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JAMA Dermatology Addresses Prejuvenation

Posted: October 8, 2013

Is it ever too early for botulinum toxin type A? A new article about the preventive use of cosmetic procedures to freeze the aging process may raise a few eyebrows—at least for those who haven’t had too many botulinum toxin type A shots.

The commentary, published online on JAMA Dermatology, states that it is “rarely too early” to start the “conservative and thoughtful use of neuromodulators, fillers and noninvasive energy-based treatments.” Critics of the concept, on the other hand, point to the potentially exorbitant cost of starting such procedures in early adulthood.

“It’s been clearly shown for a long time that frown lines, forehead furrows and crows’ feet are due to repetitive folding of skin from normal expressions,” says Kenneth Arndt, MD, a Boston-area dermatologist and co-author of the piece.

Arndt says many people in their 40s, 50s and 60s attempt to fix these wrinkles and folds once they’ve developed. But by injecting earlier, people can keep them from ever happening.

“If you slow down the use of these muscles beginning early in adult life, the lines never develop,” he says. “Rather than going backward and fixing something that’s there, you can inhibit it from starting in the first place.”

Arndt, a dermatologist and an adjunct professor of surgery at Dartmouth Medical School, points to a handful of studies to back this up, particularly a 2006 study involving identical twin sisters, one of whom used botulinum toxin type A regularly for 13 years and the other who did not.

“The study shows pictures of them 10 to 15 years later and one has a smooth and attractive forehead and the other has the expression lines you’d expect with someone with normal aging,” he says.