How frequently are Botox injections needed to freeze the aging process?

I am a 28-year-old female with fairly well-preserved skin (few wrinkles and minimal sun damage). I want to know what kinds of cosmetic procedures I should be doing now to maintain the current status of my skin and to stave off the onset of wrinkles. I know the norm for Botox injections is 4-6 months, but are these injections ineffective if I wait longer? Would other cosmetic procedures would be a better fit for me?

Doctor Answers 17


You are at the age where you want to start taking preventative measurements to maintain the current status of your skin. I highly recommend getting on a good skin care regimen to start with. If you have sun damage you might want to consider a Hyperpigmentation Cream (Hydroquinone cream). I also recommend using "medical grade" products that you cannot buy over the counter, and something that has a glycolic in the product will help too. Going to a Cosmetic office and receiving medical microdermabrasions and glycolic chemical peels can help benefit you with anti-aging. The younger you start taking good care of your skin, the less you will have to do when you are older. If you want to throw in Botox here and there maybe once every 6 months as a preventative for your aging then that would help as well. 

Redlands Otolaryngologist


Dear ckb4z7,

Thank you very much for your clinical post. A maintenance schedule for Botox is critical to maintain its aesthetic clinical effect of softening lines and wrinkles elevating the brow in mid-face, horizontalizing the commissure and improving the appearance of the masseter submandibular gland. These are a few of the many facial indications for Botox. Depending on the area that you are injecting the depth and lines and the wrinkles and the animated pattern of the patient, maintenance with “protect your result Botox” requires treatments once every 3-6 months. Some patients who are injected with very concentrated high volume Botox need only come twice a year. Smaller unit concentrations of Botox may require visits to the clinic to maintain once every 3-4 months.

Botox is one of the more popular techniques as the results are very consistent and the maintenance and treatment are reasonably affordable.

I hope this information has been of some assistance and best of luck.

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R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 93 reviews

How to look your best for as long as you can

Sun , besides heredity , is main determining factor in how you will age.
Sunscreen 365 days a year is more important than Botox. Having said that, I would tell you that some patients of mine need botox less often as time goes by. You can always do it ( or not) .It does not build up in your system. I don't see any advantage to using it if you dont have frown lines?
I think there are some excellent cosmeceuticals out there now. Please include a retinol and you will probably look your best!

Hope this helps.
PS buy some stylish hats with brims. You can be cool and stay young. I don't recomment hydroquinone especially when it is compounded with steroid ( as they thin the epidermis and make it age FASTER)

Beverly Johnson, MD
Silver Spring Dermatologic Surgeon
4.9 out of 5 stars 7 reviews

How frequently are Botox injections needed to freeze the aging process?

Thank you for your question. For patient’s that already have visible signs of aging, it is harder to treat those fine lines and wrinkles if they do not take preventative action. Usually patients in their 50’s and older require more injectable fillers to fill in deep lines that could have been prevented with treatment in their 30’s. Individuals in their late 20’s like yourself, should consider the benefits of preventative Botox to stop the development of these lines and wrinkles, rather than stressing to fix them after they have already developed on the face.

For those individuals in their 20’s that do not yet need Botox, they should avoid sun damage to prevent the early onset of lines and wrinkles. I advise young adults in their 20’s to have their annual skin checks to detect the early signs of skin cancer. With age, our skin will reflect every sunburn, golden tan, and visits to the tanning bed that result in sunspots, freckles, hyperpigmentation and possibly skin cancer. To prevent the signs of aging, apply sunscreen daily, avoid the sun from 10am-4pm, and wear appropriate clothing while exposed to UV rays to prevent lines and wrinkles. Also, patients of all ages should moisturize daily to keep their skin hydrated and use a retinol to stimulate the growth of collagen. Collagen is a protein found in the connective tissues of the body that give strength and elasticity to our skin. In addition, collagen helps stimulate cell turnover which replaces our dead skin cells.

Ariel Ostad, MD
New York Dermatologic Surgeon
4.3 out of 5 stars 17 reviews

How frequent should I get Botox injections?

Thank you for your question. Botox is a great way to prevent wrinkles. Whether or not this product/ treatment is the right one for you is a personal decision. If you are receiving treatments ever 4-6 months you are probably getting the best results from Botox. If you wait too long between treatments you allow the muscles to start moving and the wrinkles to start forming.

Have a wonderful day,

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

Botox Injections

As botox itself will only last 3-4 months, it is best to get injections done every 4-6 months if you truly want to prevent the lines from developing. The deeper the lines get, the more difficult it can be to treatment.

The best treatment for skin rejuvenation and prevention depends upon an individual’s skin type, age, ethnicity, sun exposure, and overall health. I recommend  a healthy lifestyle: a diet high in fruits, vegetables, nuts, legumes and fish; eight to ten hours of sleep nightly; limiting alcohol intake other than the occasional glass of red wine; and regular exercise. An important step for all skin types is sun protection including the use of daily sunscreen, sun hats and sunglasses, all of which help prevent aging and sunburns. When it comes to rejuvenating and prevention treatments, a combination of treatments are available including cosmeceuticals (skin care products including ZO® Skin Health or ZO® Medical, Skinceuticals® or Glo-Minerals®), neurotoxins (Botox®, Xeomin®), dermal fillers (Restylane®, Juvederm®, Esthelis®, Belotero®, Emervel®, Radiesse®), and skin resurfacing procedures (advanced laser resurfacing or OBAGI® controlled depth chemical peel).  These are advanced techniques so be sure to get an experienced dermatologist or plastic surgeon consultation for your treatment.     

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
4.9 out of 5 stars 14 reviews

Preventative measures to keep skin looking youthful

Receiving treatment with Botox at 4-6 month intervals is most effective since the Botox will only be active for 3-4 months.  Allowing dynamic wrinkles to form for too long will along these wrinkles to deepen the creases in your skin.

In addition to Botox, it's important to be on a good skin care regimen which involves sun avoidance and protection (SPF 30 or greater), a retinoid (used under the guidance of a physician), and peels/lasers under the direction of a facial plastic surgeon/dermatologist.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Botox and Preventing Aging process

Botox is a fabulous injection and well placed Botox will absolutely prevent wrinkles from forming.  Depending on how deep the wrinkles are and your genetics, I would recommend every 4 to 6 months to have Botox injected.  Again staying out of the sun and proper sun protection are essential to prevent aging.  I also am a fan of the Clear and Brilliant Laser to leave skin fresh and remove sun damage.  Please consult a board certified dermatologist with a great deal of experience with Botox for the best cosmetic results.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

How often to get Botox injections?

28 is pretty young to start Botox. However, it is not so much age dependent as it is "wrinkle" dependent. I like to tell patients that it is time to start Botox when they are able to see "static" lines. This means lines/wrinkles that are present when your face is at rest. For a young person, such as yourself, you may only need Botox 2 times a year (every 6 months). In general, Botox lasts 4 months - sometimes less than that, and sometimes more. So as you age, plan on injections 2 to 3 times a year.
There are other procedures that you might want to start looking at. Chemical peels are often nice for younger skin. I really like the Vitalize peel by Skin Medica. Using an eye cream is a great idea. You may also want to consider Retin-A (tretinoin) or a Retinol cream. Make sure to be careful with sun exposure, and wear sunscreen when you are out in the sun.

Jennifer Reichel, MD
Seattle Dermatologist
4.5 out of 5 stars 42 reviews

Freeze Aging, Botox and other anti-aging considerations.

Dear ckb4z7:

Thanks for this question. It is wonderful that younger individuals are desirous to preserve their skin on the outside but also your tissues and organs (hopefully) on the inside. Unfortunately, while exponential progress is being made on the art of anti-aging, there are no magic answers but a few active lifestyle changes you can make to preserve yourself from the environment and possibly optimize what your parents gave you. 

The aging process appears to be passive. Once you have reached the age beyond procreation, it is as if life need us no further.
Genes which direct the growth and repair aspects of our bodies down-regulate and with it:
  • hormones diminish and become imbalanced
  • the immune system weakens
  • the repair systems of our bodies seem to go to sleep
and with this:
  • our skin creases, pigments and withers,
  • brain function diminishes,
  • bones demineralize and joints lose cartilage,
  • body organs reduce efficiency
  • and so much more.
Like I said though, no need to become depressed or desperate! Medical breakthroughs are here and getting better. 


Initially, I review my patients' medical history and provide an examination to direct and manage their anti-aging care. Some generalities include:

  • Use preventable techniques to preserve your skin, eyes and other organs and diminish the risk of trauma before they occur!
  • use sunscreen and proper skin cover,
  • Yes, use Botox but this is a muscle relaxer to reduce active wrinkle lines when used cosmetically,
  • Consider the ZO Obagi Skin Health system to upregulate skin turnover and proper skin function,
  • Moderate exercise and very low bad carbohydrate, higher protein diet with good fats,
  • a low dosage daily multi-vitamin, anti-oxidants and minerals, 
  • clean water hydration,
  • sleep and reduced stress, meditation relaxation.
The list goes on but no one is living past 120 years. The future appears to be in the genes. 

I hope this has been a bit educational and YOU will contribute to the medical "fountain of youth". All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 81 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.