It’s become a favourite within the world of aesthetic tweakments and even used to treat such concerns such as migraines and jaw grinding. How safe is Botox, how long does it actually last for, whats the best age for Botox and can you become immune to Botox? We answer all in the following blog.

How Can it Be Safe?

Practitioners inject the popular treatment for reducing wrinkles, Botox, that contains botulinum toxin, directly into the facial area of their patients. You may wonder how this can possibly be safe. The secret is that manufacturers of Botox use purified, extremely small quantities of the toxin.
How Does it Smooth Wrinkles?

Botox works beneath the skin, targeting the muscles that underlie wrinkled facial areas. While it cannot erase existing lines or eliminate sagging, it temporarily immobilizes the muscles of the face where injected by blocking communication between nerve endings and the brain. By forestalling the normal contractions that take place during facial expressions, Botox makes wrinkled skin appear smoother and immobilizes its tendency to sag.

Botox is especially effective in the upper facial area, around the eyes and forehead where it can reduce crows’ feet, creases, and other wrinkles. Depending on the patient, the effects of a Botox injection last three to six months.

History of Botox Use

First utilized for facial applications by medical professionals in the 1970s to treat squinting in young children, British dermatologist Nick Lowe studied and developed Botox in the 1980s for treating frown lines.

The product received its licensing for general use in 1994, and since that time nearly 500,000 British citizens have undergone injection treatments.

While the best administrator for treatments is unquestionably a qualified professional, the rapid spread of Botox use has occasioned a similar growth in the sphere of application choices. After being approved for cosmetic use in the UK in the mid 2000s, beauticians, dentists, or the barber down the street may offer Botox treatments. If you are the practical sort, you can even purchase a do it yourself kit online.

How long does Botox last for?

The Allergan product Botox used in the suggested dose range is usually thought to last about twelve before having no clinical effect.

The action of Botox means that it is possible to see some return of movement from the six week stage as the therapeutic effect of the product starts to diminish and the nerve end plates start to reconnect with the muscles.

If you are finding that your patients are not seeing this duration of treatment there may be a few things to consider:

  • Is your patients expectation of treatment realistic?
  • Have you considered the appropriate dose for muscle mass, surface area, gender and ethnicity?
  • Does your patient have a swift metabolism
  • Are they taking any medicines including vitamins and herbal preparations that could speed metabolism?
  • Has your patient had any illnesses or events to cause a steep change in their recent aging process?
  • Is your patient a smoker?
  • Have you compromised your product by using alcohol to clean the skin or swab the vial top?
  • Have you denatured the product by inconsistent storage, excessive movement or too speedy a reconstitution?
  • Has your placement site and depth of injection been appropriate for the area being treated?
  • Did you advise your patient on aftercare?

The results are generally predictable but each treatment with toxin will produce a slightly different result. Any of the above factors could influence the outcome.

What is the best age for Botox?

Is there really an “Optimum Age” for Botox treatment? Or is this some kind of myth

Similarly…what is “too young” or “past the point of help”?

Up to a point, “Too Young” is obvious. We’ve all heard the recent controversy over the San Francisco Mom who gave Botox treatments to her Pageant-queen 8 year old daughter. There has been a media frenzy of similarly ridiculous stories. And any medically qualified Aesthetic Practitioner worth their weight in botulinum toxin knows that there is simply no question about the right or wrong in these cases. But over the age of about 18? 20? 25? Where does it begin… And where does it, or should it end?

Perhaps the debate can be split into two: the perspective of the Practitioner, and the Perspective of the Patient (note we say Patient, not Client: at Cosmetic Courses, we feel it is so important to remember that Botox is still a medically prescribed drug not just a beauty treatment…ethical decisions need to be made around this topic as with other medical procedures).

The Patient’s Perspective:

Botox provides a safe and effective means of looking more youthful and banishing wrinkles like no other treatment, for up to 4-6 months at a time. Robert Kotler (Md, FACS) makes the valuable point that, to the Patient, the best age at which to begin Botox treatment is largely based on their personal interpretation – on “what you see when you look in the mirror”.

In other words: no matter how many hundreds of times friends, family and surgeons try to persuade a 20-something patient that they have beautiful skin, if all they see when they look in the mirror is one huge wrinkle, they will fixate on it. It can make them genuinely very unhappy, however silly this may seem to other, possibly older, patients. But does this make them any less “eligible” for treatment?

Of course, the highly image-conscious environment of the Western world plays a large part in this. Women and men alike are bombarded by airbrushed images of silk-skinned celebrities. Many feel retaining youthful looks is integral to keeping ahead in their careers.

As a Practitioner, when judging the need of the Patient, it is therefore hugely important to be able to empathise: to think, why is this important to this Patient, is there some way that I can work with the area concerning them to improve it (even if it is not as pronnounced as in other Patients) and not merely to dismiss them as “not needing it” until you have tried to get inside their shoes and seen their reflection in the mirror through their eyes.

In some cases it may be a lot easier…patients who have had a lot of sun exposure, for example, often do have genuine significant forehead wrinkling, squint and glabellar lines even at a very early age.

The attitude towards patients of 65+ wanting Botox tends to be much more liberal, i.e. “Well, if they want to pay for it!” . Many people are going on working to a much older age nowadays so increasingly defending this choice through preserving their youthful looks is important. Plus the generations of highly glamorous older celebrities are making the trend for much older Botox requests just as likely as unusually young Botox patients.

The Practitioner’s Perspective:

Of course, regardless of ability to Empathise and weigh up the emotional implications for your patients (i.e. do they really need this treatment to make them feel better about themselves?) there are still practical implications for the Aesthetic Practitioner, such as the health considerations caused by age.

“Too Young” and a patient is still developing – both physically and emotionally. With the 18’s – early 20’s age group, if you strongly believe that your Patient does not have any lines to treat and is simply feeling the pressure to live up to celebrity airbrushed distortions of  reality, then perhaps it is your ethical duty to explain this. At Cosmetic Courses we believe you should never, ever perform an Aesthetic Procedure purely for the money if the patient does not need it: this will not build up trust and is abusing your medical position.

On the opposite scale, whilst there is technically no reason why Botox treatment is unsafe for patients aged 65+, such treatment is considered “off label” i.e. not the norm. You may need to check out the patient’s skin elasticity, check extra carefully that they are in good medical health with no contraindications (watch out for blood thinning medications or neurological diseases). If all this is fine, then they are as good to go as any other patient!

With all patients who fall outside the “typical” age bracket for Botox treatments (i.e. those who could obviously and easily benefit from it), it is best for both the Patient and the Practitioner if the Consultation process involves a clear explanation of the results that may be achieved and the Patient’s expectations. This will ensure that the patient is not disappointed, and the Practitioner is not expected to perform impossible miracles!

Can you become immune to Botox?

The answer to this is yes you can become immune to Botox! But it is extremely uncommon.

There are a number of different types of botulinum toxins available currently in the United Kingdom.

These include Botox, Xeomin and Azzalure.

If your patient becomes allergic/immune to one of these types of toxin it is likely one of the others will work satisfactorily for them.

Botox is normally associated with botulinum toxin as hoover is to vacuum cleaners. However not all vacuum cleaners are hoovers and not all botulinum toxins are botox.

If your patient does feel their botox treatment is becoming less effective, you need to offer them a full consultation during which you may suggest using an alternative type of botulinum toxin.

Botox Training

If you would like to advance your Botox training options we have a variety of routes for you:

It’s the injectable sweeping the world but what do we really know about the winkle buster that is Botulinum Toxin? In this blog we look at the facts & some frequently asked questions to get your knowledge tip top when it comes to one of the worlds most famous toxins.

What is Botulinum Toxin?

Used aesthetically to combat wrinkles Botulinum Toxin is a neurotoxin protein sourced from the bacterium Clostridium botulinum. It’s qualities help to relax muscles and reduce the appearance of wrinkles. Over time with extensive research and testing the injectable has proven to be able to also treat certain medical conditions.

How does Botulinum Toxin work?

Botulinum Toxin works by injecting controlled amounts of the product into the areas where you have active muscle movement. In line with our ageing process we gradually form wrinkles overtime. We develop these wrinkles as a result of repetitive active movement of certain muscle groups. The treatment works by relaxing the muscles which helps to prevent them from contracting and in turn slows down the formation of wrinkles and lines.

What is Botox?

Many use the word Botox as the name of the treatment when in fact this is just the name of one brand of Botulinum Toxin. Created by Allergan, Botox® is one of the biggest brands of Botox in the world. It would be the same as calling all vacuum cleaners a hoover… All brands of Botulinum Toxin hold their own qualities and names. Patients should be aware of the pros and cons of each to help them make an informed decision on the products used.

Are Botulinum Toxin injections safe?

Safety is incredibly important when it comes to aesthetic treatments and in order to ensure your safety it’s beneficial to know about the practice of injectables. Understanding more about this will help you to make informed decisions about your treatments.

In order for public use products need to have FDA approval. Each product approved by the FDA has gone through extensive testing in order for it to meet all guidelines and regulations set. Once given the FDA seal of approval the product is safe to use when administered by a professional.

We treat our models with Botox at Cosmetic Courses, the anti-wrinkle injection created by Allergan. The FDA have approved Botox for over 10 years.

Administered by a trained professional this procedure is safe and can achieve great results.

Are Botulinum Toxin injections permanent?

No, these injections are not permanent. On average Botox lasts for around 3 – 4 months post treatment and patients find they often need repeat treatments needed throughout the year. The right practitioner will guide you with your treatment plan to ensure your safety and achieve the best results.

Botulinum Toxin FACTS…

  • First used in the 70’s, the injectable was used to treat the medical condition of Strabismus.
  • Its journey in the cosmetic industry began in the 90’s where its wrinkle relaxing qualities were discovered.
  • Botulinum Toxin is manufactured by many companies but there are three main pharmaceutical companies used in the UK; Allergan, Galderma & Merz.
  • Headaches, excessive sweating and strabismus are some of the medical conditions which can be treated with the injectable.
  • Botulinum Toxin injections are popular with everybody, from women to men “Brotox” to business professionals “Protox“.
  • The number of women in the UK using anti-wrinkle injections has risen by 41% since 2011.

Botox Treatments at Cosmetic Courses

If you are considering Botox treatment and are looking for a high quality procedure without breaking the bank then having treatment with Cosmetic Courses may be the right option for you. All treatments are supervised by our team of expert trainers and performed by medically qualified professionals.



Register your interest today to become a Cosmetic Courses Model or give us a call on 01844 390110 to speak to our friendly customer service team.

At Cosmetic Courses, our relationship with our course delegates doesn’t end when their training does. We believe in supporting all our delegates as they embark on the exciting journey of carving out a successful career in the field of aesthetics. From the practicalities of setting up in business, to furthering your repertoire of treatments, to finding and growing your client base, we’ve a comprehensive support network in place that means once you train with us, we’re there to help you every step of the way.

Although the quality of our aesthetic training has traditionally been our strong suit, we’ve listened to your feedback about wanting more help on the marketing side, and have responded by creating a new sister website to help you.

What’s the NCN – and how can it help you?

The NCN Homepage

The National Cosmetic Network ( is a specialist clinic finder website that allows people to find and compare reputable aesthetic clinics close to them.

Our aim with the site is twofold – to give patients an easy way to find the most qualified, reputable practitioners in their area, and to help practitioners of a high standard to increase their client base.

The website shares information on non-surgical treatments, from the most established skin treatments, anti-wrinkle injections and facial fillers, to treatments for excessive sweating and thread veins, as well as innovative treatments like PRP Therapy.

A search function then lets people find quality clinics in their local area that offer the treatments. So a well-written listing that showcases your credentials could attract plenty of new clients to you.

How to get your FREE listing on the NCN

To make sure only clinics with the highest professional standards are listed on the site, and safeguard people seeking treatment, only clinics we personally approve make it onto the NCN.

And because every practitioner who has completed training with us has demonstrated they meet the required standard, we give all Cosmetic Courses delegates a free 6-month listing on the NCN for the treatments they have trained in.

When you complete any course from our varied programme, you will automatically be given a free listing on the site to help your potential patients find you.

Please feel free to take a look at the NCN website, and let us know what you think on our Facebook page. If you’d like any more information on the NCN, or any of our training courses, please get in touch with the team on 01844 390110 or email [email protected].

September 11 witnessed new legislation for the use of Botox in the US – it is now legal to administer it to the fine lines around the eyes.

Up to now the Food and Drug Administration had only approved the cosmetic use of Botox for lines across the forehead and between the brows, however doctors have been using Botox in the treatment of lines around the eyes for a number of years.

The approval came after a study led by Allergan, the manufacturer of Botox, into its efficacy as an anti-ageing injectable. In a controlled group of 833 adults one half received Botox injections to the eye area and the other half received placebo injections to the same area. The group that received Botox displayed the most sign of a reduction of wrinkles.

Although Botox was being used by doctors ‘off-record’ in this way, the approval will mean better safeguards and guidelines. Dr Marco Harmaty, Plastic and Reconstructive Surgeon at Mount Sinai Medical Center in New York, told that Botox has been used not only for crow’s feet for a number of years but also other unapproved parts of the face including creases by the side of the nose. However he also added:

“(It) does give you an added benefit and safety of saying that I’m not doing anything illegal or potentially harmful.”

The FDA approved Botox use for lines on the forehead in 2002.

Woman arrested practicing botox illegallyAn American beautician based in Florida has been arrested for administering Botox illegally, and for claiming to be a qualified nurse. In the US it’s a legal requirement for those offering non-invasive cosmetic procedures such as Botox and fillers to be medically qualified and to hold specific registration to practice.

The beautician, Sheri Goldman, had listed her profession at her beauty salon as nurse, when in fact she has no medical qualifications whatsoever. She advertised her salon and its services on Groupon, which her listed credentials including ‘surgical nurse’. She was arrested for unlicensed practice of a healthcare profession, which is a third degree crime in the US, punishable by up to five years imprisonment.

There are also other charges against her, for the same crime but in another area of Florida.

With laws soon to be introduced in the UK to regulate who can offer Botox we may well see similar cases of unqualified practitioners knowingly (or unknowingly) flouting the law, with similar repercussions.

Cosmetic Courses are an established provider of medical aesthetic training. For information on any of our courses, please contact the team on on 01844 390110 or email [email protected].

Kim Kardashian’s latest media circus involves speculation that she is still undergoing regular Botox treatments despite being 7 months into her pregnancy. Though the American socialite has neither confirmed or denied the reports that are circulating throughout US and now global tabloids, the question on many people’s lips is – if true, will this do harm to her unborn baby?

Whilst we can’t comment on the validity of the claims and therefore offer no opinion on this specific case, it is worth visiting the subject on a general basis. There is no evidence that Botox travels beyond the area in which it is injected, and in theory this would extend to meaning it would not reach an unborn baby via the placenta. That said, there is no conclusive evidence that it does not, given that it would be impossible to test this on pregnant mothers and their unborn babies.

Corroborative evidence would suggest that it is safe and indeed prescription Botox is sometimes carried out on expectant mothers suffering from other conditions that require it, such as chronic migraines or cervical dystonia (problems with posture and movement, usually in the neck and shoulders). Currently doctors are allowed to continue with Botox treatment in these cases.

There are also no regulations that prevent practitioners from offering Botox for cosmetic reasons to pregnant women. That said, most who administer it will not offer it to pregnant women for cosmetic reasons alone. This is because the reason for the Botox is seen as non-essential, and therefore the safety of the unborn foetus is given greater precedence.

Cosmetic Courses are one of the UK’s most established medical aesthetic training providers. For information on our Botox training, or any of our other aesthetic courses, contact the team on 01844 390110 or email [email protected] for more information on any of our training courses.

One London clinic is now offering a Californian-produced alternative to Botox which promises the same results minus the toxins, which may come as welcome news to those who are interested in the results of the treatment but uncomfortable with the thought of what is in it.

iovera has been dubbed ‘Frotox’ due to its use of cryotherapy, effectively freezing, to produce the same results as Botox. Its results are said to be instantaneous as opposed to the few days that it can take for Botox to take effect. However its lifespan is slighter shorter lasting a maximum duration of four months.

Developed by medical technology group myoscience, it currently tackles forehead lines (running vertically or horizontally) through administering the treatment to either temple. A device filled with liquid nitrogen is placed next to the nerves which freezes the muscles used to control particular wrinkles. Advocates suggest that the accuracy of the nerve targeting is such that it still allows movement in the muscle.

The treatment lasts for 15 minutes and is so far retailing at £300 at a Harley Street Clinic. Some detractors insist that it poses no viable alternative to Botox, which has been used for several years, until its long-term safety and capability has been demonstrated.

Cosmetic Courses are the UK’s first surgeon led Botox course provider. Contact the team on 01844 390110 or email [email protected] for more information on any of our training courses.

In a secret recording by the BBC at a Harley Street skin clinic, the clinic’s director was filmed describing how prescriptions for Botulinum Toxin could be obtained in the names of friends and family. The drug would then be stored, ready to be used by nurses to treat walk-in patients without needing to obtain a prescription first.

The nurses would instead telephone the doctor for a remote prescription before injecting patients with the ‘stored’ Botox.

If, for any reason, the doctor could not be reached before treatment, the nurses would administer the Botox injections anyway – with the doctor phoning patients afterwards.

Though remote prescription is not illegal at present, administering Botox without a prescription is against the law. It also raises concerns about patient safety.

In the light of the investigation, the General Medical Council (GMC) has said that new rules will soon be published, making it illegal for doctors to remotely prescribe injectable cosmetic medicines, including Botox.

Nurses who do not hold the V300 prescribing qualification will be required to work directly with a doctor or dentist in order to issue prescriptions.

If you would like any information on our Botox training courses, or any of our other fully accredited courses, contact us on 0845 230 4110 or email [email protected].

The Aesthetic Medicine Sympsium is one of the only true courses that gives doctors and physicians alike a fantastic chance to be taught by board-certified dermatologists about the specific techniques and training requirements for injectable cosmetics. The injectable botox training is done in a legitimate, sterile medical environment and does not allow spectators giving doctors more free time for education.

The doctors that come to the Symposium can take a second look at the training they gain by using their 3 medical training DVD’s, which offer training on: botox instruction, dermal filler instruction, and microdermabrasion instruction. The DVD’s are hosted by the IAPAM’s member Dr. Marc Scheiner, who covers the aforementioned training regimens.

Each member who attends the Sympsoum will gain a total of 19 DVD’s relating to cosmetic practice. These will allow doctors and physicians alike to recall the training that they received whenever they see fit.

Scheiner heralds study classes like the IAPAM’s, mostly because they offer real, live injection patients to practice on. This, he continues, is necessary to build the confidence needed to start to immediately offer the procedures. Jennifer Lidner, another member of the IAPAM Symposium had this to say: “In order to perform Botox treatments well, one must understand the medication and how it specifically works. Physicians must know how to appropriately dilute the product and how to safely and effectively administer it. Training should provide an in-depth discussion of facial anatomy and how to evaluate muscle movements to decide on product placement. One must understand the details of how Botox interacts with the muscles, the natural variations of the musculature of the face, as well as how to achieve beautiful aesthetic results by decreasing muscle contraction in a designed and organized fashion.

Effective training programs, like the IAPAM’s Symposium should prepare doctors to effectively handle any adverse events from both a medical standpoint, as well as helping the patient to understand the situation. Marketing assistance is also very valuable, and good training seminars, like the IAPAM’s Aesthetic Practice Start-Up Workshop, discuss how to market services.”

The seminar has grown to be quite popular, and is growing equally with the demand by doctors for professional and knowledgeable training staff.

Although an estimated 2.6 million Americans receive Botox treatments every year 75% of patients are secretive about it. In Britain, secrecy about treatment runs high as well, with 72% of women and 81% of men not saying a word about their treatments. Usually, when complimented on their improved appearance, patients make up a cover story, sometimes attributing their sudden youthfulness to the use of a sunblock or a moisturiser.

In a recent survey in southern California, plastic surgeons estimated different percentages to the level of secrecy. The average estimate is about 45%.

Dr. Edward Domanskis, a plastic surgeon in Newport Beach, estimated it to be from 60% to 70%. Dr. Ashkan Ghavami, a plastic surgeon in Beverly HIlls, approximated it to be about 60%. Dr. Val Lambros, a plastic surgeon in Newport Beach, guessed it to be from 30% to 40%. Dr. John Di Saia, a plastic surgeon in San Clemente and Anaheim, reckoned it to be less than 10%. And Dr. Michael Persky , a plastic surgeon in Encino, made an educated guess at about 15%, with 99.9% for celebrities.

Doctors are asked to keep the treatments a secret. Patients ask doctors to only call them on their mobile phones within a certain time frame. Women might only come for treatments while their husbands are out of town on a business trip to allow for enough time for the bruising to heal. Some of these women get all their treatments done all at the same time. Others spread them out; for instance, lips one month, Botox the next month, and so on.

Sculptra, a new, slow-acting dermal filler, is especially popular with secretive patients. During their research, the manufacturers learned that a certain population wanted gradual, rather than a sudden improvement in their appearance. Consequently, doctors usually ask patients if they would prefer a slower transformation in their features. With Sculptra injections, it may take from 6 to 10 weeks for the full effects to show. For secretive patients, this is a perfect solution. However, the effects of Botox and other even fillers are also easy to hide. According to Dr Val Lambros, “If you fill nasolabial folds it’s pretty easy to hide, but more advanced uses of fillers in other parts of the face, like around the lower lids can bruise and be harder to hide. Of course the chance of bruising is higher the more you want to avoid it.”