ice;
• Japanese massage.

The effect of botulinum toxin is often attributed to special serums. For example, in the description of the serum GiGi SP Biozon Age Renewal Serum it is said that its components can penetrate under the skin and act on the nerve cells that are responsible for muscle contraction, and thereby contribute to smoothing wrinkles. At the same time, if Botox injections completely eliminate wrinkles, then the instructions for serum only talk about contributing to their disappearance.

On the packaging of intensive whey of Swiss professional cosmetics Pleyana it is indicated that it is an alternative to botulinum toxin. It contains the substance SYN-AKE - a biosynthetic peptide that helps relax muscles and smooth facial wrinkles. In 2006, this pharmaceutical development was awarded the Swiss Technology Prize. During studies of the serum, it was found that it already two hours after use immobilizes muscle contractions by 82%. These studies were carried out in vitro, that is, on tissue samples.

In vivo studies (with the participation of human volunteers) also showed that with regular use for 4 weeks, Pleyan's serum helped to reduce the appearance of wrinkles, but only half (up to 52%). Botox almost completely helps to eliminate medium and deep facial wrinkles and significantly rejuvenate the face. As a conclusion, this serum can be considered as a prophylactic and for the correction of fine facial wrinkles. It cannot serve as a full-fledged replacement for Botox.

The composition of Shary whey South Korean production includes hyaluronic acid.It moisturizes the skin, prevents collagen destruction and accelerates the process of dermis regeneration. The effect, similar to the action of botulinum toxin, is not even mentioned in the instructions for Sheri's serum. It has other properties.

Another remedy that is mistakenly considered an alternative to Botox is cosmetics based on DMAE and other natural ingredients. DMAE is dimethylaminoethanol, a natural component that, when ingested, is converted to acetylcholine. As a result, signaling between nerve cells improves. Botulinum toxin also has the exact opposite effect, blocking the transmission of impulses to the muscles located under the skin area with facial wrinkles.

It’s even less worth counting on the “Botox effect” when using homemade masks, massages and other similar means. In the best case, they can saturate the skin with useful substances and make it healthier, but they are not able to eliminate medium and deep facial wrinkles.

Thus, attempts to find tools that, with significantly less labor and cost would provide the same result as botulinum toxin preparations provide, are almost impossible.

 

When Botox is not needed

Not in all cases, the problem of wrinkles must be solved with Botox. For example, you can (and even need) to do without injections of neurotoxin with:

• Age-related wrinkles caused by thinning of the skin that begins after 40 years;
• Wrinkles caused by a lack of fluid in the skin and subcutaneous tissues;
• Violation of the structure of the intercellular matrix of the skin, which occurs under the influence of age, an imbalance in the production and breakdown of hyaluronic acid, and a lack of nutrients;
• The fight against nasolabial folds, the elimination of the lacrimal groove - large, noticeable formations that are not caused by muscle contractions;
• Elimination of "puppet wrinkles";

• Decreased muscle tone and tension of antagonists, which cannot be denervated;
• Cases when Botox does not work due to individual insensitivity to botulinum toxin, which is observed in 2% of people;
• A decrease in the effectiveness of Botox after several courses of procedures caused by the development in the body of antibodies to certain substances of the drug.

To smooth small and medium depth wrinkles that have not touched the inner layers of the skin, apply shallow peels or fillers. The use of Botox in these cases is impractical.

To remove nasolabial folds, a lacrimal groove or other wrinkles resulting from age-related changes or gravitational ptosis, contour plasty with hyaluronic acid fillers or lipofilling is used. In cases of severe ptosis, a thread or hardware lift may be necessary. These procedures complement each other well and are often used in combination.

As a result, independent attempts to find an effective alternative to Botox are almost always doomed to failure. Not because there are really few alternative means and methods, but because without special knowledge and extensive experience it is not always possible to understand what causes certain wrinkles are caused and how to effectively get rid of them. And many patients even have such a superficial understanding of the problems that cause cosmetic defects that, acting on their own, they are more likely to harm themselves than to obtain the desired result.

Therefore, instead of looking for an alternative to Botox, it is much more reasonable to try to find a good cosmetologist. And he will already be able to find out the causes of the appearance of certain skin problems and will select the most rational, safe and effective way to eliminate them, either with Botox or without it.

 

Botox or fillers? Expert opinion

 

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