Foot Botox has become beauty’s strangest new trend – but not for the reasons you might think

Tired of painful high heels? Why not try ‘Foot Botox’, a cosmetic injectable that numbs the feet and is rapidly rising in popularity among dermatologists. Ellie Muir investigates a bizarre – if historically inevitable – new trend

No one (yet) is concerned about getting wrinkles on your toes. Rather, ‘foot Botox’ is all about how your feet feel (iStock)

At a wedding in October, Krystyna, 37, towered over the rest of the assembled guests in four-and-a-half-inch stilettos. Abba and “Come on Eileen” boomed from the speakers. Eventually, the party trailed off. “My family around me all kicked their shoes off under dinner tables and had to sit down for 20 minutes at a time,” she remembers. Krystyna, though, kept on going. She was on her feet for eight unstoppable hours. See, Krystyna had undergone a stiletto lift. In other words: she’d been injected with foot Botox.

By now, everyone knows about the use of cosmetic injectables to plump and prime faces, but feet? The procedure – which is rising in popularity – involves injecting a combination of Botox and dermal filler into the arch of the foot, paralysing the muscles in your heel bone. Filler is also injected into the ball of the foot, effectively adding a cushion of skin to reduce discomfort.

Where foot Botox differs from, say, Botox in your crow’s feet is that it’s not intended for aesthetic purposes. No one (yet) is concerned about getting wrinkles on your toes. Rather, “foot Botox” is all about how your feet feel. “The treatment is for anyone who wears high heels regularly and gets significant pain in their feet while wearing them,” says Dr Stephen Humble, a consultant in aesthetic medicine at Harley Street’s Hedox Clinic. There, the treatment will set you back £590. “It’s very safe, but with any treatment there are always minor risks, like infection, allergy or bruising,” he continues. “One downside is that the foot is a sensitive area, so there’s some pain with the injection. Another is that it wears off over time, so you have to repeat the procedure.”

There’s a burgeoning market for it, too. More and more heel-wearers are abandoning good ol’ Scholl “party feet” gel cushions in favour of a more permanent solution. For Krystyna, wearing stilettos became excruciating after she had children. “Normally my heels would be off before I already got home,” she says. “After a night out, I’d stand in a cold bath just to relieve my feet because they’d be so painful.”

Krystyna bought the stilettos to wear to the wedding but worried about the aftermath. “How the hell am I gonna manage it?” she thought. “I found some older articles about relieving foot pain and came across foot Botox and looked into it.” For Krystyna, wearing stilettos boosts her self-esteem. “As someone who’s a curvy size 12, I love wearing heels because they have a slimming effect, giving the illusion of longer legs.”

Foot Botox’s popularity became apparent when celebrities started ditching their working-from-home crocs for stilettos post-pandemic, with injections into the feet easing the pain of posing in heels on the red carpet. Dermatologists and other aesthetic practitioners have also since seen an uptick in patients seeking injections to make heels more manageable, according to a report by Fashionista. Humble noticed the trend and decided to offer the treatment to his clients at his clinic.

Botox’s great migration down to the feet actually started for medical rather than cosmetic purposes. “Foot Botox originated [as a way to treat] excess sweating,” says Dr Tamara Griffiths, of the British Association of Dermatologists. “It was first used in the underarms, where it can be very effective. Then use expanded to sweaty hands, feet and even other areas like the face, scalp and groin.”

We know it’s safe, but what we’re doing is niche. It’s novel

Typically, Griffith tells me, podiatrists and healthcare professionals have used Botox in the feet to treat everything from muscle spasms to tendon injuries. Injecting Botox into feet purely to make high heels easier to wear, though, is new. “There are lots of papers about injecting Botox into the feet for other conditions, for excess sweating or hyperhidrosis, so we know it’s safe to inject Botox and fillers into the feet,” says Dr Humble. “We just haven’t gotten to the point where there are scientific papers about Botox for wearing high heels. We know it’s safe, but what we’re doing is niche. It’s novel.”

Using Botox for reasons that aren’t solely medical, though, isn’t new at all. In 1978, ophthalmologist Alan B Scott began trialling the use of botulinum toxin to treat patients with crossed eyes. It was just over a decade later that a Canadian eye doctor named Jean Carruthers noticed, while using botulism to treat a patient’s eye twitch, that it also had a cosmetic bonus: her patient’s fine lines had vanished, too. Carruthers brought the discovery to her husband, dermatologist Alastair Carruthers, and the couple began experimenting with the wrinkle-relaxing treatment, and published their first study on it in 1992. Botox was later approved by America’s FDA for cosmetic use in 2002. Celebrities, the wealthy and – recently, anyway – increasingly image-conscious twentysomethings the world over rejoiced.

It means that doctors have always used Botox as a bit of a play-thing, seeing whether injecting it into assorted nooks and crannies could produce happy clients. As for Krystyna, she’s never looking back. She’s been dancing through the night in sky-high heels since her first injections in October. “I would do it again [because] it’s been amazing,” she tells me. “I can go out with my girlfriends on a Saturday night and wear my heels and not think, ‘Oh my god, I’m dreading wearing these!’”