Inside the unexpected boom of foot Botox, a procedure ridding high heels of their masochistic roots

By Malavika Pradeep

Published Dec 12, 2022 at 02:13 PM

Reading time: 4 minutes

After the COVID-19 pandemic shoved our stationary feet into Crocs, Cruggs, and Birkenstocks, the footwear industry has now announced the comeback of high heels as the ultimate symbol of a wild night out. And this time around, it turns out that its resurrection has been meticulously YOLOfied—complete with a medical procedure that’s here to stay for the foreseeable future and could potentially tempt us back into Satan’s footwear.

Fashion’s high heel agenda

Remember the time when bread shoes and mullet shoes gripped our FYPs as part of the internet’s obsession with ugly footwear? In a bid to combat the absolutely unhinged and enforced comfort trends over the pandemic, coupled with our physical return back to offices, the footwear industry is increasingly buckling back into high heels.

Starting May 2022, searches for platform heels went up 69 per cent month on month, while lace-up styles witnessed a 45 per cent monthly increase, as noted by fashion technology company Lyst. Meanwhile, British footwear and accessories brand Kurt Geiger reported that the end of global lockdowns had a dramatic effect on shoe trends—with heels becoming the retailer’s leading shoe category, overthrowing sneakers for the first time since 2017.

The company also noted that heel heights had been declining for almost a decade as the trend for mega-high heels moved on to mid-height heels or even flats. While heels greater than 100 millimetre (mm) dominated the brand’s sales between 2012 and 2015, the most popular height was reduced to 75 mm in the years leading up to 2020.

As part of the footwear’s soaring 2022 return, Kurt Geiger believes it will follow the motto of ‘the higher the heels, the better’ and expects that “there will soon be demand for the highest heel height of 115 mm, last seen in 2013.”

That being said, it’s worth noting that consumers are not particularly interested in ravaging their feet to the point of extinction this time around. Sure, the core values of the comeback hinge on being “fun, sexy, and wholly impractical,” but it’s also dedicated to taking the pain out of the ‘beauty is pain’ equation. Alongside the rise of socks and heels as one of humanity’s biggest fashion crimes, high heels are now placing the spotlight on comfort. More specifically, alleviating discomfort with a cosmetic procedure dubbed ‘foot Botox’.

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Foot Botox and the therapeutic benefits of neuromodulators

Neuromodulators (injectable muscle relaxants) like Botox have long been associated with aesthetic concerns like minimising the appearance of fine lines and wrinkles. Over the pandemic, gen Zers’ obsession with anti-ageing methods fostered a boom of baby Botox—which also led to the questionable rise of at-home Botox parties.

However, there’s more to neuromodulators than their ability to plump and prime faces. In 1989, the Food and Drug Administration (FDA) approved Botox to treat eye disorders like blepharospasm (uncontrollable blinking) and strabismus (crossed eyes). Since then, Botox has been deployed for a number of non-cosmetic reasons including chronic migraines and overactive bladders.

When it comes to the treatment’s migration to our feet, foot Botox in particular has witnessed a surge in demand post-pandemic. The procedure essentially involves injecting a combination of Botox and dermal filler into the arch of your foot. Here, fillers are also injected into the ball of your foot with the aim of adding a cushion of skin to reduce discomfort from wearing heels.

Now, foot Botox may sound like an extensive measure for donning a particular type of footwear, but it’s important to note that the procedure is not intended for cosmetic purposes—when compared to treatment for crow’s feet, for example. Instead, 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,” Dr. Stephen Humble, a consultant in aesthetic medicine at Harley Street’s Hedox Clinic, told The Independent. Foot Botox also helps bunions or calluses—the two painful side effects of wearing heels—from worsening over time and addresses conditions like hyperhidrosis (excessive sweating).

But how exactly does Botox mitigate these symptoms in question? According to experts, the neuromodulator works by paralysing the muscles in your heel bone, causing the Substance P neurotransmitter (which modulates pain) to become inactive and lead to less pain overall.

“It’s very safe, but with any treatment there are always minor risks, like infection, allergy, or bruising,” Humble continued. “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.” At the same time, it should be noted that the benefits of foot Botox last about as long as they do elsewhere in the body. Simply put, the increased movement of the feet won’t cause the neurotoxin to wear off more quickly when compared to the forehead.

Although treating the glabellar lines between the eyebrows typically involves 10-25 units of Botox, the feet can sometimes require 70 to 200 total units. Depending on the severity of the patient’s condition, foot Botox can also get expensive, and fast. At Humble’s clinic, the treatment will reportedly set you back a foot-trembling £590.

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The post-pandemic boom of foot conditions

Foot Botox previously gripped heel-wearers in 2016. At the time, the treatment became increasingly popular to help women survive parties over the holiday season. According to board-certified dermatologist Dr. Ava Shamban, after two years of revelling in WFH-friendly footwear, people are now having trouble adjusting to towering heels—which has in turn led to a rise in patients seeking care for fast-growing foot pain.

“Weight is distributed more evenly in flat shoes, [whereas] all of the pressure is thrust to the front of the foot in a heel,” the expert said in an interview with Fashionista.

Meanwhile, dermatologist Dr. Michelle Henry noted that, even if you’re not wearing six-inch stilettos regularly, factors like “sports, [tight] shoes, age, or prolonged standing on flat surfaces can all lead to the development of plantar fasciitis,” a foot condition that presents as heel and arch pain, swelling, and persistent discomfort that can last months at a stretch.

Coupled with the dramatic comeback of the footwear, it’s hence no surprise to witness more and more heel-wearers ditching their Dr. Scholl’s inserts in favour of a more permanent solution. After all, the pain associated with donning high heels is here to stay as long as they remain as a footwear option. Now, with foot Botox in the equation, the footwear choice is slowly ridding itself of its borderline-masochistic roots.

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