I put it to Dr. Shereene Idriss that she’d basically told 25-year-olds to take their preventative Botox money and fund a trip to Paris. She didn’t walk it back.
“I don’t believe in preventative Botox,” she told me. “It’s something that has always bothered me.”
Coming from her, that carries weight. Idriss is a board-certified dermatologist, the founder of Idriss Dermatology and Dr. Idriss Skincare, and she performs cosmetic procedures herself. Her problem is narrower than Botox itself: it’s Botox for people who don’t have anything to treat yet.
She’s pushing against a lot of momentum. In a 2024 Morning Consult survey, 55% of Gen Z adults said they felt pressure from influencers and celebrities to get cosmetic treatments, and 14% had already tried cosmetic Botox. Another survey from CivicScience found that 30% of Americans ages 18 to 24 had tried a nonsurgical treatment like Botox or filler — more than double the rate among adults overall.
Some of these people are barely out of high school.
What bothers Idriss is the message underneath the trend. Starting injections at 25 teaches people to be afraid of aging and to “fight it at all costs, quite literally when you can’t even afford it at that age.” That, she says, “has never sat well with me.”
She describes people with “normal emotive expressions” and nothing on their face trying to get ahead of an aging process they think is about to kick in. “It drives me nuts,” she says. As far as she’s concerned, it kicked in a long time ago, since everyone has been aging from the day they were born. “That’s not an indication to get Botox. You are not trying to embalm yourself forever.”
The evidence leaves plenty of room for her view. The theory behind preventative Botox is straightforward: relax the muscles behind certain expressions, and the lines they make are less likely to set in. Botox is well established for softening lines that already exist. The long-term case for starting injections before any lines appear is much less certain.
Her alternative goes back to her own twenties. “I was taking a Greyhound bus and going to Montreal,” she recalls, “to go see another place, to experience another culture.”
“As a general rule of thumb, I would say most 25-year-olds do not need Botox,” she says.
Her advice for 25-year-olds: go live life, and “actually earn the lines that they’re gonna try to erase later on.”
Also in this episode
Beyond Botox, we get into what happens to collagen during menopause and whether estrogen face creams are the next retinol. We also talk about the elaborate routines kids are picking up from TikTok, and what a ten-year-old actually needs on her face.
Then Idriss plays Keep One: luxury moisturizer or drugstore? Beef tallow or Vaseline? Monthly facials or one annual dermatologist visit? And if she had $500, would she spend it on skincare or a procedure?
Her answers are in the full episode below.
Sources
Morning Consult, Is a Beauty Bubble on the Horizon?, July 23, 2024. Survey conducted July 12–13, 2024, among 2,200 U.S. adults. Figures refer to Gen Z adult respondents: 55% reported feeling “a lot” or “some” pressure from influencers and celebrities to get cosmetic treatments; 14% reported having received cosmetic Botox.
CivicScience, Is Botox Redefining Beauty Standards for Gen Z?, June 18, 2024. 30% of U.S. adults ages 18–24 reported having tried a nonsurgical cosmetic treatment, compared with 14% of all U.S. adults. Self-reported survey data.