Wellness Resources
What Women Over 50 Need To Know About Botox
Botox can be a powerful tool in your 50s, but how it’s used matters more than ever, and the rules are different than they were in your 30s and 40s.
Full disclosure: I've been getting Botox since I was 37, and it's a major reason why my forehead is relatively wrinkle-free at 56. Generally, I’m very “pro-tox.”
Botox itself isn’t new. It was FDA-approved in 1989 and has decades of safety data. What is new is how practitioners use it for women over 50. If you’re considering Botox (or already get it), here are four things worth knowing:
- Longer-lasting Botox options now exist.
Traditional Botox (onabotulinumtoxinA) lasts 3-4 months. Now, there’s Daxxify (daxibotulinumtoxinA-lanm), a neuromodulator that lasts around six months.
This has pros and cons. The pro: Fewer appointments and less time spent in the chair. The con: If you don’t love the result, you’re married to it for longer.
- Choose a practitioner who understands aging anatomy.
In your 30s and 40s, Botox is mainly used to prevent wrinkles from etching into the skin. But in your 50s, the landscape changes:
- Zoom In: Menopause dries out the skin and drops collagen production. Our brow also lowers, as do fat pads.
Translation: Injecting in the “usual spots” doesn’t work anymore. Find a practitioner who understands aging bone structure, fat distribution, and skin quality (not just someone who shoves you a menu of unit pricing).
- Space out your Botox treatments.
While “Botox resistance” is rare, your body can build up a tolerance if you go too often. Most experts recommend:
- Using the lowest effective dose
- Waiting at least three months between visits
- Avoiding “booster” top-offs two weeks later as a habit
I’m not writing this to scare you. I’m being practical! If you love Botox, protect your body’s responsiveness to it. (Personal note: Though I have been getting Botox for almost 20 years, my face has always moved. I would rather have less than more. I always tell my doctors who inject me: “Don’t freeze my face. When I scowl at my kids, I want them to be able to TELL that I’m actually scowling!”)
- Botox has medical uses beyond wrinkles.
Botox isn’t just for aesthetics. It can help with everything from spasticity (an increase in muscle contractions) to bladder problems, to excessive sweating, and more.
- Science Says: Botox can also help prevent chronic migraines. A 2010 study with 1,384 adults found that those with Botox averaged 8.4 fewer headache days per month.
There’s also emerging research suggesting Botox injections between the eyebrows may help mood and depression. But the science is still very early-stage. Don’t expect your psychiatrist to prescribe Botox anytime soon.
My Rx If You’re Considering Botox
Here’s my advice as someone who’s gotten Botox for nearly 20 years (and whose brother is a world-renowned cosmetic surgeon):
Tip 1) Screen your practitioner.
Ask them how they approach Botox for women in their 50s or above. Green flags include mentions of the brow position, eyelid heaviness, and muscle balance, as well as “lower doses” and “more precise placement.”
Red flags: If they push bargain unit sales or give you a fixed number of units.
Tip 2) Know the risks.
If you have neuromuscular conditions (e.g., myasthenia gravis or ALS), trouble swallowing or breathing, or are considering therapeutic dosing, talk to your doctor. In rare cases, botulinum toxin can spread beyond the injection site.
Tip 3) Avoid flying within 24 hours of being injected.
Right after Botox, the product hasn’t fully bound to the targeted nerve endings yet. Being in the air (where pressure changes and you’re sitting upright for a prolonged time) could increase the chance of it migrating slightly from where it was placed.
To be clear: It’s not dangerous, but since Botox in your 50s is all about small, precise units, better not to risk it!
Bottom line: Botox isn’t “good” or “bad.” It’s a tool. And like every tool, it works best when the person holding it knows what they’re doing.
