If I had a dollar for every time someone asked me what the best cream for getting rid of wrinkles is, I'd probably have around... $50. (Please, I don't have that many friends.) The short answer to the question is, there isn't one. The longer answer is that your best bet is a combination of sunscreen, retinol, and dermatologist-backed skin care. (SkinMedica's TNS Essential Serum is the closest thing there is to a fountain-of-youth solution sans needles, in my opinion.) But real talk? Only Botox and fillers will actually make lines completely disappear. And that's frustrating if you don't like the idea of injecting a muscle-paralyzing toxin (or anything else) into your face.
But if you can get behind microneedling, which involves poking teeny-tiny superficial holes into the skin to stimulate collagen production and help the active ingredients in your products penetrate deeper (and only feels mildly tingly), there might be a workaround to getting the effects of Botox without going the traditional route. It's called the Botox facial. And after four very curious friends all messaged me the link to the video below, I reached out to Lisa Goodman, PA, of GoodSkin Los Angeles, to ask what the hell she's doing with that cute little stamper.
The tool, Goodman says, is essentially a sterile, gold micro-needler with a reservoir on one side to hold whatever customized ingredient cocktail she mixes for the patient's needs. Sometimes, that's a Skinceuticals serum or vitamin C; often, it's Botox or hyaluronic acid — or a blend of both. With each "stamp" of the tool, the cocktail gets pushed in at the dermal level, rather than the muscular level. (Now is an important time to note that this is an off-label usage of Botox that has not been FDA-approved.)
"Think of this like a super-upgraded facial — a facial on crack," explains Goodman. "We’ve always known that when we inject at a muscular level, it makes the skin better... This is [that knowledge] reimagined." By that, Goodman means she and many others in the field have observed that in addition to targeting deep wrinkles by freezing the muscle, injecting Botox can have some other welcome benefits, like decreasing oil production, easing rosacea-associated redness, improving skin texture, and making pores appear smaller. There is one downside: Botox for muscle retraining will last about three to four months, while this requires monthly or bi-monthly visits with fewer units.
Still, it sounds too good to be true, right? Maybe, maybe not. The doctors I asked to weigh in are very divided.
S. Manjula Jegasothy, MD, board-certified dermatologist and CEO and Founder of Miami Skin Institute, doesn't advise this use of Botox, saying, it "has never been studied, and therefore, the degree of penetration, dosing, and efficacy is very uncertain. In fact, many expert Botox injectors believe that the very narrow space where the muscles connect with the dermis is the optimal place for Botox to be injected. Reaching that exact space by an inexact process such as microneedling is unlikely." However, Dr. Jegasothy says microneedling hyaluronic acid is common as an alternative to injecting, and can improve hydration, plumpness, and firmness to a degree.
On the other hand, plastic surgeon Matthew Schulman, MD, disagrees with using Botox or hyaluronic acid for microneedling. "While there is some evidence that topical Botox may improve the appearance of the skin, there is nothing to suggest that using microneedling to direct it into the skin would have the same result. My concern is that the microneedling process will denature the Botox particles, thereby rendering them ineffective. The same is true for filler; in order for filler to be effective, it must maintain its structural integrity," he says.
But board-certified dermatologist Bradley Bloom, MD, has been using what he calls a "microdroplet technique" to inject neurotoxins and hyaluronic acid for years. He's published studies in the Journal of Dermatologic Surgery which he says show the effectiveness of the technique at improving redness and flushing, slowing oil and sebum production, and giving smoother texture, though he admits that "the mechanism by which it works is unclear, but likely has to do with inhibiting the release of chemicals that cause blood vessels to dilate and the effects on the muscles around hair follicles and receptors on the oil glands."
So, while it may be a bit too soon to officially declare the Botox facial the skin-perfecting treatment of the future, it is giving us hope that doctors are looking for ways to make office visits
a whole lot less painful. Trypanophobics, rejoice!
a whole lot less painful. Trypanophobics, rejoice!