Botox on thin skin, what are my options?

Although Botox may have been sufficient to resolve your wrinkles in the past, as we continue to age, our needs change. Botox works in patients with both thin and thick skin, but aging not only makes the skin thinner, but also atrophies the underlying muscle and bone. You are probably losing collagen and elastin in your skin, which are the building components that keep it looking plump and supported. If you want to avoid fillers, you can improve the texture of your skin with a variety of lasers including both non-invasive and no-downtime treatments with intense pulsed light (IPL) or more aggressive ablative lasers with minimal downtime that can stimulate collagen production to minimize wrinkles and enhance Botox's effects. A high-quality skin care routine, including topical antioxidants and SkinMedica’s HA5 hyaluronic acid cream are also helpful. Please consult a board-certified dermatologist who has a number of anti-aging strategies to help you move through each stage of life looking beautiful and youthful.

The indication of Botox or other neurotoxin, such as Dysport, for reducing muscle contraction creating wrinkles does not change for thick or thin skin, however, patients will thinner skin may need some building of collagen or volumizing to the face to get the best aesthetic result.  I am a proponent of combination rejuvenaton treatment, and it is common in my practice to perform Botox, Fillers and Skin rejuvenation treatments with lasers, microneedling, RF or IPL to maximize the appearance and benefits.

Botox works in the muscle, not the skin. However, because skin, muscle and bone thin with age, to look more rejuvenated you may need to begin stimulating collagen in your skin with hyaluronic-acid fillers, such as Juvederm, Restylane and Voluma. Please see a board-certified dermatologist to come up with a new strategy to rejuvenate your aging skin.

Hello, and thank you for your question.  The effects of Botox are not dependent on the thickness (or thinness) of one’s skin, so I suspect that your doctor has suggested fillers to add volume to your face, thus achieving the best overall aesthetic result. I would suggest that you speak to your doctor and ascertain exactly what he is suggesting – and the results he would expect from this – before making a decision. Best of luck! 

It is difficult to assess what is going on without a photo.  Since botox is injected into the muscle it should not matter the thickness of the skin.  It may be after all these years you have developed a tolerance to botox and changing the dose or switching to another neuromodulator would be helpful.  It may be that your provider has suggested dermal fillers to get the best results.  Dermal fillers will replace volume and lift to the face which may be what you need.