Is There a Right Age to Start Anti-Wrinkle Injections?

By Vireon Medical Editorial TeamFirst published 5 November 2026Evidence checked through 5 November 2026

Short answer

No single age is right for everyone, but there is a clear lower limit: cosmetic botulinum toxin products are licensed for adults, and in England it is illegal to give them to under-18s for cosmetic reasons. Beyond that, timing depends less on a birthday than on whether lines are already visible, what is causing them, and what the person wants to change. Starting early “to prevent wrinkles” is a common idea, but the evidence that it changes long-term ageing is limited.

Key points

Cosmetic botulinum toxin is approved for adults only; safety in under-18s has not been established.
In England, cosmetic injections for under-18s have been illegal since 1 October 2021, even with parental consent.
Effects are temporary, usually around three to four months, so any “early start” means years of repeat treatment.
Evidence that preventive injections delay ageing comes from small studies and a single twin comparison.
Daily sun protection is the best-supported way to slow visible skin ageing at any age.

The lower age limit is legal and medical

The one firm rule concerns young people. In England, the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 made it an offence to give botulinum toxin or fillers to anyone under 18 for cosmetic purposes, or to arrange such treatment, from 1 October 2021.¹ Parental consent does not make it lawful. The law also covers under-18s visiting England from elsewhere.¹

There is a narrow exception: registered doctors, nurses, dentists and pharmacists may treat an under-18 when a doctor has approved the treatment.¹ This exists for genuine clinical reasons, not appearance.

The product licensing points the same way. The US prescribing information for onabotulinumtoxinA (a common botulinum toxin type A product) approves it for temporary improvement of certain facial lines “in adult patients” and states that safety and effectiveness have not been established in children.² Rules differ between countries, so anyone treated abroad should not assume the same protections apply.

For adults, what decides the timing?

Botulinum toxin works by temporarily relaxing the muscles that crease the skin. That makes it suited to dynamic lines, which appear with expression, such as frown lines between the brows, forehead lines and crow’s feet. Lines that have become etched into the skin at rest, or changes caused by volume loss, sagging or sun damage, respond less well or not at all.

So a clinician would usually look at several factors rather than age alone:

whether lines are visible only with movement, or also at rest
how strong and habitual the person’s facial expressions are
skin quality and sun exposure history
medical factors that may rule treatment out, such as pregnancy, breastfeeding, a neuromuscular disease (a condition affecting nerves and muscles), drooping eyelids or weak facial muscles⁶
the reason for wanting treatment, and whether expectations are realistic

Two people of the same age can therefore receive very different advice. A clinician may also suggest waiting, which is a legitimate outcome of an assessment rather than a refusal.

Does starting early prevent wrinkles?

The idea behind “preventive” injections is reasonable: if a muscle creases the skin less often, a permanent line may form more slowly. The evidence, however, is Limited.

The study most often quoted compared one pair of identical twins over 13 years. The twin treated two to three times a year had no visible forehead or frown lines at rest, while her sister, treated only twice, did.³ Areas not treated aged similarly in both. This is interesting, but it is two people, with no way to separate the effect of the injections from other differences between them.

A 2025 systematic review (a structured summary of all relevant studies) on preventive use included nine studies and could not pool them because they were too different.⁴ Most looked at existing wrinkles or short-term skin measures over weeks, not younger people without lines followed for years. The authors concluded that long-term safety and effectiveness “are not yet fully established” and called for better long-term studies.⁴

Question	What the evidence shows
Does it soften existing dynamic lines?	Yes, temporarily, in licensed areas in adults²
Does starting young delay lines decades later?	Not established; small and short-term studies only³⁴
Is long-term repeated use from a young age well studied?	No; long-term data in this group are lacking⁴

What is and is not known about early, preventive use.

Is there an age when it works less well?

Possibly. In the licensing trials for frown lines, only a small group of participants were 65 or older, and they responded less often than younger participants.² At day 30, about 39% of those aged 65 or over were rated as responders, compared with 83% of those under 65.² The numbers in the older group were small, so this is a signal rather than a firm rule.

The likely reason is the type of line rather than age itself. Older skin tends to have more lines present at rest, more volume loss and more laxity (looseness), which muscle relaxation alone does not address. For those concerns, a clinician may discuss other options, or none.

What starting early commits you to

Effects usually appear within a few days, peak at around 10 to 14 days and last roughly three to four months on average.⁶ Starting in your twenties therefore means a long run of repeat treatments if you want to maintain the effect. Each session carries the usual short-term side effects, such as bruising, headache or temporary eyelid drooping.⁶

All botulinum toxin products carry a warning that the effect may spread beyond the injection site, which in rare cases can cause swallowing or breathing problems.² This is uncommon at cosmetic doses, but it is one reason the treatment should be given by a qualified, registered professional.

By contrast, daily broad-spectrum sunscreen of SPF 30 or higher and avoiding tanning are recommended by dermatologists to slow visible skin ageing, with no age threshold.⁵

When to seek medical advice

Seek urgent medical help if, in the hours or weeks after any botulinum toxin injection, you develop difficulty swallowing, speaking or breathing, or widespread muscle weakness. These can be signs that the toxin’s effect has spread and can be life-threatening.²

Common questions

Can a 17-year-old have anti-wrinkle injections with parental permission?

Not in England for cosmetic reasons; parental consent does not change the law.¹ Treatment is only possible from a registered health professional when a doctor has approved it.

Is 25 too young?

Age 25 is within the licensed adult range, but whether it makes sense depends on whether there are lines to treat. If there are none, the benefit of treating “in advance” has not been reliably shown.⁴

Is it ever too late to start?

There is no upper age limit in the licence, but response may be weaker when lines are deep or caused by sagging rather than muscle movement.² A clinician can explain which of your concerns it may and may not change.

If I stop, will my wrinkles get worse?

When the effect wears off, muscle movement returns and lines gradually reappear as before.⁶ There is no good evidence that stopping speeds up ageing.

Bottom line

The only firm age rule is the adult threshold, written into law in England and into product licences. After that, the deciding questions are what kind of lines you have and why, not how old you are. Injections to prevent future wrinkles remain an unproven reason to start.

Sources

Department of Health and Social Care. Botulinum toxin and cosmetic fillers for under 18s. GOV.UK; 2021. https://www.gov.uk/government/publications/botulinum-toxin-and-cosmetic-fillers-for-under-18s/botulinum-toxin-and-cosmetic-fillers-for-under-18s. Accessed 5 November 2026.
Allergan (AbbVie). BOTOX Cosmetic (onabotulinumtoxinA) for injection: full prescribing information. US Food and Drug Administration-approved labelling. https://www.rxabbvie.com/pdf/botox-cosmetic_pi.pdf. Accessed 5 November 2026.
Binder WJ. Long-term effects of botulinum toxin type A (Botox) on facial lines: a comparison in identical twins. Archives of Facial Plastic Surgery; 2006;8(6):426-431. doi:10.1001/archfaci.8.6.426. https://pubmed.ncbi.nlm.nih.gov/17116793/
Marinelli G, Inchingolo AD, Trilli I, et al. Proactive aesthetic strategies: evaluating the preventive role of botulinum toxin in facial aging. Muscles; 2025;4(3):31. doi:10.3390/muscles4030031. https://www.mdpi.com/2813-0413/4/3/31
American Academy of Dermatology. Wrinkle remedies. AAD. https://www.aad.org/public/everyday-care/skin-care-secrets/anti-aging/wrinkle-remedies. Accessed 5 November 2026.
Cleveland Clinic. Botox injections. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/8312-botulinum-toxin-injections. Accessed 5 November 2026.

Article history

5 November 2026 — First published.