It's National Botox Day -- Here's What Women of Color Need to Know About Botox
We've all heard it before -- Black don't crack. And judging by the seemingly ageless visage of women like Face Flawless Skin friend Angelique Miles, 53, celebs like Gabrielle Union, 46 and Angella Bassett, 61, the old adage seems to hold. It is true, that in contrast to white counterparts, Black skin is typically slower to show the classic signs of premature aging. This might begin to explain why the sisters don't request Botox as often as their less melanin-rich counterparts. In celebration of the first National Botox Day, November 20, we thought we’d explore Botox and how it's perceived and used by Women of Color.
What is Botox?
Botulinum toxin (Botox) is derived from Clostridium botulinum -- a poisonous neurotoxin. According to The National Institute of Health, Botox is used to manage several medical conditions ranging from facial spasm, headaches, hypersalivation, hyperhidrosis, and more. Most of us know of Botox because of its FDA approval to treat lines and wrinkles. I still remember seeing those frozen faces in the early days and being in awe (and shock) of the magic of Botox. While I still see botched Botox jobs, what New York Based Mount Sinai and Harvard Trained Dermatologic/Mohs surgeon Dr. Michelle Henry and others refer to as Spock brows, far more people get Botox, and it goes entirely smoothly.
How Does Botox Work to Treat Fine Lines and Wrinkles?
According to the Botox Cosmetics website, Botox "works beneath the surface and temporarily reduces the underlying muscle activity that causes moderate to severe frown lines, crow's feet and forehead lines in adults – to help them look visibly smoother." While Botox and other neuromodulators like Xeomin and Dysport "help with wrinkles on the forehead and around the eyes, it will not work on deeper set lines," say, Dr. Sofia Din, board-certified Family Medical Doctor and author of Do we really need Botox? A Handbook of Anti-Aging Services.
At What Age are Women of Color Getting Botox?
Since Botox doesn't work on deeper set wrinkles, it explains why most people use it as a preventative measure. According to Dr. Henry and Dr. Din, Caucasian women present earlier for Botox treatments, some in their early twenties. While Women of Color request Botox treatments almost a decade later in life, their late 20s to early 30s. Dr. Din states that "Caucasian women's skin ages very quickly, and they tend to get a lot more sun exposure, so their skin gets affected more." Dr. Henry shares, "melanin is photoprotective against UV damage, so we see the formation of fine lines and wrinkles in Women of Color later in life."
Black women are asking about Botox and other fillers now, but that wasn't always the case. According to Dr. Henry, "There's quite a dramatic shift in how Women of Color view Botox and other injectables. Social media and the media, in general, are having an impact. In the past, media directed to Women of Color presented Botox as something to alter their identity and make them appear 'less Black.' Now we are seeing lots of women who look like us using Botox and all minimally invasive treatments to enhance and preserve their looks rather than to change it." Dr. Din has also seen a shift in how her patients of Color perceive Botox, "Women of Color are getting less afraid of using Botox and are getting interested in maintaining the architecture of their faces for the long run."
“In the past, media directed to Women of Color presented Botox as something to alter their identity and make them appear ‘less Black.’ Now we are seeing lots of women who look like us using Botox and all minimally invasive treatments to enhance and preserve their looks rather than to change it.”
Who is Authorized to Give Botox Injections?
You shouldn't be rolling up to someone's apartment for Botox injections. We're just not doing that! Dr. Henry stated that authorized injectors vary by state. In New York, only physicians, plastic surgeons, registered nurses, and physician assistants under the supervision of a physician can legally give Botox injections. You want to ensure that the person doing your injection is skilled in dealing with your type of skin. While Botox works on Women of Color in the same way that it works on all others, people with melanin-rich skin have to be concerned about hyperpigmentation. You have to pay close attention to the skill level and experience of the person you choose to inject you. Dr. Henry shares, "Hemosiderin deposits (brownish discoloration near the skin's surface) is harder to resolve in patients of Color [...] You have to observe patients and see how muscles pull. Injections should be slow and precise to prevent unwanted effects."
What are the Side Effects of Botox Injections?
Botox has been around for almost three decades. There are countless studies on its usage and effects in general. According to Dr. Henry and Dr. Din, here are the most common as it pertains to its use in cosmetics:
Uneven result
Spock brows
Drooping lids
Frozen/Unreal Look
Facial muscle weakness
What questions should a Woman of Color ask her doctor (or practitioner) before getting Botox injections?
I pride myself on asking questions when I'm at the doctor's office -- any doctor. If they can't take the time to answer my questions, I find someone who can. Dr. Henry shares, "you want to ensure your practitioner has proper credentials. You also want to make sure that they will customize their treatment to you because everyone is different." Here's a list of questions from both Dr. Henry and Dr. Din to ask your injector:
Have you performed Botox Injections on Skin of Color?
Will I still be able to move my brows, and will it look natural?
How much Botox do I need?
What are the potential side effects, and how will they be addressed if they occur?
How long will it last?
Have you ever dropped any brows in your career?
What are the most severe side effect you have ever dealt with, and how was it resolved?
How often do you perform this procedure?
Do you have before and after pictures of people similar to me?
How Much Does Botox Cost and How Long Does it Last?
The cost of Botox can vary widely. In many cases, geography plays a role. Dr. Henry shares, "overhead in New York is higher than it is in Texas so you'll find more expensive Botox in New York." Also, some practitioners charge based on their skill level, clientele, experience, and where injection site. Dr. Din states that Botox can cost between $12 to $15 per unit. According to Dr. Henry, the average number of units injected in a patient at any one time is between 4 and 25.
Each person is unique, so the longevity of Botox can vary from patient to patient. Drs Henry and Din both state that the effects can last anywhere from two to four months. The doctors and others speculate that people like marathon runners or those that are very active might metabolize Botox faster.
What to Do Before and After Botox injections
I'm sure I've seen a movie or two where there's a Botox party with copious amounts of alcohol and drugs. However, according to Dr. Henry, you should avoid alcohol before and after Botox injections. Henry goes on to say you want to avoid anything that thins the blood; we're looking at you Aspirin. Your injector should also tell you to avoid handstand, inversions, and anything that would cause a rush of blood to the face -- that yoga class can wait.
On the Fence About Getting Botox for Your Brown Skin?
Botox has been around for decades and has been extensively studied. According to Dr. Henry, some of the first recipients of Botox (the clinical version) were kids, and they received up to 400 units to treat issues like Cerebral Palsy. Botox Cosmetics administered to relax facial lines, wrinkles, and smooth skin is administered in 4 to 25 units. That’s far less than what was given to kids. The effects of Botox last 2-4 months, so whatever the result, you won't have to live with it forever.
If you want a more in-depth answer to the questions of "Should I Try Botox?" Dr. Din has written an entire book on the subject.
Black don't crack, but it sure will crease, crinkle, and sag eventually. I'm not yet in the market for Botox, but it is definitely in my skincare toolbox for later. Any injectable that aims to enhance your face without it looking altered or fake is an option worth exploring. Consider taking preventative measures early. For Women of Color, that might mean a tiny bit of Botox here and a little filler there starting in the 30s. Tiny tweaks can go a long way and may appear more natural and go mostly unnoticed (by others) because the enhancement is so slow and gradual over time. Whatever you do in your attempt to delay the ravages of time, ensure that you have the right information to make a sound decision about the enhancement and preservation of your beautiful Black skin.