Baby boomers have always been obsessed with youth, but the pressure to look young is now greater than ever. Thus, a growing number of ordinary Canadians are getting Botox injections to make their faces look younger, regarding the procedure to be a choice far less drastic than cosmetic surgery.

Botox, a purified form of the toxin that causes botulism, decreases the activity that causes wrinkling. It is injected into facial muscles in key areas in which muscle contraction regularly occurs — namely, on the forehead, between the eyes and around the mouth — and temporarily paralyzes them.

Botulinum toxin Type A, which goes by the brand name Botox, was used to treat muscle spasms in the 1980s, says Dr. Ian Landells, a dermatologist in St. John’s and president of the Canadian Dermatology Association. It was approved for cosmetic use by Health Canada in the 1990s.

Since hitting the market in cosmetic form, Botox has become a pervasive part of our culture. There are Botox parties (at which guests drink cocktails and get a hit or two of Botox) and meeting groups. You can even watch someone getting Botox injections on some reality-TV shows. And there are several only-in-Hollywood stories: tales of young starlets indulging in regular treatments before they hit age 20; rumours that some older actors have had to cut back on using Botox or risk losing acting gigs. (It is, after all, difficult to convey emotion when your face is paralyzed.)

And Landells relates certain horror stories: the mother of an eight-year-old pageant princess who took her daughter in for regular injections; a death in Florida attributed to a physician who tried to cut costs by making his own version of the toxin.

The CDA says Botox’s side effects are minimal as long as the drug is administered by an experienced practitioner. “This is a medical procedure,” Landells says, “and it should be done in an appropriate setting by someone with experience.”

The CDA also recommends you follow after-care advice. In some cases, for instance, cosmetic Botox can relax muscles that you had no intention of relaxing, such as the one holding up an eyelid. This eyelid droop, called ptosis, can occur when the dose is too high or if you somehow stimulate the toxin, making it travel immediately after injection. To avoid this, Landells advises against lying down or handling the injection site for four hours after treatment.

And, finally, because the effect of Botox wears off, you need to get the treatment repeated every three to five months, he says. Over time, anecdotal evidence suggests the targeted muscles weaken even more, extending the time between visits to six or seven months.

There are more significant side effects listed on the product monograph, including adverse events involving the cardiovascular system — some of which have been fatal. But, Landells says, the more severe reactions tend to involve the use of Botox for cerebral palsy or other serious conditions that require a higher or more frequent dosing schedule.

The CDA says there is no issue with the long-term use of Botox. But grumblings from some in the scientific community suggest otherwise, as the toxin hasn’t been in use long enough to gauge long-term consequences.

Research conducted by the University of Calgary, for instance, indicates that Botox might weaken muscles elsewhere in the body. The study found that rabbits injected with botulinum toxin A experienced muscle loss and atrophy far from the injection site six months after being injected.

Research in the field of psychology suggests Botox might affect us in ways we don’t yet understand. Early studies have indicated that removing part of the facial expression can dampen the intensity of certain emotions for some people. Experts agree it’s too early to draw any conclusions from that research.

However, the frozen look shared by individuals who have taken their love of Botox too far isn’t something for which good dermatologists strive.

Says Landells: “I spend more time talking people out of procedures than trying to explain what they should have.” IE