Here’s a riddle: What’s a nearly invisible and weightless substance that can boost a politician’s image if done right, and make them a laughingstock if done wrong?

That’s right, Botox has hit the nation’s capital. Medical spas dispensing neurotoxins are now all over the D.C. area, and plastic surgeons have proliferated from Georgetown to Arlington, Va. Though no elected officials have copped to getting injections, doctors say they have treated them, and that demand has grown at a time when politicians are more visible and scrutinized for their age and appearance than ever.

At the recent Republican National Convention , speculation over Rep. Matt Gaetz’s electrified eyebrows and forehead overshadowed his typically fiery speech. Esquire magazine called the Florida congressman’s face “the mug that launched a thousand memes.” More like a million: On social media, Gaetz was compared to everyone from Wayne “Mr. Las Vegas” Newton to the Real Housewives to “Star Trek”’s Spock to Butt-Head from “Beavis and Butt-Head.” Rep. Derrick Van Orden (R, Wisc.) jumped on the bandwagon, likening his fellow party member to an “AI powered inflatable sex doll” on X. Gaetz’s office did not respond to requests for comment.

In recent years, Botox use has become more widespread and less taboo in many circles . But while armchair dermatologists have speculated about the cosmetic regimens of pretty much every well-preserved politician one could think of, from President Biden and Nancy Pelosi to Kristi Noem and Donald Trump, it’s still unheard of for elected officials to speak about such things.

Rep. Matt Gaetz (FL) speaks on Day 3 of the Republican National Convention (RNC), at the Fiserv Forum in Milwaukee, Wisconsin, U.S., July 17, 2024. REUTERS/Mike Segar

It took the considerable resources of the House Ethics Committee to reveal former congressman George Santos’s use of campaign funds for his own Botox injections in its report last November. By contrast, Noem had no problem extolling the virtues of her cosmetic dentist in a video during her recent glow-up . Representatives for Santos and Noem did not respond to requests for comment.

Cosmetic dermatology clinic Ever/Body opened four locations in the D.C. region between 2022 to 2023. Maria Rouse, the company’s market director for that area, said those openings were intended “to geographically support our growing clientele.” She said the centers have seen consistent growth, especially the Logan Circle location.

While Ever/Body can’t disclose details on its clients, Rouse said, “Given D.C.’s political landscape, we have seen a steady increase in influential people looking to feel refreshed and confident with the services we offer.”

Dr. Terrence Keaney, a D.C.-area dermatologist, said that he’s treated politicians for as long as he’s been in practice (12 years now), and demand has only grown. The difference is that now, he said, politicians are more public-facing than ever and generally more active on social media. It’s part of an overall trend toward noninvasive treatments, with the rise in selfies and video meetings. Keaney said several people had texted him about Gaetz’s face; he wanted the record to show that Gaetz was not one of his patients.

According to Keaney, nonsurgical procedures like Botox can be a way of projecting strength and health as a leader, along with good hair and makeup for debates and press conferences. He said these signals often work on the voter subconsciously. “You want someone who has the energy and vitality to keep up with everything that’s going on in the world…You want someone who’s not going to bed at 7 o’clock at night.”

Keaney, who says he is used to working discreetly with politicians, thinks that the secrecy might have something to do with the procedures’ reputation as expensive and rarefied. “These are considered luxury treatments that not everyone can afford, and they are appealing to voters of all socioeconomic status,” he said. “I think that’s partly why there are politicians who are probably reluctant to admit to doing this.”

Botox is by far the top procedure in Keaney’s office. But he warns of the risks of poor application, which creates “a negative feedback loop” for high-profile users.

“There are a million other patients who are public-facing figures who have Botox and you don’t really know, and they look great, and we compliment how well they’re aging, but sometimes a poor outcome draws attention to it,” he says.

Beverly Hallberg, the president of Washington media coaching firm District Media Group, said she often gets asked by clients whether they should do Botox. Hallberg, who often works with politicians, said that it was more often from men than women, in one-on-one sessions without their staff around.

“I always say no,” said Hallberg. “I think you run more risk than potential payoff because if it’s not done well, the story becomes about what work someone has had done,” she said.

“Everything that I teach, from TV makeup to clothing to body language and facial expressions, shouldn’t be for any of it to stand out,” Hallberg said. “When people like the way you look, they usually don’t even pinpoint it.”

Hollywood celebrities like Olivia Colman and Kelly Ripa discuss their cosmetic dermatology procedures openly. Could elected officials ever follow in their footsteps? It certainly seems headed that way. White House press secretary Karine Jean-Pierre and Rep. Alexandria Ocasio-Cortez have both posted “get ready with me” videos outlining their (non-Botox) beauty routines in an intimate, candid style—like influencers.

“It wouldn’t surprise me if 10, 20 years from now Botox just becomes as routine as doing your hair and makeup,” Keaney said.

Write to Rory Satran at rory.satran@wsj.com