A remarkable new study of the use of Botox in America has revealed that some women suffer a “crack-like” addiction to the process, as they attempt to top up previous treatments.
The number of women aged between 19 and 34 having the cosmetic procedure has risen by 41% since 2011, according to the American Society for Aesthetic Plastic Surgery. Men are also increasingly turning to Botox – they now make up 10% of all users, leading to it being dubbed “Brotox”.
Many younger female users are persuaded by dermatologists that the drug – derived from botulinum toxin, the world’s most lethal neurotoxic agent – will stop wrinkles forming. But Dana Berkowitz, a 38-year-old gender studies professor at Louisiana State University, who has herself used Botox, argues in her book Botox Nation: Changing the Face of America that this expectation is based on a flawed idea of what Botox can do, leading to frequent return visits to the plastic surgeon.
She told the Observer: “It is and it isn’t preventative: it’s complicated. You’re injecting this neurotoxin into your facial muscles to prevent them from being able to move. If you can’t express an emotion for long periods of time, you don’t get certain lines.
“However, the problem is that Botox only lasts for between four and six months, so once you start seeing those lines form again you go back. Women I interviewed talked about it in terms of it being addictive. One said she was ‘crack-like’ about it.” Berkowitz added: “The problem for me is that in targeting younger women the doctors are trying to create this lifetime consumer.”
While researching her book, she read many magazine articles that quoted dermatologists, cosmetic surgeons and beauty “experts” talking about the preventative properties of Botox and the notion of starting early. These included statements such as: “You want to clean up your room before it gets too dirty.”
Berkowitz said: “It’s not the advertisements that are doing this marketing; it is happening in a much more insidious way.”
Botox was approved for cosmetic use in 2002 and 11 million Americans have since paid for it, at between $ 300 and $ 400 a session. Berkowitz interviewed women in their 20s and 30s and learned that many believe the claims about prevention. “I heard things like, ‘I use Botox because it’s a pre-emptive strike’, or ‘my friend is really smart: she’s started using Botox at 22 – that way wrinkles don’t even form’.”
Berkowitz explores the way the multibillion-dollar beauty and anti-ageing industry in the US boosts sales by cultivating feelings of inadequacy.
Many of the women she spoke to first chose to undergo the injections after hearing about a clinic offering it at a discount or going to a Botox party. More women between the ages of 22 and 40 use Botox than do women over 60, according to the American Society for Aesthetic Plastic Surgery.
Nicole Garcia, a beautician, first tried it when she was 26. She told Berkowitz: “I started using it because my mom actually told me I needed it. I always make this confused face when I am watching TV, and she is the one who noticed it and always pointed it out.”
Myka Williamson, a yoga instructor in New Orleans, was interviewed for the book when she was 31 and had just had her first child. She tried Botox when she was 29 at a friend’s house: “It was a Botox party, so that kind of was a little risky – not doing it at a doctor’s office but at someone’s house. But I was kind of feeling like I had nothing to lose and, you know, it was experimental, and I wanted to try it.”
Williamson had used it once since the party and was planning to have more sessions once she stopped breastfeeding.
While the drug was for the most part safe, said Berkowitz, there had been reports of side-effects, including blurred vision and drooping eyelids, and some of the women she spoke to had suffered headaches. Botox can also be a gateway to other, more invasive cosmetic procedures, such as dermal fillers.
Rachel McAvoy, a 30-year-old meteorologist from Minnesota, told Berkowitz: “I love Botox, but the only problem is that now the attention is taken away from my forehead and I’m starting to notice my parentheses around my mouth. I feel like I want fillers there.”
Berkowitz said that when she began researching her book she was 31 and strongly opposed to Botox. But she changed her mind over the years and had injections herself when she was 34.
She explained: “It was partly because I grew older. Also, as part of the book project, I read hundreds of articles on Botox in women’s magazines, which was the worst thing I could have done for my sense of self-worth.
“I was an active feminist and had stayed away from those. Then I interviewed women my age who told me I was stupid not to have it – and dermatologists, one of whom said I was being negligent.
“It was a very strange feeling to have something foreign taking over your face. The ability to move the top of your face is gone. Then people started complimenting me. It was like having a little secret.”
She said she has experienced both the appeal of Botox and the shame of using it – “not just for being vain but also for what I perceive as a personal failure in adhering to the core ethics of feminism”.
She had it again two years later and decided to tell her students: “I was giving a lecture on bodies and beauty culture and I remember thinking, ‘I’m such a fraud’. Here I was navigating very complicated tensions as a feminist, and so I wrote an essay and had them read it. It opened the door to a wonderful conversation about feminism and body culture. I am really happy that I came out to them.”
Berkowitz, who last had Botox before her wedding six months ago, thinks better role models are needed for women. “The body work that celebrities engage in is so public, for all the world to see – like in the Real Housewives shows and the Kardashians. How do we make ageing become cool?”
Asked to comment on Berkowitz’s argument that the preventative theory of having Botox is flawed, Dr Dan Mills, the president of the American Society for Aesthetic Plastic Surgery, who has a practice in Laguna Beach, California, told the Observer: “It is true that the more you wrinkle the skin in one particular way, the more likely you are to get creases there, so I’m not going to say that it isn’t preventive.
“If you started in your twenties and did it your whole life, you wouldn’t have any wrinkles where your elevens [lines between the eyebrows] are. The more you use the muscles, the more you will see the wrinkles, so there is truth to both sides of this argument.”
Allergan, the company that owns the Botox brand name, did not respond to a request for comment.
Is America developing a ‘crack-like addiction’ to Botox beauty?
