Don’t like how you look on Zoom? Many young Americans are now getting Botox


I’m 41 years old, and as I begin to fret over my crow’s feet and the creases between my brows, I’m noticing a lot of suspiciously line-free faces on people my age or older.

Botox used to be something celebrities got but never talked about. But now, even women in their early 20s are getting Botox to prevent wrinkles, and posting about it on social media.

“In [the year] 2000, there were only 780,000 Botox procedures,” said Dana Berkowitz, professor of sociology at Louisiana State University and author of Botox Nation: Changing the Face of America. “Fast forward 20 years later and that number is over four million. That is a massive, massive increase. It’s only, like, 5% of the population who’s gotten Botox, but it seems like everybody’s getting it because it’s just so normative. Try watching a soap opera from the 1980s — their faces move!”

Jennifer Hartley is a critical care nurse and owner of Seattle’s boutique med spa Skin Synthesis.

“I hear a lot about the Zoom Boom,” Hartley said. “People who are working remotely spent a lot of time on Zoom, looking at themselves thinking, oh my goodness, these lines, I have jowls, it’s sagging.”

“The average millennial takes 28,000 selfies annually,” Berkowitz said. “We are becoming increasingly used to seeing ourselves through this camera lens. So, yes, Zoom is definitely fueling it.”

Yes, I, too, want a forehead as tight and smooth as a butternut squash, but I’m afraid of the potential long-term health affects of injecting botulinum toxin directly into my face.

“Unfortunately, we don’t have any great formal long-term studies that demonstrate what happens with use of Botox,” said Dr. Tina Nandi, assistant professor of dermatology at Johns Hopkins University School of Medicine. “But the product was FDA approved in 2002 for the treatment of facial wrinkles and so now we’re close to two decades of safety demonstrated in patients receiving it on multiple occasions.”

But what about cancer? It feels like everything can give us cancer!

“I think it’s important to understand how botulinum toxin works,” Nandi said. “It modifies the way the nerves to your facial muscles work. So it doesn’t really interfere with DNA or your cell division, which is often the basis for cancer.”

Professor Berkowitz says Botox has been used medically since the 1980s, even to treat children with cerebral palsy.

I asked her how Botox is impacting our society and our collective self esteem.

“Our normal, naturally aging faces are no longer good enough,” she said. “One of the slogans of Botox was: ‘Like you, only better.’ What that means is that you are actually not good enough,” she laughs. “Like you, just better.”

One study showed that women who don’t get treatments tend to hang out with other women who don’t get treatments. But if even one of those women decides to get Botox?

“It was almost like a domino effect,” Berkowitz said. “[They think], ‘I don’t want to be the only one.'”

Tacoma’s Katie Bracken never considered Botox, until she got divorced and started trying out dating apps in her early 50s.

“I did have one fella tell me that the bags under my eyes needed some of that tightening cream,” Bracken said. “I’m definitely thinking about stuff for my face, but I don’t know. I’m not sure I’m that kind of person. But I’m lonely. It’s an interesting predicament that I never thought I’d be in.”

Whether a woman gets Botox to attract a man or for herself, Professor Berkowitz says the pressure to look young is baked into our culture.

“They’re getting it because they understand that women who look younger and prettier are treated better and have higher salaries and might get better dates,” Berkowitz said.

But even she’s had Botox.

“I feel like my face looks like a Shar-Pei right now! As soon as I stop breastfeeding I will likely go back to getting Botox,” Berkowitz said. “Do I feel like I’m failing at individual feminist ethics? Absolutely.”

If you decide to get Botox, all of the experts I spoke with were very clear about one thing: Choose a trusted, medical professional, not a “Botox party” in someone’s living room. Find a practitioner with lots of experience who mirrors the aesthetic you’re looking for.

“There is a ton of anatomy that you need to know really, really well, which is very complex in the face,” Hartley said. “You really have to understand the physiology of aging. It’s not just the science, there is an art.”

Listen to Rachel Belle’s James Beard Award nominated podcast, “Your Last Meal.