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Home❯Tweakment❯Toxins

Toxins

Written by: Alice Hart-Davis

Updated by: Becki Murray

Last Updated: 19 November 2025

Toxins – or botulinum toxin A if you want to get technical – are one of the best-known categories of drug in the world. Primarily used for wrinkle-relaxing injections by reducing muscle activity in the area, toxins have a number of other uses cosmetically and medically. For example, as well as softening wrinkles, they can help reduce tension in tight jawlines and around your neck and shoulders, specifically the trapezius muscle (remember ‘Barbie Botox’). You can have toxin injections to control excessively sweaty hands and armpits too, as they work by blocking the activation of your sweat glands.

Of the number of brands on the market, one is certainly the best-known and most commonly used by practitioners, but because toxins are prescription-only medicines, we can’t talk about individual brands here. Toxin is extremely popular in the aesthetics world due to its relatively cheap cost (compared to a surgical face-lift, for example), reliable results, minimal pain level, and the short time it takes to perform the procedure. Scroll down for all the toxins FAQs.

CATEGORY

Injectables

EXPECT TO PAY

£ 200 - 300

TWEAKMENT TIME

30 minutes

LONGEVITY

3 - 6 months

ANAESTHESIA

None

DOWNTIME

None

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How do toxins work?

Botulinum toxin A interferes with the transmission of nerve impulses that tell muscles to contract. It does this by blocking the acetylcholine receptors in the muscle.

It is injected into the muscles to soften the appearance of frown lines and other ‘dynamic’ wrinkles which form where we use facial muscles to make expressions. Toxins reduces the ability of these muscles to contract, so it can soften frown lines, or lift downturned corners of the mouth. The product is injected into the muscles responsible for making these expressions, to weaken them for three-six months, which in turn will, for example, soften your frown lines, or lift downturned corners of the mouth.

Let’s address the elephant in the room. A nerve toxin, to be precise, that, let’s be honest, someone else is going to inject into your face. However, because of its toxic nature and widespread usage, there have been a lot of studies done to ensure its safety. It is widely accepted that, when administered by a skilled and responsible practitioner, you have nothing to fear.

How do toxins work for reducing tension?

As well as softening wrinkles, toxins can be injected into areas that are prone to tension, such as the jawline and trapesius muscle, to provide fairly instant but temporary relief for teeth-grinders and desk-workers with poor posture. They work by inhibiting nerve cell communication in the areas injected, leading to the relaxation of the muscles, which can also shrink over time. This reduces knots and pain, as well as leading to the appearance of a slimmer neck and shoulders.

Can toxins treat excessive sweating?

Yes – toxins are actually FDA-approved for treating excessive sweating, specifically when injected into the armpits. They have been shown to work for sweaty hands and feet too. They can reduce sweat production in a targeted area when injected there by blocking the release of the neurotransmitter that signals the sweat glands to produce sweat, tackling excessive sweating at its source.

What I think about Botox in your 20s

crows feet wrinkles

What can toxin be used for?

There are so many ways in which toxins can be used, but some of the more common ones are:

  • The ‘eleven’ lines between the eyebrows.
  • Crow’s feet wrinkles at the sides of the eyes.
  • In the forehead, to soften horizontal lines
  • In the ‘bunny lines’, the horizontal wrinkle-lines at the top of the nose.
  • In the jaw, to reduce muscle clenching of the masseter, the main chewing muscle
  • In the trapezius muscle to reduce muscle tension around the neck and shoulders 
  • In the chin, to relax a ‘cobblestone’ chin
  • Beneath the corners of the mouth, to reduce a habitual grumpy downturned-mouth expression.
  • In the upper lip, to reduce the lip retraction which makes a smile look ‘gummy’
  • In the neck, to soften a stringy-looking neck or to make it appear longer and slimmer.
  • In the armpits, hands or feet, to help tackle excessive sweating

For more uses, including toxins as a treatment for depression, download my full toxins factsheet.

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What are some alternatives to toxins?

Nothing will relax the muscles that create dynamic wrinkles in the way that botulinum toxins can. But if you don’t fancy it, there are many other approaches to try. You could:

  • Try other treatments that will reduce the appearance of lines by boosting collagen growth within the skin, such as microneedling, fractional laser treatment or Tixel.
  • Use stick-on patches that will remind you when you are frowning, such as frownies.co.uk. Relax your forehead and stick on a patch. When you frown, the patch will tweak at your face and remind you to relax your expression.
  • Try serums containing Argireline. This is a peptide that has a relaxing effect on dynamic wrinkle lines around the eyes. It will not have as marked an effect as toxins, but studies suggest that it can help if used at a concentration of 10 percent.
  • Use a night cream containing retinol. This will stimulate the growth of collagen within the skin and this will reduce the appearance of wrinkles.
  • Practise feeling serene. I’m not joking. Sit in front of a mirror, frown, and then work out how to actively relax your forehead. Practice that movement, along with an exhale.

As for body concerns:

  • Posture is key. When you are working ensure the height of your chair and monitor are such that you don’t have to crane our your computer. Practice pulling your shoulders back and down too to release tension.
  • Get a deep tissue massage to work out areas of muscle tightness where knots have formed, such as in the shoulders. 
  • Invest in a stronger antiperspirant – or get the advice of your GP – if your sweating feels excessive.

Medik8 r Retinoate Youth Activating Cream Day Night

Where can I get toxin injections?

Toxins are prescription-only drugs, so have to be supplied by a medical professional who is qualified to prescribe — in the UK, that means a doctor, a surgeon, a dentist, or a nurse-prescriber (a qualified nurse who has taken a further course to become a non-medical prescriber). Prescribing pharmacists can also prescribe toxins, and many are taking training courses in injecting the toxin, too.

The injections can legally be given by someone working under the supervision of that qualified professional, though the prescriber is the one who takes responsibility for the treatment. The makers of wrinkle-relaxing toxins are scrupulous about only supplying their products to medical professionals.

Are there any side effects to toxin injections?

As with any injections, there can be bruising or bleeding at the injection site, but the main issues with toxins stem from over-treatment. Aesthetically, too much of it results in a frozen-looking face that can’t express emotion. If muscles are poleaxed with toxins for too long or too often and don’t get a chance to regain their full range of motion, they may begin to waste away through lack of use. Inexpert injecting can lead to drooping (ptosis) of the eyelid or brow, which will last until the effects of the toxin start to wear off — another good reason for starting with a low dose.

Download my guide to toxins for more information about side effects.

Wrinkle-relaxing injections – Before and afters

Practitioners that offer Toxins

Practitioner Images-5
Dr Mandy Mak

Cosmetic Doctor

The M-ethod Aesthetics by Dr Mandy, 114 New Cavendish Street, London, W1W 6XT

Dr Mandy, a medical aesthetic doctor with dual accreditation in the UK and Greece, leads The M-ethod Aesthetics, an esteemed Obagi Ambassador Skin Clinic....

HeadshotR
Caterina Alvarez

Cosmetic Nurse-Prescriber

Alvarez Aesthetics, Beautique, Bank Chambers, Church Street, Penistone, Sheffield, S36 6AR

Caterina Alvarez, the founder of Alvarez Aesthetics, is a former NHS community nurse with a unique blend of academic excellence and practical experience....

Dr Liesel Holler
Dr Liesel Holler

Cosmetic Doctor

Dr Liesel Holler Clinic, 30B High Street, Chislehurst, BR7 5AN

Dr Liesel Holler MBBS MRCA is a highly-skilled medical doctor who specialises in advanced medical aesthetic procedures that helps restore and enhance natural...

Kirsty Eastland
Kirsty Eastland

Cosmetic Nurse-Prescriber

NP Aesthetics, Lovat Bank, 37 Silver Street, Newport, Pagnell, Buckinghamshire, MK16 0EK

Kirsty is an accomplished Advanced Nurse Practitioner boasting over two decades of nursing expertise, with a remarkable eight years dedicated to the field of...

View Practitioners in Your Area

FAQ ABOUT Toxins

How much does toxins cost?

This varies depending on how many areas you have treated, but expect to pay from £150 per area (the lines between the eyebrows is one ‘area’, the crow’s feet are another ‘area’, horizontal lines on the forehead are a third ‘area’) at a reputable clinic and £450 or more for a top practitioner. Bear in mind that prices at prestigious clinics at prestigious addresses, like Harley Street in London, will be higher than elsewhere.

Download my guide to toxins for an insider tip to keeping the cost down while still getting the best treatment.

How long does toxins take to work?

You’ll start seeing the effects take hold within a week and the treatment will reach full effect in 10-14 days. The procedure itself takes hardly any time. About 10 minutes if you’re getting one or two areas done. The initial consultation is a longer process (which is a good thing and one of the hallmarks of a good practitioner) so set aside an additional 30-40 minutes for your first time. All said and done, you’ll be in and out within an hour.

I would always recommend always booking in for a review two weeks after treatment, by which time the full effects of the treatment will be showing. That way, if you end up with, say, one eyebrow arching higher than the other, your practitioner can make a small adjustment to even things out. Most practitioners will not charge you for this review appointment, and you can always cancel it if you are happy with the way your face is settling down.

How long does toxins last?

Toxins last from two to six months, depending on how much is used and the level of muscle activity in the area. A very light treatment with toxins, perhaps described as ‘baby toxins’ or a ‘microdose’ of toxins, will be wearing off after two months. An average treatment will last for three months. A stronger treatment of more toxin will give a more obvious result (i.e. it will pretty well stop all movement in the area where it is injected) but will last for five or six months.

What happens if I stop getting toxins?

After two to six months, the effects of toxins will be wearing off as the muscle develops more acetylcholine receptors to pick up signals from the nerves, and the muscles will fully recover their function. Amazingly, this is a reliably observed process that happens time after time, even with serial toxins fanatics. (More seriously, this effect has been studied over many years with patients who have repeated treatment with toxins treatment to control muscle spasticity . With this sort of treatment, much larger doses of toxins are used than in cosmetic treatment.)  The upside of this is that if there’s something you don’t like about the result then you can tell your practitioner and they can make sure to adjust your treatment accordingly. The downside, of course, is that this is a repeat cost that adds up over time.

ASK ALICE

Alice answers your question. Want to ask Alice a question? Pop it in here and check back in a few days for the answer.

Dear Alice, thanks again for an always fantastic information guide. I finally made of my mind and decided to have toxin, got an appointment and went to the consultation. It’s a great but.. a little voice inside is still a little nervous,...

Hi, that's completely understandable to be anxious ahead of trying any tweakment. Have you discussed these particular concerns with your practitioner? If you have, I hope they would have reassured you that they have enough skill and experience to place the toxin in just the right places so that it will soften your wrinkles without wiping them out, and without making your brows drop. Also, first time, it's good idea to ask for a really light dose, just enough to give you an idea of what the treatment can do. It won't last as long as a regular dose, but if for any reason you don't like the results, then you aren't stuck with it for so long....

Hey Alice, just recently I found your Tweakments Guide and it has become my best read. I wanted to ask your opinion. I’m 56 and take good care of my skin but I still have deep wrinkles in my forehead, some around eyes and clear...

Hiya, TTG editor Georgia here. Your question cut off, but to answer the part about wrinkles on the forehead and around the eyes – wrinkle-relaxing injections will easily sort these out.

Best treatment for under eye dentation heading on edge of cheek bone and fine lines?

Hiya, TTG editor Georgia here. I'm not sure exactly what you mean by 'dentation' under the eyes. If you're talking about a kind of hollowing then you may be a candidate for tear-trough filler, but this is a very intricate filler placement that certainly isn't suitable for everyone, so use our Practitioner Finder to find someone experienced in treating the eye area and book in for a consultation. And wrinkle-relaxing injections will soften those fine lines at the corners of your eyes....

I have a very deep forehead wrinkle that I try to hide with my fringe. What is the best treatment for this, please?

I'd suggest you made an appointment with a great practitioner to get their view on what has caused the line, and what the best way to soften it might be. Most of the horizontal lines on our foreheads are from the way we raise our eyebrows, and the lines settle into place over the years. Because these lines are caused by muscle movement, wrinkle-relaxing injections of botulinum toxin A should help soften your line. For lines which are really deep, it may make sense to treat it with a soft kind of hydrating filler, but a skilful practitioner will know just what to do....

Hi Alice, my question is about barcode lip lines. I've had toxin there and supposedly it needs to be repeated every 2 months. What's your feedback on toxin in that area?

Hmm, you only want the tiniest bit of toxin in the upper lip to avoid overly weakening or temporarily paralysing the muscles so you can't properly move your mouth. If you're happy with the results then great, if not there are other options like RF microneedling, resurfacing laser, and dermal filler.

Hey Alice! What's your suggested tweakment for downturned corners of the mouth without plumping the lips? I'm a 32 year-old man. By the way, you look unreal!

Hiya, TTG editor Georgia here. It might be suitable to have some carefully-placed toxin to soften the pull of that muscle that's causing the corners of the mouth to turn and droop down, and also maybe a bit of filler to prop up the corners of the mouth but injected in the bit to the side of the mouth, not in the lip, so it won't in any way affect the shape or size of your lips. Find a great practitioner who does a lot of work around the mouth who can advise. (PS Alice says Aw thanks😘)...

How can I solve my forehead wrinkles without droopy eyelids?

With wrinkle-relaxing toxin, injected by an expert practitioner with lots of experience and a good understanding of anatomy – you will find lots of these practitioners on here.

I have had toxin for sometime for my crow's feet but it doesn't seem to be as effective. Would filler in the temple area help? I noticed you had it done recently.

Completely depends on your face. If the crow's feet toxin doesn't seem to be doing much, is your injector getting it into the right muscles? I have it regularly, but just want the muscle activity damped down, rather than wiped out – I still want to be able to smile in a genuine way!

Does regular toxin over time lead to muscle atrophy?

Hiya, TTG editor Georgia here. Muscles that are continuously topped up with toxin will weaken over time. This will obviously happen to us all eventually as we age anyway, but it’s worth being aware that you are, in a way, willing your facial muscles to weaken before their time. That being said, it’s not something that practitioners seem to particularly worry about, and a lot of people have wrinkle-relaxing injections for decades without showing these unwanted effects. If you wait until your muscles have recovered their full range of movement before having another treatment, this is less likely to happen. ...

I have a very deep line across my forehead. I hate it so much – what do you advise, please?

I'd suggest you made an appointment with a great practitioner to get their view on what has caused the line, and what the best way to soften it might be. Most of the horizontal lines on our foreheads are from the way we raise our eyebrows, and the lines settle into place over the years. Because these lines are caused by muscle movement, wrinkle relaxing injections of botulinum toxin A should help soften your line. For lines which are really deep, it may make sense to treat it with a soft kind of hydrating filler, but a skilful practitioner will know just what to do....

Two weeks ago I had some toxin and now my right eyelid has a droop. The last toxin I had was over three years ago previous to this.

Sounds like your practitioner has over-treated/ hit the wrong muscle – if you have toxin injected in the muscle that lifts the eyelid, it weakens the muscle, so the eyelid will droop. The muscle will recover its function in a couple of months. Maybe next time, choose a practitioner with more experience with toxin?

Will using wrinkle relaxing injections affect the nerves on a long-term basis?

In a word, no. There have been huge numbers of clinical studies around botulinum toxin treatment and they show that every time the toxin is injected and blocks the nerve-receptor cells on a muscle (which stops it working to a greater or lesser extent), the muscle, after a short while, grows new receptors, and regains its function.

View more on Ask Alice page

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