Question: I have been using Botox for two and a half years (I am a 50-year-old woman), and now I feel like my skin needs a break from all those toxins. At the same time, I do not want to live with wrinkles during my Botox hiatus. Are laser peels effective at removing wrinkles as an alternative to Botox?
Answer: Laser peels are certainly effective at removing wrinkles but, if the wrinkles are due to overactivity of facial muscles, then these wrinkles will tend to recur rather quickly if persistent use of Botox is not continued. Essentially, there are wrinkles that are due to muscle motion, which are called dynamic wrinkles, and then there are wrinkles that are due to aging and sun exposure and smoking, and these would be considered static wrinkles. Laser resurfacing can treat both types of wrinkles, and static wrinkles will take an extremely long time to recur. Dynamic wrinkles, however, can recur in a matter of months due to the overactivity of the musculature that is creating the folding over of the skin in that region, and this freshly lasered skin does tend to be more susceptible to wrinkling. I would therefore recommend that you go ahead and consider a laser resurfacing but would recommend that you continue with the use of Botox or Dysport, especially in the early phases after the laser resurfacing, to prevent these wrinkles from recurring quickly. Once the skin has completely healed after the laser resurfacing, you may consider going on a Botox hiatus at that time but I would typically recommend about 6 months after a laser peel before discontinuing your Botox treatments.