Better than BOTOX - or not?

It seems that you cant go anywhere without seeing a sign that reads "Better Than BOTOX" promoting some type of topical (applied to the surface) skin cream. The first product to be marketed with this ingenious tag line is Strivectin. Strivectin is a skin cream made with plant derived extracts that may or may not help your skin look more youthful. The product was originally designed for treatment of stretch marks related to pregnancy or rapid weight gain.

Recently, I saw a booth at a local mall in near Beverly Hills with a sign reading the same text - "Better than BOTOX!" promoting another skin cream. I immediately had the same thoughts cross my mind as the first time I saw these words.

"They can't say that!" I thought.

Here is why. In order to compare the type of products being called "better than BOTOX" to BOTOX itself you must first understand BOTOX.

BOTOX is a trade name registered to Allergan Inc. based in Irvine, CA. The BOTOX product comes in cosmetic and therapeutic formulations. BOTOX is a toxin that has long been known to cause paralysis if ingested in foods (canned foods or honey) contaminated by a bacterium called Clostridium Botulinum. In the very low doses used medically, BOTOX is an INJECTABLE (not topical) substance that is directly injected into the target muscles. It can also be used in nerve endings that cause sectretion from certain glands such as salivary or sweat glands.

The mechanism of action of BOTOX is directed against the passage of signal from nerves to muscles. When BOTOX enters the neuromuscular junction, it blocks the transmission of the signal from nerves to muscles for approximately 3-4 months. In order to acheive the same blockage causing temporary paralysis, BOTOX must be re-injected once its effects are noticed to fade away.

In most cosmetic patients, active wrinkles in the area of the forehead, and around the eyes are improved by partially paralyzing the muscles causing the wrinkles with BOTOX. In younger patients who use BOTOX regularly, the deep furrows in the brow, forehead, and crow's feet areas may be prevented by decreasing the muscle activity under these wrinkle-prone areas.

Now lets compare the creams. Neither of these "Better than BOTOX" creams are injectable, therefore, none are directly applied into the muscles causing wrinkles in the face. Neither of the creams have any effect on the muscles at all. Neither of the creams have been proven by peer reviewed research to help prevent wrinkles in the areas that BOTOX can be used. Furthermore, creams and topical applications to the skin have very unreliable absorption profiles. We know that many medications / chemicals can be absorbed through the skin, but most of the skin creams have not been studied, and cannot be expected to have any effect on anything beneath the surface of the skin.

In summary, "Better than BOTOX" is a comparison of apples and oranges, and should not be taken to mean that any of the topical skin creams that you can buy at the mall will ever replace or supercede BOTOX. As always, you should consult your favorite Facial Plastic Surgeon, or Dermatologist prior to using any of these skin products.