Is low-dose botulinum toxin (Botox) or microneedling more effective for preventative rhytides in young individuals?

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Last updated: May 4, 2025View editorial policy

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From the Guidelines

For preventative wrinkles in young people, low-dose neurotoxin is generally more effective than microneedling. This approach is supported by the concept of preventing dynamic wrinkles from becoming permanent by relaxing facial muscles with neurotoxin injections. Although the provided study 1 discusses the use of microneedling combined with autologous platelet concentrates (APCs) for treating acne scars, it does not directly address the prevention of wrinkles in young people. However, it implies that microneedling can be effective for skin texture and minor scarring, but it does not target the muscle movements that cause expression lines.

The use of low-dose neurotoxin, such as Botox, Dysport, or Xeomin, in areas prone to dynamic wrinkles (e.g., forehead, between eyebrows, crow's feet) can prevent these lines from becoming permanent. Typical preventative doses range from 10-25 units of Botox (or equivalent) every 3-4 months, which is lower than the doses used for treating established wrinkles. This method works by temporarily relaxing the facial muscles, thereby preventing the skin from creasing repeatedly in the same places.

Key points to consider:

  • Low-dose neurotoxin directly addresses the cause of dynamic wrinkles by relaxing facial muscles.
  • Microneedling, while beneficial for skin texture and scarring, does not directly prevent wrinkles caused by muscle movements.
  • Starting preventative neurotoxin treatments in the mid-20s to early 30s can be beneficial, with potential addition of microneedling for enhanced skin quality benefits, as supported by the concept of combining treatments for optimal outcomes 1.

Given the current evidence and focusing on the prevention of wrinkles in young people, low-dose neurotoxin is the preferred method for directly addressing the cause of dynamic wrinkles, with microneedling potentially offering additional benefits for overall skin health.

From the Research

Comparison of Low Dose Neurotoxin and Microneedling for Preventative Wrinkles

  • There are no direct studies comparing low dose neurotoxin and microneedling for preventative wrinkles in young people.
  • However, several studies have investigated the efficacy and safety of microneedling for various dermatologic conditions, including skin rejuvenation and wrinkle treatment 2, 3, 4, 5.
  • Microneedling has been shown to be a safe and effective treatment option for improving skin texture, reducing fine lines and wrinkles, and enhancing collagen production 2, 3, 4, 5.
  • A study on magnesium microneedle patches for under-eye wrinkles found significant improvements in wrinkle index and dermal thickness after 12 weeks of application 6.
  • While low dose neurotoxin is not mentioned in the provided studies, microneedling appears to be a viable option for preventative wrinkles in young people due to its minimally invasive nature and limited side effects 2, 3, 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Microneedling: A Comprehensive Review.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2017

Research

Microneedling in All Skin Types: A Review.

Journal of drugs in dermatology : JDD, 2017

Research

Microneedling: A Review and Practical Guide.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2018

Research

Microneedling: Where do we stand now? A systematic review of the literature.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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