Gen Z loves Botox. It’s ruining their faces.

Many Gen Zers are known for embracing all things skincare and anti-aging − but has their obsession with Botox gone too far?
On TikTok, the #botox tag has accumulated 1.3 million posts, with some in their early twenties even going viral for looking much older than they actually are, thanks to overdoing Botox, fillers and other cosmetic treatments.
Gen Z’s Botox craze isn’t just relegated to social media. According to a 2022 survey from the American Academy of Facial Plastic and Reconstructive Surgery, close to 75 percent of facial plastic surgeons reported an increase in the number of patients they’ve seen under 30 requesting cosmetic surgery or injectables.
Dermatologists also tell USA TODAY many of these patients cite concerns about looking old, despite still being in their early twenties.
“It’s mostly not necessary and just a real source of anxiety,” dermatologist Dr. Brooke Jeffy says of Botox for Gen Z. “Oftentimes they’re moving their face, and we don’t even see wrinkles, but this is what they’re afraid of.”
So when is the right time to consider Botox, if at all? Dermatologists say the answer varies depending on the individual, but, in general, your 20s are way too soon. In fact, Botox during this phase of life can create more problems than it solves.
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People get Botox, or botulinum toxin, injected for a variety of reasons, including to smooth wrinkles and treat migraines.
Though Botox has become more common, aspects of it remain widely misunderstood by Gen Z, contributing to their misuse of it, dermatologists say.
For instance, Jeffy says, many Gen Zers don’t realize Botox must be done regularly over time to maintain results. Botox results usually last for three or four months, and regular rounds can be costly.
“That’s a really long road ahead when you’re starting this out in your 20s,” Jeffy says. “There’s a little bit of a misconception among some of my patients I’ve chatted with who just think that, ‘Oh, you kind of get this done once, and then you never have to think about it again.’ ”
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Jeffy says she’s also seen many Gen Z patients express interest in “preventive Botox” − that is, Botox to stave off wrinkles before they develop.
While there’s some merit to this strategy, Jeffy doesn’t usually recommend it. Instead, she says, most people are better off saving Botox for their 30s or 40s, when wrinkles actually develop.
“The right time (to get Botox) is when someone is really starting to see a faint, fixed line, meaning they see it there when their face is not moving,” she says.
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Botox can also make someone who doesn’t have wrinkles look older if it’s overdone or not done well. If someone looks like they’ve gotten a lot of Botox, people may think that person is at an age when Botox is usually necessary to smooth out wrinkles.
Botox can also alter your face shape in negative ways if done poorly.
“It can change the shape of their eyebrow and almost make them look older, because they can’t emote anymore and they almost look robotic,” dermatologist Dr. Anthony Rossi says. “Unfortunately, we’ve seen a lot of bad Botox just from untrained people or people who are doing it that don’t really have an aesthetic eye.”
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It’s also possible to develop resistance to Botox the more you get it. This becomes an issue when someone overdoes Botox in their 20s, only for the treatment to not work as well when they’re older and actually have wrinkles.
“I have seen it happen, and that’s why I’m very cautious,” Rossi says. “They may think more is more, but it’s really not.”
Psychotherapist Stephanie Sarkis previously told USA TODAY that, while she’s fine with people pursuing cosmetic treatments if they wish, they should examine their motives for doing so − and understand superficial changes won’t resolve deeper issues.
A cosmetic treatment is not a decision to take lightly or rush. For Gen Zers who want youthful, healthy skin, Rossi says wearing sunscreen every day will do much more than Botox will. Staying hydrated and avoiding cigarettes and alcohol will help too.
“If I have a patient coming in for regular Botox and they’re sunburnt, I’m like, ‘What are you doing?'” he says.