Botulinum toxin for cosmetic treatments in young adults: An evidence-based review and survey on current practice among aesthetic practitioners

Abstract

Background: Botulinum toxin A (BoNTA) treatments are popular worldwide. Young adults, less than 41 years of age, are an important cohort of patients seen in practice, and the optimal dosage of BoNTA in this age group remains poorly defined. Aims and Objective: To determine the optimal dosing of BoNTA across different age-matched cohorts by reviewing the literature and to evaluate current BoNTA practices among aesthetic practitioners when treating younger versus older adults. Methods: An evidence-based literature review was performed to evaluate the current evidence on BoNTA injections for cosmetic indications in millennials (born between 1981 and 1996) and young adults. A cross-sectional online survey was distributed to aesthetic practitioners to assess their current practice with BoNTA. Results: There is a paucity of high-quality research on BoNT in millennials. Our literature review suggests different patterns of practice when treating younger adults. Specifically, our survey revealed that: (1) younger adults are receiving, on average, fewer units of BoNTA at the glabella, forehead, and crow's feet, (2) younger toxin-naïve patients are also afraid to look frozen or unnatural, and (3) wrinkles prevention was the most common reason for seeking treatment in younger patients. Conclusion: The literature review supports the efficacy of BoNTA for correcting wrinkles in millennials. Our findings provide further insight into the dosing pattern of cosmetic BoNTA and motivating factors for seeking treatments in young adults. This valuable information will help practitioners with treatment planning when seeing patients from different age cohorts. An individualized approach and a lower dosage of BoNTA in toxin-naïve younger adults are recommended.