In September 2023, the government reported that they were launching an inquiry into unregulated cosmetic activities, in an effort to protect consumers from “botched” procedures like Botox. The UK government news report went on to say that there were around 900,000 Botox injections each year, and in 2022 there were over 2,000 complaints related to the injection.

But were these complaints for botched procedures? Botox, short for botulinum toxin, is derived from clostridium botulinum, a bacterium that produces dangerous biological substances that attack the nervous system. Specifically, Botox blocks the release of acetylcholine, a neurotransmitter responsible for muscle contraction. While orthodox medicine uses Botox in medical management[i] (despite there being far less toxic alternatives), more commonly, it’s used as an aesthetic treatment to reduce the appearance of wrinkles. This article will discuss the long-term consequences of Botox, and why consumers may truly be unhappy with the results, and it’s not because it needs further regulation.

Becoming paranoid about the appearance of aging?

What is Botox?

C. botulinum produces 8 separate exotoxins[ii] (toxins that are released directly into the area that the bacteria has colonised). The type used for cosmetic Botox injections is the most potent type of the eight exotoxins, botulinum toxin-A. Botulinum toxin-A is also the same toxin type that gives rise to Botulism, a disease that is fatal in 5-10% of cases. This is why medical professionals sometimes call Botox the “miracle poison,” as it’s made of one the most hazardous toxins ever investigated for medical use.

In 2021 it was estimated that there were 7.3 million cosmetic Botox injections, and by comparison, negligible use for justifiable medical practice. Botox cosmetic income is estimated at $6.4 (£5.08) billion dollars yearly[iii], and remains by far the most popular treatment, outpacing all other injectable cosmetic procedures[iv].

Botox is a neurotoxin, and it has numerous adverse effects and serious side effects. Aside from temporary paralysis, flu-like symptoms, allergic reaction, pain, and bruising, which is consistent anytime something toxic is injected into the skin. Botox also permanently paralyses the muscle. After repeated use, it shrinks and inactivates normal muscle function, as well as damages the skin and near-by tissues at the injection site (such as lymph and sebaceous glands.)

By paralysing the muscle underneath skin that has reduced elasticity and strength, Botox is thought to sometimes eliminate the appearance of wrinkles. The loss of skin elasticity is still there—but the muscles are not accentuating it by functioning normally. Long-term use leads to muscle atrophy (the complete loss of muscle function). In some cases, this muscle atrophy can be reversed when you stop using Botox, in others, the facial expression and muscles are permanently changed for the worse.

It cannot be underestimated the addictive nature of Botox injections. Botox' effects are temporary. Though many aestheticians purport every individual will receive the same anti-wrinkle effects, this is by far not the case. Initially, it can take multiple Botox injections over weeks before the muscles become “conditioned” to respond to the toxin. The level of conditioning varies from person to person as the body responds to the neurotoxin in different ways. After repeated treatments to maintain the “conditioned” skin, the muscles eventually develop a “tolerance” toward the toxin, reducing its efficacy.

And remember, this skin is already subject to pre-mature aging—this skin does not have a healthy elasticity or integrity, that’s why it’s wrinkling. Therefore, people are often forced to have more frequent injections as the muscle tone breaks down from repeated exposure to the toxin. When the toxin tolerance level is reached, to maintain any structure to the face, more “miracle poisons” are injected, Botox and dermal fillers, leading to irreversible damage.

Our Skin is a Vital Sign

Aging should be incremental and subtle throughout the years. So, when wrinkles suddenly appear, or you start to look older than you feel, the solution is to balance the internal environment that’s gone a bit haywire. Just because the lines seem to have popped out of no-where, that doesn’t mean the solution is a visit to the dentist for a Botox injection. It’s to get to the bottom of all the toxins, pollutants, and nutrient deficiencies that are leading to the premature aging process, and over time, ill health.

Never forget–our skin does and should evolve over time. It is by design that our faces change from decade to decade. Let’s not equate eternal youth with eternal beauty.

Skin changes over the years.

Aging is a natural part of life.

Wrinkling, sagging, puffiness, and changes in colouration indicate critical nutrient deficiencies and internal health challenges. These health challenges can be environmental (air pollution), but often, it’s based on our own choices, like drinking coffee, excess alcohol, smoking cigarettes, heating hydrogenated oils (like sunflower oil, rapeseed oil or vegetable oil), or eating processed junk food in general. Botox masks these environmental challenges, nutritional deficiencies and poor lifestyle decisions, while introducing permanent structural issues to the face.

In Traditional Chinese Medicine (TCM) the face is an essential component of diagnosis—not just of nutritional deficiencies manifesting in the skin (the exterior), but disharmony of the body’s organs (the interior). Premature skin aging is often seen as an imbalance within the body, and facial lines are assessed to understand and treat the root cause of aging.

Forehead lines: Horizontal lines on the forehead, when observed with other factors, relate to issues within the digestive system and bladder. This could be due to stress, gut dysbiosis or compromised bladder function. Increasing pre and pro-biotics in the diet, or supplementing, not only supports the gut microbiome, but also the skin microbiome[v], and can address the underlying digestive upset. Pre- and pro-biotics have been linked to reduced skin inflammation, and contributes to the “youthful glow.”

Lines between the eyebrows: The utilisation of the face will lead to some frown lines, but sudden or deepening frown lines could signify liver imbalances or digestive issues. The B vitamins are critical for the liver’s detoxification process. These vitamins are often associated with good skin health as well. A deficiency in vitamin B5 (pantothenic acid)[vi], B6[vii] (pyridoxine) and B12 (Cobalamin)[viii], and the other B vitamins, have long been associated with skin drying, lack of skin integrity and lack of skin elasticity.

Under eye lines or puffiness: In TCM, this often relates to disharmony in the kidneys. Other symptoms would be problems with sleep or fluid balance in the body. Dietary fat-soluble vitamins (A, D, E and K) are critical for their antioxidant and anti-inflammatory benefits. Vitamin A has gained interest for it’s potential to reduce scarring in kidney disease[ix]. Deficiency in vitamins D, E and K have been linked to chronic kidney disease (CKD) progression and have been investigated as critical vitamins necessary for prevention of CKD and kidney stones.[[x]][[xi]][[xii]] It’s no surprise these vitamins also impact collagen production, skin regeneration and repair, and reverse UV radiation damage—all essential components of firmer, smoother skin.

Nose lines and lines around the mouth (nasolabial folds and marionette lines): These lines are often associated with digestive issues or as TCM describes it, issues associated with the spleen and stomach. Vitamins C, D, A and B are critical for digestive health. Vitamin C impacts collagen production and ensures skin can stretch and return to its normal shape[xiii], not just in the face, but in the gut lining. Magnesium is also a potent skin protectant that helps regulate muscle contractions in the digestive tract and face. This not only helps with gut motility (reducing constipation) but also helps in reducing the appearance of fine lines and wrinkles due to facial contractions[xiv]. Magnesium benefits over 300 biochemical reactions in the body, including skin health, and naturopaths sometimes call it the miracle mineral!

TCM practitioners will consider the location, depth and appearance of facial lines, and other factors, to make crucial diagnosis. Hiding these lines with toxic chemicals like Botox could delay accurate diagnosis, and lead to reduction in overall health. With premature aging, it’s important to consider the root cause of the lines, as once that’s addressed, you will naturally see a more youthful, wrinkle-free face.

Choosing a Path: Empowerment Through Knowledge

It’s well known, through science and alternative healing, that nutrition on our skin. Studies indicate that herbs, vegetables, and fruits contain anti-aging phytochemicals (resveratrol, quercetin, curcumin, etc.), capable of minimising wrinkles and enhancing skin health. And essential nutrients like our vitamins, minerals, and proteins act as building blocks for the skin, fostering collagen production, and protecting against oxidative stress, thereby preserving the skin’s brightness.

The decision between Botox and nutrition is ultimately a personal choice. But it shouldn’t be a choice made from speed or convenience—there are many quick and easy approaches to health you can take in your own home, with half the budget of Botox, and more sustaining effects.

While you’re on your journey of skin regeneration, try some simpler and effective anti-aging treatments:

1. Facial Cosmetic Acupuncture: This can be done on the head, face, and neck. It’s been proven to be effective* at improving contour lines of the face and promoting facial elasticity. The most common, but rare side effect is bruising at the needle site. There are no severe adverse effects, and it works alongside a nutrient dense protocol to address the underlying causes of aging.

2. Facial Steaming: Moderate outdoor humidity and steam benefits the skin by providing hydration. In humid environments, the skin tends to retain moisture better, keeping it plump and supple. If you are in a cool environment, facial steaming encourages the blood flow, increasing oxygen levels in the skin, leading to a fresher, tighter appearance. This increase in circulation to the skin also stimulates collagen and elastin production, reducing the appearance of wrinkles and fine lines.

3. Natural Anti-Aging Face Masks/Creams: Turmeric, Gotu Kola, ginger, Frankincense, cinnamon, sage, rosemary, avocado, pomegranate and cucumber are just some of the proven herbs, spices and fruits that reduce the signs of aging. Most masks and creams can be made easily at home, and you can apply as many times as you like, which only further nourishes and supports your skin.

I make the moisturiser below every time I buy a bouquet of roses to ensure my skin remains smooth and supple:

Rose and Avocado Body Moisturiser (makes about 40g or 1 ¼ oz)

1 tsp cocoa butter and shea butter mix

1 tsp avocado oil

2 tbsp rose petal infusion (register for the CNM course Natural Skincare to learn how to make a rose infusion!)

1 tbsp non-GMO organic natural emulsifying wax, like carnauba

1 drop Frankincense essential oil

2 drops of rose essential oil

3 drops geranium essential oil

**Instructions:**

Melt the cocoa and shea butter with the avocado oil in a bowl set over a saucepan of boiling water (*bain-marie*)
Gently heat the rose petal infusion and emulsifying wax in a small saucepan until the wax has completely dissolved in the infusion. Slowly add the infusion to the oil mixture, whisking together until blended (about 10 seconds
Wait for the mixture to cool, then add the essential oils.
Store in a sterilised jar with a tight lid. Use a spatula or spoon to remove the moisturiser to keep fresh. Store for 3 months.

Additionally, there are some things you can do for yourself that will keep your skin in optimum health. Try the below holistic living strategies:

Nutrient dense diet: Antioxidant-rich fruits and vegetables, omega-3 fatty acids found in oily fish, and collagen-boosting nutrients like vitamin C and zinc contribute to skin elasticity, hydration, and overall health. Consider vitamin supplementation or herbal tinctures under the guidance of a qualified herbalist or naturopath. Cultivating a diet rich in nutrients that nourish the skin empowers us to celebrate the beauty of aging and living in one.
Sunlight for Vitamin D: Moderate exposure to sunlight is essential for the body to produce vitamin D, which supports healthy skin, skin recovery and overall well-being.
Clean Air: Being in clean, fresh air can help improve skin clarity. Spending time in natural environments with low pollution levels can reduce skin irritation and inflammation. Riding your bike in the park rather than on a busy street, and hiking are all ways to get fresh, pure oxygen into your skin.
Fresh water bathing: Mineral-rich water, containing sea salt or magnesium, and certain natural minerals found in the environment (such as in hot springs or mineral springs) can have beneficial effects on the skin. Mineral rich waters improve skin texture, clarity, and even skin tone.
Stress Reduction: Natural environments, such as parks or green spaces, can help reduce stress. Lower stress levels positively impact the skin, as stress can contribute to skin issues like acne, eczema, dryness, and premature aging.
Movement: Physical movement promotes blood circulation. Improved circulation enhances the skin's appearance by strengthening the skin and adding vitality. This is the “youthful glow” that many talk about.
Mind-Body Connection: Mental well-being reflects favourably on skin health. When you have peace of mind, you tend to furrow your brows less, smile more, sleep better, and eat better. We can’t underestimate the power of the mind to stimulate healing and rejuvenation.

Bathing deeply moisturises the skin, water is absorbed by the outer layer of the skin (stratum corneum), which can help maintain skin moisture and prevent dryness. Warm water improves circulation, opens the pores and improves sleep.

Conclusion

Spiritually and energetically, we age to enhance humanity.

The more we experience over time—the more we add to relationships, work, and cultural perspectives. And that leads to an enriched society. We are only alive due to the brilliance, tenacity, insights, and activities of our ancestors. And only through the guidance of those who are older, do we become better versions of each passing generation.

Therefore, aging is a natural, beautiful process, marked by the evolution of our skin. Each line etched on our faces signifies a unique journey—a testament to a life lived, emotions felt, and experiences cherished. And premature aging is reversible, especially when caught in time.

As we navigate the art of graceful aging, let us embark on a journey guided by the science of nutrition, nurturing our skin from within and celebrating the beauty of every stage in life.

References:

[i] Ali S. Al-Ghamdi, Noah Alghanemy, Hanan Joharji, Dhafer Al-Qahtani, Hasan Alghamdi, Botulinum toxin: Non cosmetic and off-label dermatological uses, Journal of Dermatology & Dermatologic Surgery, Volume 19, Issue 1, 2015, Pages 1-8, ISSN 2352-2410, https://doi.org/10.1016/j.jdds.2014.06.002.

[ii] Nigam PK, Nigam A. Botulinum toxin. Indian J Dermatol. 2010;55(1):8-14. doi: 10.4103/0019-5154.60343. PMID: 20418969; PMCID: PMC2856357.

[iii] Botox Market Size by Product Type (Botulinum Toxin A and Botulinum Toxin B), Application (Therapeutics, and Aesthetics), End-Use (Spas and Cosmetic Centers, Hospitals, and Dermatology Clinics), Regions, Global Industry Analysis, Share, Growth, Trends, and Forecast 2022 to 2030. https://www.thebrainyinsights.com/report/botox-market-13252

[iv] Top nonsurgical cosmetic procedures worldwide in 2021. Statista. <https://www.statista.com/statistics/293449/leading-nonsurgical-cosmetic-procedures/>

[v] Al-Ghazzewi FH, Tester RF. Impact of prebiotics and probiotics on skin health. Benef Microbes. 2014 Jun 1;5(2):99-107. doi: 10.3920/BM2013.0040. PMID: 24583611.

[vi] Yang M, Moclair B, Hatcher V, Kaminetsky J, Mekas M, Chapas A, Capodice J. A randomized, double-blind, placebo-controlled study of a novel pantothenic Acid-based dietary supplement in subjects with mild to moderate facial acne. Dermatol Ther (Heidelb). 2014 Jun;4(1):93-101. doi: 10.1007/s13555-014-0052-3. Epub 2014 May 16. PMID: 24831048; PMCID: PMC4065280.

[vii] Rajani Prasad, A.V. Lakshmi, Mahtab S. Bamji, Impaired collagen maturity in vitamins B2 and B6 deficiency—Probable molecular basis of skin lesions, Biochemical Medicine, Volume 30, Issue 3, 1983, Pages 333-341, ISSN 0006-2944, https://doi.org/10.1016/0006-2944(83)90025-X. (https://www.sciencedirect.com/science/article/pii/000629448390025X)

[viii] Kannan R, Ng MJ. Cutaneous lesions and vitamin B12 deficiency: an often-forgotten link. Can Fam Physician. 2008 Apr;54(4):529-32. PMID: 18413300; PMCID: PMC2294086.

[ix] Nephrology Dialysis Transplantation, Volume 16, Issue 3, March 2001, Pages 441 444, https://doi.org/10.1093/ndt/16.3.441

[x] Williams S, Malatesta K, Norris K. Vitamin D and chronic kidney disease. Ethn Dis. 2009 Autumn;19(4 Suppl 5):S5-8-11. PMID: 20077598; PMCID: PMC2878736.

[xi] Clinical Kidney Journal, Volume 16, Issue 12, December 2023, Pages 2559–2566, https://doi.org/10.1093/ckj/sfad162

[xii] Theuwissen E, Smit E, Vermeer C. The role of vitamin K in soft-tissue calcification. Adv Nutr. 2012 Mar 1;3(2):166-73. doi: 10.3945/an.111.001628. PMID: 22516724; PMCID: PMC3648717.

[xiii] Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin Health. Nutrients. 2017 Aug 12;9(8):866. doi: 10.3390/nu9080866. PMID: 28805671; PMCID: PMC5579659.

[xiv] Gröber U, Werner T, Vormann J, Kisters K. Myth or Reality-Transdermal Magnesium? Nutrients. 2017 Jul 28;9(8):813. doi: 10.3390/nu9080813. PMID: 28788060; PMCID: PMC5579607.

Aging Gracefully: Nutrition vs. Botox