I can tell you from my own experience with my daughters. Sooner rather than later.
Results are quicker and cheaper. Plus, they are able to experience the cosmetic effects when they are most sensitive to the opinions of their peers. In other words is better to have this finished before middle school and high school years.
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Oh I’m realizing this now. I mean the ideal window is sooner than I had even imagined. Part of the problem is that most orthos are lazy and basic and only rearrange teeth. They don’t oversee jaw development. Most kids have underdeveloped jaws from a confluence of reasons basically having much to do the what the Mew’s harp on about. It takes early, active, and aggressive management to establish proper breathing and posturing habits to nip issues in the bud. I’m in course correction mode for them all.
Just making an unrelated, but related comment.
It was just last week my PT (who has magical powers and dose freaky things to one’s face) was criticizing how braces are fitted. He said you should not be laying back with your head in that position because that is not how your jaw naturally rests. That means they are changing the shape in an unnatural position (EUREKA!)
He also said this about the position we are in when doing eye tests
This actually made sense!!!
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Skin has tiny smooth muscles attached to hair follicles. Superficial, very dilute botox can reduce sebum and make enlarged pores look smaller for a few months. This use is off-label. It’s usually done with lots of tiny intradermal injections (often in the hundreds). I tried it once and my skin looked smoother for a few months. If you want to read more, search for “micro-infusion Botox,” or marketing names like “glass skin Botox facial” or “GlowTox.”
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Here we go, first impressions of the DEP device
The machine arrived today and I couldn’t resist trying it. I washed my face, did a light peel, and used 4 ml of a 10 mg/ml HA serum (the kind for microneedling) since it felt like the safest, low-cost option for a first run.
The device is straightforward to operate, but it isn’t painless. On my face and neck I could only tolerate levels 1–2; I tested level 3 for a few minutes. The 4 ml of serum was gone in about 10 minutes. The sensation is odd like an electric current passing through the skin and the vibration makes it a bit more tolerable, but it’s still borderline painful. The serum also takes a while to absorb, and it’s definitely not just evaporating.
Immediately after, my skin looked plumper. The small, superficial neck lines vanished, though I’m pretty sure that’s temporary plumping. I was surprised by how easy the device is to use, but I had hoped it would be less painful. I think the serum penetrated, and by morning I’ll know more. I did get some redness from the current, and it was easy to see which areas were treated versus untouched. I suspect some of the instant plumpness came from the electrical effect itself.
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Did you use the syringe in the handheld DEP device, or did you just free-hand it?
But yes - it does hurt sometimes.
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I just went freehand 
. Is there a way to take off the syringe holder? It feels pretty bulky, do you know?
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I have not looked into that issue yet. I prefer the single handed operation so far, but will try the freehand at some point.
Just to follow up on this potential application - it looks interesting. From CGPT5:
Here’s a clear, practical overview of what “micro-infusion Botox” is (often called micro-Botox, microtoxin, meso-Botox, or intradermal BoNTA), followed by a concise evidence audit so you can see exactly how strong the data are and where it’s still thin.
What it is & how it’s done (process)
- Goal: refine skin quality rather than freeze muscles—i.e., reduce oil/sebum and shine, shrink the look of pores, soften superficial fine lines, calm diffuse redness/flushing. Mechanism is thought to include blocking cholinergic signaling to sebaceous/eccrine units and local neurovascular effects in the dermis. MDPI
- Where the toxin goes: intradermal (very superficial) micro-droplets across the treatment zone (cheeks, T-zone, nose, sometimes neck/jawline). Not the usual intramuscular sites used for expression lines. PubMed
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Delivery methods:
- Stamping/microchannel devices (e.g., AQUAGOLD®) that press hollow microneedles into the skin to infuse a dilute cocktail (commonly BoNTA + hyaluronic acid; sometimes vitamins/antioxidants). Aquavit Skin Health
- Manual micro-droplet injections spaced ~0.5–1 cm apart with a fine needle. Lippincott Journals
- Typical mixes & dosing (varies by study): dilutions around 1–3 U per 0.1 mL with very small volumes per point; total cheek doses in split-face trials range ~10–20 U per cheek (some used more). Exact product/dilution varies (ona-/abo-/inco-BoNTA). Lippincott Journals
- Onset & durability: improvements often appear within 1–2 weeks and can last 8–12 weeks (occasionally up to ~3–4 months) depending on endpoint (texture, nasolabial wrinkle score, pore size, sebum). PubMed
- Adverse effects: usually mild/transient (pinpoint bleeding, redness). If doses are high or depth too deep, diffusion can temporarily weaken nearby mimic muscles; one RCT reported facial palsy at 30 U in one cheek (no events at 20 U). PubMed
Clinical evidence at a glance
Best overall summary
- 2024 systematic review + meta-analysis (10 studies; 5 RCTs, 5 cohorts; n=153): intradermal BoNTA improvedsebum production, pore size, erythema, wrinkles, skin texture/elasticity; no effect on hydration. However, all outcomes were underpowered on trial-sequential analysis—i.e., promising but not definitive; more/larger trials are needed. Lippincott Journals
Randomized/controlled human trials (face skin quality)
- Split-face, single-blind RCT (JCAD 2017, n=10): intradermal BoNTA improved skin texture and produced a mild midface “lift,” but did not significantly reduce pore size or sebum in this small pilot. No product-to-product differences (ona vs abo). PubMed
- Double-blind, split-face RCT (Ann Dermatol 2022, n=18): iBTXA vs saline in the cheek improved nasolabial fold wrinkles (through 12 weeks) and skin texture (through 8 weeks); pore size improved only at week 2; sebum not significantly changed. One facial palsy case at 30 U/cheek; no events at 20 U. PubMed
- Additional split-face trials summarized in 2024 meta-analysis: varied products/dilutions; pooled analysis showed significant improvements in pore size (SMD −2.34) and skin texture (SMD −0.52), with high heterogeneity and underpowered TSA—read as signal present but not definitive. Lippincott Journals
Sebum/oil control (face/scalp)
- Mechanistically and clinically, BoNTA can reduce sebum; multiple small trials/observational studies support this, but results are mixed in higher-quality RCTs. Reviews in Toxins (2021) and PRS Global Open (2024) conclude intradermal BoNTA can lower sebum, though stronger trials are needed. MDPI+1
- Scalp sebum (ASJ 2023): randomized, intradermal BoNTA vs saline showed efficacy for scalp oiliness with acceptable safety (adjacent domain but supports sebum mechanism). OUP Academic
Redness/flushing/rosacea (intradermal micro-droplets)
- 2025 scoping review & meta-analysis (7 studies; 2 RCTs): improvement in erythema at ~3 months post-treatment (SMD ~1.68); overall data limited and heterogeneous; suggests BoNTA is useful for erythematotelangiectatic rosacea but more robust trials are needed. PubMed+1
- Prospective & pilot studies (various designs) also report benefit for flushing/erythema; several case series/controlled split-face trials exist, and mechanistic work suggests neurovascular/anti-angiogenic effects may contribute. PMC+2DermSquared Skin+2
Acne, scars, and texture
- Expert consensus and roundtable review (ASJ 2023) describe practical improvements in pore size, oil, rosacea, acne, and fine lines with intradermal micro-doses; these are practice-based recommendations rather than RCTs. OUP Academic
- Split-face study for acne scars (2024): Micro-Botox vs fractional CO₂ laser both improved scars; Micro-Botox acted faster but effects were shorter-lived—underscoring that benefits may be temporary for this indication. Lippincott Journals
How to interpret all this (bottom line)
- What’s solid: Several randomized split-face trials show meaningful improvements in superficial texture and certain wrinkle scores over ~8–12 weeks, with generally low adverse-event rates when dosing is conservative and injections are intradermal. PubMed+1
- What’s promising but variable: Pore-size and oil/sebum reduction. Pooled estimates suggest benefit, and mechanistic logic is strong, but individual RCTs are inconsistent—likely due to small samples, varied products/dilutions, endpoints, and devices. Lippincott Journals
- What’s emerging: Rosacea erythema/flushing. Early RCTs and pooled analyses show improvement at ~3 months, but the literature is small and heterogeneous; it’s a reasonable off-label option in refractory cases, typically combined with other modalities. PubMed
- Durability: Expect 8–12 weeks of benefit for most skin-quality endpoints, sometimes a bit longer; plan maintenance if you like the effect. PubMed
- Risks/technique matters: Stay intradermal, use modest per-cheek totals (many trials cap at ~20 U/cheek), and avoid high volumes/depth near muscles you don’t want to weaken. PubMed+1
If people are looking offshore for these types of products, it looks like only Xeomin (Merz) is a reasonable bet due to it not requiring refrigeration:
Storage Requirements for Botox Brands (Unreconstituted, Prior to Use)
| Brand | Refrigeration Required? | Storage Details (Unreconstituted) | Notes |
|---|---|---|---|
| Botox (Allergan/AbbVie) | Yes | Store at 2°C to 8°C (36°F to 46°F) in a refrigerator. Can be stored at room temperature (up to 25°C/77°F) for up to 24 hours during transport. | Must be kept refrigerated to maintain potency; freezing is not recommended. |
| Dysport (Ipsen/Galderma) | Yes | Store at 2°C to 8°C (36°F to 46°F). Do not freeze. | Sensitive to temperature changes; refrigeration ensures stability. |
| Xeomin (Merz) | No (unique) | Store at room temperature (up to 25°C/77°F) for up to 36 months, or refrigerate at 2°C to 8°C (36°F to 46°F) for flexibility. | “Naked” toxin (no complexing proteins); stable without refrigeration, making it easier for shipping/storage. |
| Jeuveau (Evolus) | Yes | Store at 2°C to 8°C (36°F to 46°F). Protect from light; do not freeze. | Similar to Botox in storage needs; refrigeration is critical for potency. |
| Daxxify (Revance) | Yes | Store at 2°C to 8°C (36°F to 46°F). May be stored at room temperature (up to 25°C/77°F) for up to 72 hours during transport. | Peptide-stabilized; strict refrigeration prevents degradation. |
Key Points for Consumers and Professionals
- Refrigeration (General Rule): Most brands (Botox, Dysport, Jeuveau, Daxxify) require refrigeration at 2°C to 8°C (36°F to 46°F) before reconstitution to ensure the botulinum toxin remains effective. Xeomin is the exception, offering room-temperature stability, which simplifies storage for clinics.
- Post-Reconstitution: Once mixed with saline, all brands must be refrigerated (2°C to 8°C) and used within 24 hours (Botox, Jeuveau, Dysport) or 4–6 weeks (Xeomin, Daxxify, under specific conditions) to avoid potency loss. Always check manufacturer guidelines.
- Why Refrigeration Matters: Botulinum toxin is a protein that can degrade if exposed to heat, light, or freezing, leading to reduced effectiveness or safety risks. Improper storage by providers can result in suboptimal results (e.g., shorter duration or no effect).
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Bingo, sounds like my experience exactly. Except I can take more discomfort and go up to a level 3 on the face (though not everywhere). The best way to do it is start at 1 and after a few minutes bump up to a 2 and then a few minutes later still, to a 3. There’s a certain habituation and desensitization that happens that way. Low vibration for me is typically more comfortable than either high or none. And yes it’s an inconvenient process compared to injection, it takes a long time, but the product definitely makes it to the other side. If I knew how to inject properly I would stick to that. But being able to self administer these cool treatments without basically becoming a nurse, is mind blowing. I’ve been too busy of late with kids schedules now that they’re back to school to do a session but my skin still looks at its best from the session I did in August!
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FWIW…
On the “pain” issue, use a lidocaine cream(many places available online to purchases) as use for doing tattoos and “botox” injections
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Thats an interesting idea… you could use the lidocaine cream and increase the “voltage” being delivered and therefore (perhaps) the penetration of the solution into the skin.
Not sure if this is true or not, but something to research…
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12 hours later, my skin has calmed down. It still feels a bit “numb", an odd but not uncomfortable sensation, especially in the areas where I had to work longer to get the serum to absorb (electricity? product in the skin?). The upside: my skin looks smoother and plumper, similar to the effect I get a few days to a week after a skin-booster injection, but this time it was almost immediate. I used a simple HA serum; with a more targeted product I might be able to track clearer changes over time.
I wouldn’t want cream ingredients on my skin with DEP, since it drives them deeper. In one of the DEP videos they actually talk about using DEP to infuse lidocaine solution (not cream) before laser or other more invasive treatments.
On my face, lidocaine cream only numbs the superficial skin; injections still hurt about the same. A cold compress before injecting helps me more.
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Fyi, when I’ve had numbing cream applied, the docs always remove it before the procedure.
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FWIW…
AI generated;
How to apply lidocaine cream
- Cleanse the area: Wash the skin where the injection will take place with a gentle cleanser, though this step is sometimes done by the practitioner as well.
- Apply the cream: Squeeze a thick, even layer of lidocaine cream onto the skin, making sure to cover the entire area that will be treated.
- Do not rub: Gently place the cream on the skin without rubbing it in.
- Cover the area: Place a plastic wrap or occlusive dressing over the cream to keep it in place and help it absorb into the skin.
- Wash your hands: Wash your hands immediately after applying the cream to avoid accidental transfer.
- Wait for the numbing effect: Leave the cream on for the time specified by your doctor, which is typically 30 to 60 minutes, to allow the skin to become numb.
- Remove the cream: At your appointment, the practitioner will remove the cream and wipe the area clean before the injection.
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FWIW…
Post this to another thread, will be of value to some here.
Review the training programs available, in my view the cost is reasonable . Same training some physician take.
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Did you do your face or neck? Let us know how long your numbing effect lasts. Your HA serum wasn’t a sterile serum like for injections? Just a regular serum? Thinking about getting a generation 3 for my neck.
Overall I wouldn’t say the DEP hurts though, at least in intensity level up to 3. At 3 it’s a sizably uncomfortable feeling, but it’s not pain like you’d get from a needle.
After 36+ hours, I still feel a bit of this sensation. It’s not unpleasant or painful, just different. My husband commented on my skin, saying it looks really good, like I used a filter or something. It does indeed look plumper. Nothing magical, but you can feel it when touching, like it’s a bit cushioning.
I used a simple HA gel, 10mg/ml, not intended for injection. However, the product description stated: “Add the product to a gel intended for use in transdermal mesotherapy or any other type of electrotherapy treatment, such as ultrasound, ionisation, or other medical devices used in aesthetic treatments.”
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Yes, it’s mostly tolerable, though the neck is a bit more unpleasant than the face. The vibrations definitely help. Where I notice it hurts, it’s when you get close to the hairline and my beard, as the electric current seems to pass through the hair into the skin and sting. Otherwise, it’s very tolerable, especially when I’m in charge of the device. It gets more uncomfortable when someone else is at the helm.
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