“I’m a dermatologist and here’s what to do if you don’t want Botox”

Including the treatment Kim Kardashian loves

Editor / September 15 2023

Botox has basically become the norm in recent years, but as great as it is for those who rate it, not everybody falls into said sector. So what about those of us who fall into the ‘reluctant’ realm?! Are we supposed to sit here and do nothing while our peers are plumping and tightening their skin to the nines?

Well, no - not if we don’t want to! There are in fact alternatives, and some options even count the celebrity crowd as fans.

When it comes to beauty, there’s not a stamp of approval we trust more than Kim Kardashian’s. After all, she herself was in the ‘not keen on Botox’ camp for years, and discovered some stellar youth-boosting alternatives throughout that time.

What are these enticing alternatives and how do they help, you ask? We spoke to Dr Robert McDonald from Sky Blue Dermatology to find out everything you need to know…

What are the most common ageing-related skin complaints?

As a dermatologist, Dr McDonald is a sounding board for everything skin-related, and many of the main concerns and complaints centre around signs of ageing.

For some, skin ageing is perceived as dull, lustreless skin,” he explains regarding some of the most common complaints. “Patients may present with blemishes or brown sunspots. Some have a sense that their appearance has changed but at the same time they find it difficult to describe what it is about their skin that is causing their dissatisfaction. It can be subtle differences in the shadowing under our eyes caused by age-related contour changes. It may [also] be more obvious age lines and jowls.”

So what’s possible in the youth-boosting department if you’re struggling with these types of skin concerns? “As a dermatologist, my priorities are firstly prevention, and then repair and maintenance,” Dr McDonald shares. Here are some dermatologist-approved options…


What topical skin care steps are recommended as Botox alternatives?

“The desire for a more youthful appearance fuels a skin care industry competing for a share of this lucrative market,” notes Dr McDonald, warning consumers not to fall for every piece of snappy marketing. “Not surprisingly, there are an ever-increasing number of products claiming anti-ageing benefits. However, these claims are not [all] backed by the type of data required by pharmaceutical companies when developing medicines.”

However, there is one that passes Dr McDonald’s test. “One class of ingredients that may be the exception are the retinoids, which are vitamin A-like molecules,” he explains. “These have been researched extensively and do seem to promote collagen production in the skin and may lessen wrinkles. The more potent forms require a prescription from a doctor. There are different forms available in over-the-counter skin care products – look for one containing a retinol or retinal (retinaldehyde).”

What treatments can be used as Botox alternatives?

Dermatologists have a number of options/modalities with which to repair aged skin,” says Dr McDonald, breaking down some recommended treatment options for those wanting to fight visible signs of ageing. “Superficial age changes can be treated with chemical peels, lasers and intense pulsed light (IPL), or a combination of these.”

“Deeper changes with loss of tissue elasticity historically required surgical intervention. Fortunately, we now have a large number of injectable products that allow us to replace volume and to restore youthful contours without the need for invasive surgery.” Great news, we know!

“There are also now a large number of energy-based devices promoted for skin tightening and rejuvenation. However, the results or benefits of these treatments are often a little underwhelming and temporary,” he explains. Again, though, there’s an option that seems to stand in a league of its own. “It has been difficult to ignore the potential offered by these devices and as someone interested in technology, and wanting to be able to offer a non-invasive treatment that would address deeper changes, I made the decision to acquire the Potenza.”

Wondering what exactly Potenza is (and what it can do for you)? Allow Dr McDonald to explain…

What is the Potenza treatment and how does it work?

“Based on science and skilful engineering, the Potenza [treatment] combines radiofrequency (RF) energy and micro needling (MN),” he shares. “It has evolved from previous models and the end result is a pretty amazing device. It also has a number of unique features that separate it from other RFMN devices.”

“Essentially, when the Potenza is activated, an array of needles penetrate the skin and a pulse of RF energy is delivered to the tissues. This energy heats and coagulates tissue and stimulates repair mechanisms resulting in the production of collagen and elastin, and ultimately improvement of skin quality and laxity.” Um, impressive stuff! Makes sense as to why Kardashian is a fan now, doesn’t it?

“A key component are the needles which are insulated to protect the top layer of the skin (epidermis). The needle depth is variable and is also a parameter set by the operator. This is critically important as skin thickness varies according to the facial region.”

As for how these needles work, they utilise two different modes. One, called ‘Monopolar’, allows energy to be drawn down deeply to where all the collagen magic happens within the skin (without the need for the needles to dive as deep). Talk about working smarter, not harder! The other is ‘Bipolar’ where the energy can be more focused.  These options give more options to treat different skin concerns, from laxity and pore size to scarring.  Potenza also has a range of different tips available, including a tip that will infuse topicals into the skin, such as PRP.  


How many Potenza treatments are recommended for best results?

“The Potenza has fairly wide applications for skin ageing, from mild changes in younger patients, to more moderate issues in older individuals,” Dr McDonald notes. “Stimulation of collagen production, and skin tightening involves a series of three treatments.”

“Treatments take about 45 to 60 minutes and two passes are made over the areas of concern. In older patients with more skin laxity, settings are adjusted for the 2nd pass to target deeper structures and produce lifting effects,” he tells BEAUTYcrew.

Can I get Potenza and Botox?

“You probably can have botulinum toxin treatments at the same time as Potenza treatments, but I am not aware of any study confirming this,” Dr McDonald warns, recommending leaving a gap between treatments.

Long story short, it’s actually A-OK to have Botox straight afterwards following Potenza, however, if going the other way around (having Botox first), a 3 week wait before heading in for Potenza would be recommended.

Dr. McDonald does have another tidbit of advice re: teaming treatments together, though: “I would be more wary of combining Potenza with dermal hyaluronic acid treatments. If the dermal filler has been placed deeply, Potenza targeting just superficial tissues would not be a problem,” he adds. Noted!

What downtime comes with a Potenza treatment?

“Patients experience redness, swelling and sometimes a small amount of pinpoint bleeding. Depending on the intensity of the treatment, these side effects settle within 1 to 3 days,” he confirms. “Unlike some laser treatments there is no bruising or scab formation. And unlike chemical peels, there is no darkening of the skin or peeling. There is some discomfort during the procedure, which is managed with topical numbing creams and cold air. Pain after the treatment is usually negligible.”

Nothing gets us wanting to lock in a treatment like hearing the benefits are plentiful and the post-treatment pain is negligible! BRB, booking in…

Main image credit: Getty Images

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Delaney began her career in the Australian beauty media industry in 2015, landing amidst the glossy world of women’s lifestyle magazines (or more literally, in their beauty cupboards). Since then, she has gone on to write across a multitude of beloved Australian media brands, including OK!, NW, InStyle, and Harper’s BAZAAR. She’s covered every side of beauty content, from directing beauty editorial shoots to rounding up the best glossy serums for golden hour skin. Having spent nearly a decade immersed in the beauty realm, Delaney’s knowledge of beauty is as extensive as her collection of tinted lip oils (read: extremely extensive). Delaney is currently the Digital Managing Editor of BEAUTYcrew, and her beauty wisdom also appears across beautyheaven, ELLE and Marie Claire. She enjoys channelling her personal hobby (testing beauty products) into her professional work (talking about testing beauty products), and considers perfecting the art of a cat eye in a moving car her life’s greatest accomplishment.

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