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DocSpot: Be proud of your wrinkles and crow's feet

Sir Cliff Richard has admitted trying Botox injections to get rid of lines in his forehead. He says that because of his Peter Pan title, ‘I have had to live up to something that nobody actually can. You are going to age. It’s a fact of life.’ Actually, frown lines and crow’s feet around the eyes aren’t just caused by age; they are due partly to your genes, and partly to sun exposure and smoking. But they are also evidence that you have been using your facial muscles to communicate with other people. In the 1970s, some psychologists sat for hours in a bowling alley, noting down people’s facial expressions. They found that people did not smile or frown at the skittles when they hit or missed them, but they smiled or frowned when they turned to face their friends.


Eyebrow communication

This is particularly true of forehead lines. Beneath the forehead lie the muscles that lift the eyebrows, and our eyebrows are integral to our communication with others. We use our eyebrows to give a running commentary on what other people are saying or doing, or what we are saying ourselves - fully raised for disbelief, half raised for surprise, half lowered for puzzled and fully lowered for angry. We also use our eyebrows to acknowledge friends - psychologists have discovered that when we meet a friend we very quickly raise and lower our eyebrows a fraction, within a sixth of a second. We don’t know we are doing it, but presumably our friend notices it at a subconscious level.
 

Smile if you’ve got crow’s feet

And crow’s feet may mean that you are a genuine person who smiles a lot. For a genuine smile, facial muscles lift the corners of the lips and also scrunch up the eyes. In a phoney smile, however, the lips move but the eyes are not involved. This is how we can quite easily distinguish a phoney smile from a genuine one. (Also, phoney smiles usually last longer, whereas a genuine smile usually lasts a maximum of 4 seconds.)
 

How botulinum toxin works

Botulinum toxin is the most poisonous biological substance known, so it might seem an unlikely candidate for dealing with Sir Cliff’s wrinkly brow. The toxin is produced by Clostridium botulinum bacterium, which normally lives in soil. But if it gets into food, which is then not cooked properly, it can cause ‘botulism’. (In 1822, it was thought botulism was caused by sausages - botulus is the Latin word for sausage.) The toxin blocks the transmission of nerve impulses, and causing death usually by paralysing the muscles used for breathing. It is so poisonous that just one milligram is enough to kill 20 million mice.
 
The bacterium produces seven different toxins, named A to G. Scientists have now formulated the type A toxin in tiny, tiny doses so that it can be used safely as a treatment (Botox and Dysport). They are currently working on types B, C and F. Earlier this year, the British Medical Journal listed 33 different medical conditions that have been treated with Botox or Dysport. They are mainly conditions in which muscles or glands have become overactive, and the toxin paralyses the overactivity.
 

Cosmetic surgery with Botox

Sir Cliff would have had tiny injections of Botox into his forehead muscle. It would have taken about 10 minutes. After several days, the ‘frown’ muscles would have weakened, causing the skin creases to soften. The effect usually lasts about 3 months, and then further injections are needed. The treatment is safe, but some people are left with a drooping eyelid.
 

Botox on the NHS?

For some conditions, such as twitches, Botox injections are available under the NHS but only from specialist neurology centres that deal with movement disorders. If you have a twitch problem, talk to your GP. Otherwise, the injections are classified as cosmetic procedures, and you would probably need to go to a private clinic. Look at our advice on cosmetic surgery.
 

Last updated; Tuesday, August 29th 2017


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