Botox or hyaluronic acid?: This is what the different treatments look like

Botox or Hyaluronic Acid?
This is what the different treatments look like

Just a few years ago, Botox was a popular anti-aging remedy, especially in the celebrity world. In the meantime, however, the neurotoxin is also on everyone’s lips in our everyday lives. Equally trendy is hyaluronic acid to fight wrinkles or create more volume in the face. Why has the demand for both substances increased recently?

“Many patients report that due to the many online meetings, which have increased significantly over the course of the pandemic, they constantly saw their own camera image and thus first noticed certain wrinkles on their face,” explains Lisa Schultes, specialist in ear and nose – and ear medicine from HNOmedic. In an interview with the news agency spot on news, she explains the differences between Botox and hyaluronic acid and the treatment options.

What exactly is Botox and how does it work?

Lisa Schultes: Botulinum toxin, or Botox for short, is a neurotoxin that inhibits the release of the messenger substance acetylcholine in the synaptic cleft of the nerve cell. Actually, acetylcholine is taken up by receptors here, which stimulates the muscle to contract. If this messenger substance is missing, this leads to dose-dependent muscle relaxation – superficial wrinkles in the skin smooth out or even disappear completely.

And what can we imagine by hyaluronic acid?

Schultes: Hyaluronic acid is an important component of our skin. It is found in connective tissue, among other things, and has the ability to bind large amounts of water, which gives our skin a certain elasticity and firmness. With increasing age, however, the natural hyaluron content in our body decreases – wrinkles appear. Depending on the crosslinking of the injected material, different results can be achieved by injecting hyaluronic acid. By injecting non-crosslinked or slightly crosslinked hyaluronic acid, the skin can be padded over a large area, for example to smooth small creases on the face or décolleté. If you use a higher cross-linked hyaluronic acid as a filler, you can increase the volume of your lips or cheeks, for example.

What is the difference between Botox and Hyaluronic Acid?

Schultes: With regard to wrinkle treatment, Botox can primarily be used to treat mimic wrinkles. By relaxing the muscles, these more superficial wrinkles can be smoothed out. The neurotoxin does not work immediately, but only after about two to four days and reaches its maximum after about 14 days. Hyaluronic acid always creates a certain volume build-up. On the one hand, this can be used to smooth out deeper wrinkles, on the other hand, it can be built up in desired areas such as lips or cheekbones. The effect is immediately visible here. It can be roughly said that the upper third of the face is more likely to be treated with Botox, and the lower two-thirds are more likely to be treated with hyaluronic acid. But of course there are exceptions here too.

Can both substances be used in combination?

Schultes: Yes. If relaxing the muscles is not enough to smooth out the wrinkles because they are already very deep due to age or a very pronounced facial expression, you can also inject hyaluronic acid here in order to achieve the desired effect.

Does botox or hyaluronic acid have a longer lasting effect?

Schultes: The durability of both treatments depends on several factors. Among other things, how pronounced the muscle movement is in the treated area, how much the skin is stressed by sun and other environmental influences and, especially in the case of hyaluronic acid, the moisture content of the skin. In general, Botox treatments last between three and six months, depending on the region. If hyaluronic acid is injected into the lips, for example, the result lasts six to nine months, depending on the filler.

What is better or healthier for the body?

Schultes: In principle, both substances are foreign materials that are injected into the body. However, the possible complications are much more serious with hyaluronic acid injections. Admittedly, even with Botox, if it is applied in the wrong places, there is a risk of cosmetically unsightly results, such as asymmetry and even drooping of the eyelid. However, in most cases this can be remedied by “counter-injecting” Botox into the right muscle groups and is completely reversible after three to six months when the Botox loses its effect. If hyaluronic acid is applied incorrectly, e.g. into a blood vessel, in the worst case this can lead to the occlusion of this vessel and thus reduced blood flow or the affected area dying off. If this is the case, an immediate reaction must be taken and the hyaluronic acid must be dissolved by injecting an enzyme that leads to its degradation. In any case, it is advisable to have such treatments carried out exclusively by specialists with special training, who can also recognize and treat such complications immediately.

Has the demand for botox and hyaluronic acid increased in recent years? Have there been any changes in the age groups?

Schultes: In recent years we have seen a significant increase in demand for both hyaluronic acid and Botox treatments. Actually, we thought that due to the obligation to wear masks, fewer patients would be interested in beauty treatments, but exactly the opposite was the case. Many patients report that due to the many online meetings, which have increased significantly over the course of the pandemic, they have constantly seen their own camera image and have only noticed certain wrinkles on their face. In addition, more and more younger patients are coming who want to use Botox to prevent the formation of deeper wrinkles.

Do you think it is important to provide more information about the differences between the two substances?

Schultes: Due to the increasing demand, the range of Botox and filler treatments is also growing. Unfortunately also to dubious people. I think it is extremely important to explain the differences and possible risks and, above all, to create awareness that it is advisable to only be treated by doctors with the appropriate training.

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