A dermatologist's guide to anti-aging treatments: Botox, peptides, more

Key points

• Dermatologist Dr. Elizabeth Hale says Botox selectively weakens muscles by blocking acetylcholine release.
• Hale warns baby Botox wears off faster and may raise the chance of antibody formation.
• Hale calls Sculptra her single favorite procedure, citing gradual and natural-looking volume restoration.

Dermatologist Dr. Elizabeth Hale, who practices at CompleteSkinMD, has shared her guidance on popular anti-aging treatments, from Botox and fillers to peptides and salmon sperm facials. She said botulinum toxin injections are the most common minimally invasive cosmetic procedure in the United States, accounting for about half of the total.

Hale said she and her sister, also a dermatologist, perform that type of injection "every single day" at their practice. She described the treatment as safe and effective when handled by a licensed professional.

How Botox works

According to Hale, Botox weakens muscles by stopping the release of acetylcholine, a neurotransmitter that controls facial movement. Without contraction, the appearance of lines reduces. She said the product is derived from botulinum toxin A, a toxic substance that can lead to death if mishandled, but is safe in a dermatological setting.

Hale said Botox is also FDA approved for hyperhidrosis, or overactive sweat glands, and migraines. She recommends allowing "a little movement" at injection sites as patients age to keep the face looking natural.

Consistency is very important

— Dr. Elizabeth Hale

Baby Botox and other trends

Hale said baby Botox uses a smaller dose and can be somewhat preventative, but it lasts less time, requiring visits every one or two months instead of four to six. She said frequent mini injections might increase the chance of antibody formation, and recommends a regular dose that wears off completely before repeating after four months.

On PDRN, a form of salmon trout sperm injected commonly in Korea, Hale cited reports of granulomas or nodules and suggested peels or topical formulas instead of injections. She said red light therapy can reduce inflammation and stimulate some collagen, but called the effects not dramatic, and said there is not enough data yet on peptides.

Hale said Sculptra, a biostimulatory filler that stimulates natural collagen production, is her single favorite procedure. She said consistency with sunscreen of SPF 30 or higher, cleansing and moisturizing is the foundation of healthy skin.