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Facial exercises help reduce wrinkling

Facial wrinkling is a nightmare for all beauty seekers and is almost universally treated with Botox injections throughout the world. Botox can reduce forehead frown lines and crows' feet wrinkles, giving people a more relaxed and youthful appearance that lasts for several months. But the effects take a few days to kick in and the fastidious beauty-seeking socialites can’t wait that long as they have pressing social engagements to meet immediately or just the next day, so they look for ways and means of speeding up the beauty process.

"Patients often leave getting their Botox to the last minute," said Dr. Murad Alam, professor of dermatology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. "If people get their botulinum toxin right before a social engagement or important work event, they may worry it won't start working in time. Speeding up the effects could be important to people."

For people who can't wait the three or four days for the wrinkle smoothing effects of botulinum toxin (Botox) injections to kick in, a new Northwestern Medicine study shows facial exercise after the injections speeds the change in appearance by about one day. In addition, it's helpful to be able to tell patients facial exercise is truly evidence based, Alam said.

Conventional wisdom in the medical community used to be exercising the treated muscles would make Botox work sooner. Then, some doctors suggested it didn't seem to make much of a difference, and it fell out of favour, Alam said. "But we wondered who was right," Alam said. "Since there had not been any well-designed randomized studies comparing exercise and no exercise side-by-side, we decided to do one."

In the study, 22 adult women with forehead wrinkles were treated with botulinum toxin. Half were then asked to exercise their facial muscles over four hours after the injections; the other half were not. The exercises included raised motions of the forehead and scowls (i.e., knitting the brows) in three sets of 40 repetitions separated by 10 minutes. Six months later, after the treatments' effects had worn off, participants were retreated. This time, the experiment was reversed, with those who had exercised last time now avoiding facial exercise, and the others performing exercises.

Both dermatologists and participants rated forehead wrinkles to be better in two to three days after treatment when injections were followed by facial exercise, compared to three to four days without exercise. (J Amer Academy Dermatol 25 October 2018)


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