There was a time when Botox was treated like Voldemort: Everyone knew it had magical powers, but no one said its name. Now things have changed—so much so that Botox is regularly the subject of conversation. So let's expand the dialogue with a growing list of uses for the wizard of injectables.
Manage acne. Botox can curb oil production, reducing breakouts. "To totally treat acne, you'd need to use doses of Botox so large they'd prevent you from constricting your facial muscles," says Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. "But tiny amounts of Botox injected very superficially help reduce oil production, and you can still have facial expressions." Though he'd recommend it for any patient struggling with acne, Zeichner would likely advise trying another dermatologist-prescribed treatment, like spironolactone or birth control pills, first. And though it can technically be used to quell oil production anywhere on the face, he cautions against using it all over because of potential effects on muscular activity (a.k.a. frozen face). The most effective and common area for using Botox to curb oil production, he says, is the forehead.
Get a temporary face-lift. Jessica Wu, an assistant clinical professor of dermatology at the University of Southern California, uses Botox to shape her jaw, lift the tip of her nose (more on that in a second), and relax wrinkles around her eyes and forehead every three months.
Mimic a nose job. So about that Botox nose-job thing: Around age 40, your nose can begin to sag and become more hooked, which can make your whole face appear droopy; Botox can help by lifting the nose and taking off years in about ten minutes. For this type of treatment, a doctor can inject Botox at the base of the nose (between the nostrils), which can release the depressor muscle that pulls the nose downward, making the whole face appear more lifted.
Soften your jawline and chin. Grinding your teeth can make your jawline wider over time; dermatologists can inject Botox into the area, which shrinks the muscle and narrows the jawline. The results, which last for a year, can also have other positive effects, like making your cheeks appear more lifted and relieving the pain and soreness that can result from teeth grinding.
Tighten jowls. If your jawline has become less defined, a little Botox along the muscles of the jawbone can pull the skin up for a crisp, defined effect.
Lift your lips. Kylie Jenner–style fillers aren't the only way to fake voluminous, youthful-looking lips. Dermatologists can also inject tiny drops of Botox along the upper lip border in order to roll the top lip up and out slightly so it appears plumper. It's subtler than collagen injections, and because the technique requires less Botox than other areas of the face, it's also less expensive.
Smooth your neck. Horizontal wrinkles can be temporarily erased with what some dermatologists call a "Botox necklace." Tiny amounts are injected into the muscles above and below the lines, all the way around the neck; when they relax, the skin looks smoother. Neck muscles can start to enlarge and protrude as we age, resulting in the appearance of thick, tight cords. And if that didn't already sound bad enough, the muscles in the neck and the superficial muscles of the face are connected to one another, so the neck can pull the rest of your facial features forward. Botox, once again, is the answer. Relaxing the neck muscles leads to softened wrinkles, gets rid of the cords, and lifts the face. Basically, it's a nonsurgical face-lift. All of that sounds too good to be true until you remember that Botox breaks down every three to four months, so repeat visits will be necessary.
Youth-ify your décolleté. With age (and sun exposure), lines can develop between the breasts for some women. To smooth them out, doctors can inject Botox into the pectoral muscles.
Stop migraines. "It's not totally understood how Botox works for migraines," says Zeichner. "The theory is that it blocks the pain signals being sent to the brain and that it relaxes the muscles in the head so they're not as sensitive to pain." In this case, a doctor would inject Botox into the forehead, temples, and scalp. But Zeichner sees this as a last-resort migraine treatment. "It's appropriate for patients who have frequent migraine attacks that aren't improving appropriately with traditional migraine medications." And it's not without potential downsides. "The problem is that neurologists who inject Botox for this reason don't always consider the cosmetic result, and some patients come in with fully frozen foreheads and dropped brows," he says.
Calm excessive sweating. "Similar to the way Botox works on muscles, it prevents the message from your nerves from getting to your sweat glands," says Zeichner. "If the gland doesn't get the signal, then it doesn't produce sweat, which means there will be no wetness in that area." So doctors can use Botox to treat hyperhydrosis (medically diagnosed excessive sweating) by injecting the area—say, the underarms or palms. Dermatologist Amy Wechsler says, "I've injected Botox into the scalp, forehead, and temples, as well as the underarms, palms, and soles of the feet, to stop excessive sweating in those places for six months. The results are significant." This usage has been approved by the FDA, and for some people, it makes a major difference. "It can be a life-changing treatment for people with pathological sweating. I recommend it for people who have tried clinical-strength and prescription antiperspirants with no success and for those people who have significant embarrassment from sweating or need to change clothing during the day because of it," says Zeichner.
Make blowouts last. Yes, really. "Some women who get Botox in their forehead have reported that they don't sweat around their hairline and their blowouts last longer," says Francesca Fusco, an assistant clinical professor of dermatology at Mount Sinai Hospital in New York City. Some people have taken the no-sweat thing a step further and begun getting Botox injections expressly for the purpose of keeping their blowouts fresher for longer by injecting Botox in the scalp and at the hairline. Although Fusco has heard of some dermatologists obliging, she refuses. "If too much Botox is injected in the forehead, you can get heavy eyelids," she says. Might we suggest investing in a good dry shampoo instead?