Patients often come in to the clinic very close to the day of an important social event, seeking Botox injections. In such cases, doing simple facial exercises can accelerate results by helping the toxin bind to the nerve cell receptors sooner to relax muscles, according to a new study published in the Journal of the American Academy of Dermatology in October.
This is the first time the effect of facial exercises has been rigorously studied for the Botox effect, and Murad Alam, M.D., a physician and professor of dermatology at Northwestern Medicine pursued this research because he found that while conventional wisdom advised doing exercises, in recent years, it fell out of favor because many doctors didn’t think it made much of a difference. He wanted to see if it would actually help speed up the effect, especially to help those who wait until the last minute to get the treatment, so they didn’t worry whether it would start acting in time.
He enrolled 22 adult women with forehead wrinkles in the study. Half of them were asked to perform simple facial exercises — raised motions of the forehead, and scowls while knitting the brows, in three sets of 40 repetitions separated by 10 minutes. The other half was the control group which did nothing.
“We had them start the exercises while in the office,” Dr. Alam says.
Both the participants and the clinicians found that the appearance of wrinkles lessened within two to three days if they did the exercises, as opposed to three to four days if they did not — so results were seen approximately one day sooner when facial exercises were performed.
“It’s useful to know that it can be sped up. It’s pretty easy to do, not a lot of work, it doesn’t take much time either,” Dr. Alam says.
Two weeks after the treatment, there was no difference in either group. There was also no difference in how long the treatment’s effects lasted between the two groups. So the benefits were primarily in how quickly the wrinkles reduced in appearance.
As a cross-over study, the 22 women switched groups after six months. According to Dr. Alam, this was to reduce bias and improve consistency of his findings. He also decided to wait six months instead of the typical three- to four-month interval after which a Botox treatment is repeated, mainly to ensure the residual effects from the previous treatment wore off.
“We used Botox, but I assume it would be the same for the other neurotoxin products that are similar,” Dr. Alam says.
Technique to Ensure Expressiveness
Study participants found no discomfort from stiffness, and were able to do their exercises comfortably immediately following the treatment.
“Some people have concerns that their face will be frozen and they can’t be expressive. What I always tell them is that young babies don’t have lines, yet they’re expressive,” Dr. Alam explains. “When I treat people, I always leave a little bit of activity on the side of the face and soften the center of the face, so it doesn’t look like a lot is going on.”
He says this approach ensures that movement is not frozen.
“If you inject a lot on the sides of the forehead above the brow, it’s hard for the brow to move and it can lower the brow which most people don’t want. The general goal is to minimize motion but not freeze it. The center of the face is where our eyes track mostly, so if there are fewer lines there, they look relaxed.”
He emphasizes that toxins for cosmetic use may be the safest available in dermatology, because there have been no serious side effects in several decades of using them.
“Approved toxins for cosmetic purposes that are used appropriately, are actually safer than aspirin,” Dr. Alam says.