Can Botox cause wrinkles if I get too many injections?

BOTOX Cosmetic does not cause wrinkles, though it may appear that it does.  This is because BOTOX Cosmetic works by blocking the signal that results in muscle contraction.  If a given muscle or area of muscle cannot contract due to the signal being blocked, adjacent muscles or adjacent areas of the injected muscle may try to compensate and work harder to accomplish what the muscle did before it was injected with BOTOX Cosmetic.  This compensation may make it appear as if BOTOX Cosmetic "caused" wrinkles, though in actuality it does not.

The other issue to consider is that wrinkles that remain after the BOTOX Cosmetic takes effect may appear more obvious to you than they did before BOTOX Cosmetic was injected.  This is because of the contrast between those wrinkles and the smoother areas where BOTOX Cosmetic was injected.

One needs to understand that BOTOX Cosmetic will not remove any wrinkles or lines that are already etched in the skin.  For these, one needs to consider other treatment alternative such as skin resurfacing procedures (e.g., laser, chemical peels, dermabrasion) and/or injectable filler materials (e.g., Juvederm, Restylane).

It is important to communicate your goals before you receive an injection of BOTOX Cosmetic.  Many patients want a natural look which allows you to still move those facial muscles without looking "frozen."  Communicating with your physician is of paramount importance to obtaining a result with which you will be happy.

Botox does not cause wrinkles.  However, Botox does reduce muscle activity where it is injected.  Sometimes this reduction in muscle activity will cause other areas that are not injected with Botox to move a little bit more.  This may cause the appearance of increased wrinkles in the areas that are not treated. 

Some areas on the face, such as the area directly above the lateral eyebrow, should not be treated with Botox because of the potential for side effects, such as a drooping eyebrow.  Because this area does not generally get any Botox, the area above the level eyebrow may look somewhat more wrinkled after Botox treatment than it did before Botox treatment.

Although Botox does help reduce the appearance of dynamic wrinkles (wrinkles that appear with motion), it does very little for static wrinkles (wrinkles that are present at rest). When the dynamic wrinkles are reduced the static wrinkles may appear worse. 

Furthermore, continued exposure to skin damaging things, such as ultraviolet light and cigarette smoke, will continue to cause wrinkles despite Botox.  That is why good skincare is important whether or not you are receiving Botox treatments.

It would be unusual for Botox to cause more wrinkles.

Botox works by blocking the nerve signals for the muscle and thus preventing the muscle of contracting. It help to smooth out wrinkles because the action of the muscles causes the wrinkles and by blocking this action, the wrinkles are improved. In theory, Botox should not increase wrinkles.

One word of caution:

Be sure to disclose any Botox injections you have had to the person performing the injections. Large doses of Botox, generally more than are used in cosmetic treatments have been associated with problems. If you are going back for multiple doses in a very short period of time, this may result in a complication.

Botox works by blocking signals between nerves and muscles.  This stops muscles from contracting. Different people may require more Botox to get the result that they desire.  For this reason most doctors will recommend touch ups at about 7-10 days. 

As wrinkles start to smooth out on one part of your face, you might start to notice wrinkles on other parts that weren't treated.  This sometimes creates the illusion that you now have more wrinkles!