Hyaluronic acid or botox for the face? What are they for and what are the differences?

Hyaluronic acid is a substance (a complex sugar or polysaccharide) known for its high capacity to hydrate tissues by attracting water molecules. It is present in high concentrations in the skin during the early years of life and adolescence.

“As we age, starting from around the age of 30, the concentration of hyaluronic acid, elastin, and collagen decreases, leading to reduced skin firmness, a gradual loss of elasticity, and the subsequent appearance of wrinkles. With hyaluronic acid fillers, we can restore lost volume and ‘fill in’ the grooves that have developed in the skin,” explains Dr. Marino.

Botulinum is a substance produced by a bacterium called Clostridium botulinum.

“Its function is to temporarily and reversibly block the release of acetylcholine at the neuromuscular level. Acetylcholine is the substance responsible for transmitting signals to the muscles to induce contraction. By selectively reducing the contractile activity of the muscles that cause wrinkles, botulinum helps to smooth out those wrinkles,” the expert continues.

As previously mentioned, hyaluronic acid and botulinum work in entirely different ways:

• Hyaluronic Acid: Fills in wrinkles.
• Botulinum: Smooths out wrinkles.

“Another difference,” the expert notes, “is that:

• Hyaluronic acid is a substance already naturally present in the body, which makes it non-allergenic and biocompatible, as well as absorbable.
• Botulinum toxin is an external substance, although it is absolutely safe.”

Which Wrinkles to Treat with Hyaluronic Acid

Due to its filling effect, hyaluronic acid fillers are particularly effective for treating:

• Glabellar wrinkles (wrinkles between the eyebrows).
• Nasolabial folds, which are the deep lines that run down the sides of the nose.
• Marionette lines, which start from the corners of the mouth and extend downward towards the chin.
• Wrinkles that form above and around the mouth.

In addition, it is used to:

• Redefine the oval of the face, giving it firmness.
• Enhance and redefine the lips.
• Correct proportions and volumes of the cheekbones and chin.

Which Wrinkles to Treat with Botulinum

Commonly treated wrinkles with botulinum include:

• Wrinkles caused by the corrugator muscles and located in the glabella, the area between the eyebrows.
• Forehead wrinkles.
• Periorbital wrinkles, commonly known as ‘crow’s feet.’

Botulinum is also a useful in treating excessive sweating (hyperhidrosis) in the armpits, hands, and feet. By acting on the acetylcholine responsible for activating sweat glands, it helps eliminate sweating and the associated odor.

Whether it's hyaluronic acid fillers or botulinum, both treatments are injectable procedures. “The treatment involves injecting, with very fine needles:

• Hyaluronic acid at different concentrations depending on the type of imperfection.
• Botulinum into the skin or its depth.

Local anesthesia is generally not required, although anesthetic creams can be used if needed. The sessions last about 15 to 30 minutes, depending on the treated area. Immediately after, you can resume your work and social activities.”

Regarding the results of both hyaluronic acid filler treatments and botulinum treatments:

• Hyaluronic Acid Fillers: Results are immediately visible and typically last for about 8-10 months.
• Botulinum Toxin: The effectiveness is not immediate; initial results generally begin to appear after one week and improve up to two months. After 3-4 months, the effect gradually starts to diminish.

Hyaluronic acid, being a natural and biocompatible substance, generally does not have significant contraindications.

“The treatment with botulinum toxin,” concludes Dr. Marino, “is not recommended for:

• Individuals who are allergic to albumin.
• Pregnant and breastfeeding women.”