How does Botox in a bottle work? Results look amazing!

I have a friend that ordered Botox in a bottle online and she showed me this unbelievable serum for undereye puffiness. She has almost no lines since she started using it, and looks much much younger and fresh. Is this a for real?

Harkette10

F, 44, California

There are some excellent topical creams and serums that help fight wrinkles. These include vitamin C and vitamin E serums and hyaluronic acid moisturizers. Some topical products claim to be "Botox in a bottle", but they are not preparations of botulinum toxin, the active ingredient in Botox Cosmetic.

Botulinum toxin blocks the neurotransmitter that allows the brain to control your facial muscles. By freezing these muscles Botox prevents the facial movements that cause wrinkles to get worse -- or from ever appearing in the first place.

Over-the-counter facial serums can help your skin exfoliate, encourage skin cell turnover, improve collagen production, and sometimes even appear to contract lax skin by creating a plumping effect. But despite all their benefits, even the best line-fighting creams and serums don't prevent the muscles that cause facial wrinkles from moving.

There are some newer generation facial serums that include trendy ingredients like Agireline and Acmella Oleracea. These ingredients purportedly inhibit neurotransmitters in a similar fashion to Botox and are aggressively marketed as being the "closest thing to Botox" and "Botox in a bottle".

I would advise you to be extremely skeptical of these claims. Amazon.com and other online marketplaces are filled with dubious products unsupported by clinical evidence.

Even if these ingredients were capable of penetrating as deep as the muscle layer and could penetrate the neuromuscular junction where nerves activate muscle movement, there would be very little way of controlling how these ingredients traveled within the skin.

Botox by contrast, can be injected at precisely the right spot within each muscle. That same precision would be impossible with any topical preparation. Furthermore, even if there were a topical preparation that had the ability to successfully inhibit acetylcholine like Botox, such a drug would absolutely require FDA approval -- something which no "Botox in a bottle" product has yet.

My guess is that your friend is using an over-the-counter product which encourages skin cell turnover and the production of the skin's building blocks: collagen and elastin fibers. These products make a good addition to any skin care routine but don't have anywhere near the wrinkle inhibiting effect of Botox.

If you're interested in reducing forehead lines, smile lines, crows feet and other facial wrinkles, I suggest meeting with a board-certified dermatologist or plastic surgeon to discuss which options make the most sense for you.

Botox Cosmetic is a brand name for injectable botulinum toxin manufactured by Allergan. Botox is one of the most popular clinical cosmetic treatments in America, with over 7 million procedures performed annually.

In the hands of a skilled injector, Botox immobilizes the facial muscles that cause fine lines and wrinkles. It's popularity is due to its extremely rapid results which reduce crows feet, frown lines, and other visible signs of aging -- along with its low incidence of side effects.

There are no over-the-counter versions of Botox.

Many topical skin care products have claimed to be as good as Botox but they are completely different products with different mechanisms of action. Botulinum toxin is a potent neurotoxin which blocks the neurotransmitter acetylcholine to prevent the muscle contractions that cause facial lines.

Topical serums and facial creams don’t at all work in the same way -- and there are no legal topical formulations of botulinum toxin.

Two popular topical anti-aging products are hyaluronic acid serums and vitamin C serums. Both of these product types encourage skin cell turnover which can, over time, increase collagen production and possibly smooth some very fine lines. Other types of serums plump the skin, which temporarily reduces the appearance of some wrinkles.

There's nothing wrong with these popular serums, but they’re far from a Botox alternative. Not only do they take months to work (unlike Botox, which takes under a week), they have a vastly different approach to wrinkle reduction, and the results are generally far less noticeable.

I'm not sure what specifically was in your friend's "Botox in a bottle", but it isn't Botox. Without further details I can't say for sure if it does anything at all. But if you're interested in Botox treatments I advise you to contact a board-certified dermatologist or plastic surgeon for actual Botox injections, rather than experiment with an at-home, DIY wrinkle treatment that may have no effect at all.

Botox is a trademark of Allergan corporation and is a prescription-only, injectable formulation of botulinum toxin. There is no such thing as a topical "Botox in a bottle". While there has been some talk about developing such a product, there have been no official announcements and certainly no FDA approval.

Because of some potentially serious side effects, Botox injections must be administered by a physician or a professional injector under the supervision of a physician. A skilled injector knows exactly how much Botox to use, exactly where to inject it to achieve the desired effect, and at what depth. Botox injected in the wrong place can have embarrassing, and sometimes serious, results.

Considering the skill and precision Botox treatment requires, I think it's unlikely that a DIY topical Botox preparation is ever going to be available for home use.

It's not clear what exactly your friend ordered online, but it almost certainly wasn't "Botox in a bottle" (at least I hope not). More likely it was a topical serum. There are many different types of facial serum including skin tightening serums, plumping serums, moisturizers and exfoliants. Some of these have their uses and can impart a low level of visible rejuvenation or delivery of nutrients to the skin -- but they’re not nearly as effective as Botox.

If you're looking for a Botox alternative, there are two other formulations of botulinum toxin to be aware of: Dysport and Xeomin. Both of these prescription products share a similar mechanism of action with Botox and require a physician or trained injector to perform the procedure.

If you have a fear of sharp objects and loathe needles, there are many other wrinkle fighting procedures that may make sense for you. I encourage you to meet with a board-certified dermatologist or board-certified plastic surgeon to discuss other options like chemical peels, laser therapy and microdermabrasion.

In the meantime I would avoid anything that claims to be Botox and is available without a prescription.

Be very very careful ordering any Botox online as this is highly illegal and unregulated.  Botox is a neurotoxin  and scan be highly dangerous if not performed by highly trained physicians or extenders under direct supervision.

No-real Botox is prescription only-throw it away.

Without knowing exactly what is in this product, it is impossible to say. Botox itself is used for frown lines and smile lines, please be sure you always see a board certified plastic surgeon and discuss your options with him prior to making any decisions on your own.