Botox is usually used to reduce the appearance of frown lines, which can make a person appear older. But in November 2012, a New York City doctor specializing in facial injectables announced a new Botox treatment that has nothing to do with looking youthful. It’s called PokerTox and is intended for serious gamblers who struggle to maintain their poker faces.

A Problem for Poker Players

For dedicated poker players, one of the keys to a successful game is having a good poker face. “Poker is a game about reading people — it’s almost more about personalities than it is about the cards,” says Ellen Leikind, poker player, author of Poker Woman: How To Win at Love, Life, and Business Using the Principles of Poker and founder of Poker Prima Divas, a company that teaches women poker to enhance their business skills. Leikind says that if a poker player’s face gives away their excitement or frustration, they might lose the game — and a lot of money, too. But sometimes, no matter how hard the player tries to keep his emotions hidden, the little muscles in his face tense and wrinkle, unconsciously betraying his emotions — commonly known as a “tell.”

Jack Berdy, MD, a specialist in aesthetic medicine and medical director of Smoothmed Medi Spa in New York City, N.Y., has come up with a unique solution for gamblers to avoid giving away their game: Botox. Dr. Berdy calls the procedure “PokerTox,” and it’s a customized cosmetic Botox treatment that helps gamblers maintain a steady, smooth expression during a stressful game of poker. After injecting Botox into a poker player’s face, the player’s forehead will appear more relaxed, making it harder for others to figure out how he is feeling. This could potentially mean the difference between winning and losing for some players.

The Story behind PokerTox

Berdy knows firsthand how important a poker face can be. “I used to be a significant gambler,” he says. “Most poker players have some tells, or some facial emotions, that can give away a hand. The goal [of PokerTox] would be to restrain that expression, which is what we do with Botox every day. It just seemed like a natural fit.”

What to Expect from PokerTox

The PokerTox procedure is the same as any other cosmetic Botox treatment: Berdy uses a needle to inject tiny amounts of Botox into a patient’s facial muscles, which reduces the appearance of lines and wrinkles. This usually takes about 10 minutes.

What is different for poker players, however, is the consultation process. “Some players may know exactly what they want to change,” says Berdy. Others, however, might need guidance to figure out what improvements can be made to their poker faces.

“Along with the patient, we’re trying to figure out what emotions would reveal his hand and how best to restrain them,” Berdy says. The location, size and amount of Botox injected can vary from patient to patient, depending on how their face reacts to different emotions. By watching a patient’s face while playing poker, the doctor can assess the best level of Botox treatment needed to achieve a tell-less facial expression.

Duration and Cost of PoxerTox

Like all Botox treatments, the effects of PokerTox will last for three to four months. The cost of PokerTox is also the same as normal Botox treatments, which can range from $600 to $800. “There’s no premium for gamblers,” says Berdy.

A Poker Player Weighs In On PokerTox

Leikind, who has been playing poker since she was a teenager, says that PokerTox might not be effective for all poker players. She explains that tells aren’t limited to facial expressions — a poker player can also give up her game by suddenly talking too much, lunging for the chips or having a neck vein start to visibly throb. “If you’re a person who is a natural scowler, and that’s a tell of yours, obviously Botox can fix that. But there are a lot of things that Botox can’t fix,” says Leikind. “I wish I could tell you that Botox could get rid of every poker tell that there is, but there are just too many other ones.”