What's the deal with Botox?

Perry Wilson (0:00)

Emily, for the past week, in preparation for this episode, I've been staring at everyone's foreheads as I watch. I'm watching for any signs of eyebrow movement, and now I'm staring at your forehead. Oh, look at that.

Emily Oster (0:15)

Oh, I don't.

I am a no-go on Botox. I am afraid of needles in my face.

Perry Wilson (0:21)

Okay, well, that I understand, but-

Emily Oster (0:24)

Are you a Botoxer?

Perry Wilson (0:26)

I've never done it, but you know what? After this episode, I might have to change my tune. We'll see. We'll see how it shakes out. But I have a fun little activity for us before we get started. Okay, I have a quiz for you, because as you may know by now, botulinum toxin is the single most toxic thing in the entire planet, gram for gram. So it is incredibly, incredibly toxic. So of course we should inject it into our faces. What could go wrong?

Emily Oster (0:55)

What good plan?

Perry Wilson (0:57)

My quiz for you is for you to tell me how much more toxic is botox than a couple of things. Okay, so here we go. Take your best guess. So we're going to start with arsenic. How many more times more toxic is botox than arsenic gram for gram? Ten.

That's a good guess, but the answer is actually, it is 15 million times more toxic than arsenic.

Emily Oster (1:24)

Okay, so I was off by a few orders of magnitude. Not close. But now I'm prepared.

Perry Wilson (1:29)

All right, you're ready. Cyanide, that's pretty bad.

Emily Oster (1:32)

Ten million.

Perry Wilson (1:33)

Okay, all right. I think you're getting it. It's only six billion times more toxic than cyanide. What about sarin gas, notorious chemical warfare agent?

Emily Oster (1:48)

I'm going to go with 50 I feel like this one's bad.

Perry Wilson (1:51)

50 It's bad. It's bad. Sarin is bad. Is that the one from The Rock? I think it might have been. Oh, no, that was like VX or whatever. But botulinum toxin is 100,000 times more toxic, gram for gram.

Emily Oster (2:03)

Again, I overcorrected.

Perry Wilson (2:05)

Than sarin gas. Uranium, radioactive uranium.

Emily Oster (2:12)

Is this like if you ate it?

SPEAKER_3 (2:14)

Like if I ate the uranium.

Perry Wilson (2:15)

For I injected you with uranium again.

Emily Oster (2:20)

3,000.

Perry Wilson (2:21)

Botox is 200 million times more toxic than uranium. Last one, tetanus toxin. Tetanus.

Emily Oster (2:30)

Six billion.

Perry Wilson (2:32)

Only twice as toxic.

SPEAKER_4 (2:34)

Oh, **** you. It's ridiculous.

Perry Wilson (2:37)

Tetanus toxin is actually incredibly toxic, and also comes from a clostridium genus of bacteria. So those bacteria know what they're doing when it comes to killing humans. This is just the tip of the iceberg of the interesting stuff that botox can do that we need to talk about today.

Emily Oster (2:53)

I'm very excited for this episode because of course we are going to get to your face. But I think the basic, I am just so interested in the question of how we got from, this is the most toxic substance known to man, to like, let's inject it into various parts of our body and see how that goes.

Like, what could go wrong?

Perry Wilson (3:13)

Isn't science awesome?

Emily Oster (3:18)

I'm Emily Oster. I'm an economist and a data expert.

Perry Wilson (3:21)

And I'm Perry Wilson. I'm a medical doctor.

Emily Oster (3:23)

It is Thursday, October 8th, 2026, and this is Wellness, Actually.

Perry Wilson (3:28)

Because you're getting a staggering amount of health and wellness information nowadays from every source imaginable. And some of it is awesome.

Emily Oster (3:36)

And some of it is, well, actually bulls**t. Fortunately, we're both people who know how to read studies, how to parse the data, and can tell you what's worth thinking about and what you can safely ignore.

Perry Wilson (3:50)

But before we dig in, a note that this podcast is for educational purposes and should not be construed as medical advice. We don't know your unique situation, so talk to your doctor for personal health decisions.

Emily Oster (4:01)

This week, we're asking, what's the deal with Botox? Perry and I will give the official smash or pass, and we'll get to your question of the week. But first, let's do the Health News Roundup after the break.

And now for the Health News of the week. Perry, it's Nobel Prize week. We are recording this on Monday, and the Nobel Prize in Physiology and Medicine was just announced. This is always very exciting. They always give it for something that is difficult to understand.