Young Women Embrace “Barbie Botox” Trend, Igniting Health Concerns Among Doctors


A rising trend known as “Barbie Botox” is enveloping an audience of youthful women, some in their twenties, who are swiftly embracing toxin-based procedures in pursuit of resembling actress Margot Robbie’s character in the recent Barbie movie. However, this recent drift in aesthetics alarmed physicians, who speculate that this trend could cultivate resistance among users and potentially disrupt future medical applications.

“Trap Tox,” the procedure’s alternate term, is a traditional method where doctors administer botulinum toxins like Botox into upper back trapezius muscles to alleviate migraines and shoulder discomfort. However, the Barbie movie’s release in July precipitated a consumer shift favoring its cosmetic effects over its medical benefits. The popularity of this trend skyrocketed on social media, with the hashtag ‘BarbieBotox’ reaching over 11.2 million views on TikTok.

The procedure is aimed to sculpt a slimmer, more contoured neck—a trait now associated with the actress playing Barbie, says Dustin Sjuts, CEO of Revance Therapeutics. According to Scot Glasberg, the president-elect of the Plastic Surgery Foundation, the clients are no longer seeking treatment for wrinkles or lax skin but instead seek to reduce their neck dimensions for a more streamlined appearance.

Such injections’ approval for cosmetic application is confined exclusively to facial procedures. Therefore the trapezius injections exist in a legal gray area referred to as “off-label” dealings. The U.S. Food and Drug Administration assigns the accountability of “off-label” usage to healthcare professionals and requires them to evaluate these procedures for medical appropriateness.

Two toxin brands, Daxxify by Revance and Jeuveau by Evolus Inc., acknowledged to Reuters the upward swing in the “Barbie Botox” trend but remained doubtful of any consequential sales boost. AbbVie Inc., the Botox maker, declined to comment on the situation.

Historically, these toxin-based injections have been favored by individuals older than 40 years—a demographic that represents an estimated annual sales value exceeding $3 billion in the U.S alone.

However, physicians voiced their concern about toxin usage surge among younger women. A group of six doctors expressed the fear that underqualified staff administering procedures at certain medispas pose a significant risk of complications.

Increased usage among a younger demographic possessing stronger immune systems raises the likelihood of these products becoming less effective over time, says Shilpi Kheterpal, a dermatologist at the Cleveland Clinic. Additionally, the import of qualified personnel administering these treatments, especially within ‘medispas’ that lack strict regulation, cannot be overstated.

This unregulated environment permits various medical practitioners, including family and OB-GYN physicians, to administer injections. A growing trend is the throve of physician assistants and nurse practitioners currently handling injections.

The toxins are generally safe, but incorrect administration could potentially impact neighbouring muscles, potentially weakening them for months.

While the science isn’t conclusive yet, Evolus CEO, David Moatazedi, noted that doses used for aesthetic purposes are significantly less than therapeutic doses and that the products are known to be safe, but concerns regarding this latest trend’s long-term impacts persist.


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