Horizontal lines across the forehead come from the muscle that raises your eyebrows. They are one of the three areas BOTOX® Cosmetic is FDA-approved to treat on the upper face, and at Shield Dental Care in Burke, VA, they are part of our Botox service.
What causes forehead lines
The frontalis is a broad, thin muscle across the forehead. It is the only muscle that lifts the eyebrows, so it works every time you look surprised, raise your brows in conversation or strain to see. Over time the skin creases where it folds. Some people also use the frontalis to hold heavy brows or lids up without noticing, which matters when it comes to treatment.
Why forehead lines are treated together with the frown lines
The frontalis lifts the brows, and the frown muscles between the eyebrows pull them down. If only the forehead is relaxed, the muscles that pull down are left unopposed, and the brows can sit lower or feel heavy. For that reason, the FDA-approved dosing for forehead lines is 20 units in the forehead given together with 20 units in the frown lines. In practice, most forehead treatments are planned as upper-face treatments.
BOTOX Cosmetic is FDA-approved for moderate to severe forehead lines in adults. Dysport and Daxxify are approved for the frown lines only, so using either of them on the forehead is off-label. Off-label use is legal and common, but we will tell you when a use is off-label so you can decide with that information.
Who is a good candidate
The best candidates have lines that come from movement, and brows and eyelids that sit where they want them. If your brows are low, or your eyelids are heavy, relaxing the forehead can make them feel heavier, because the muscle you have been using to lift them is now doing less. We check for this at the consultation. Sometimes the right answer is a lighter dose, a different pattern of injections, or not treating the forehead at all.
What to expect
- Consultation: we watch the forehead and brows move, check brow and lid position, and review your health history.
- Treatment: several small, shallow injections across the forehead and between the brows. It takes a few minutes.
- Aftercare: stay upright for a few hours, do not rub the area, and leave hard exercise until the next day.
Results start to show within a few days and build over about two weeks. They usually last around three to four months. Treatment should not be repeated more often than every three months.
Side effects
In the Botox Cosmetic forehead-line trials, the most common side effects were headache (about 9 in 100 people) and a temporarily lowered or heavy brow (about 2 in 100). Redness, small bumps and bruising at the injection points are common and short-lived. Like all botulinum toxin products, Botox carries a boxed warning about the rare spread of its effect beyond the injection site. Trouble swallowing, speaking or breathing, or new vision problems, in the hours or weeks after treatment need urgent medical attention.
Pregnancy, breastfeeding, a nerve-and-muscle condition such as myasthenia gravis, an allergy to any botulinum toxin, or an infection at the injection site are all reasons to wait or choose something else. Our Botox overview has the full list.
Frequently Asked Questions
Can I have just my forehead done?+
It is possible, but the approved dosing treats the forehead and the frown lines together, because relaxing the forehead alone can let the brows drop. We will explain what we recommend for your face at the consultation.
Will my forehead look frozen?+
It depends on the dose and where it is placed. Many people prefer to keep some movement, and a lighter treatment is an option. We ask what you want before we start.
Why do my eyebrows feel heavy after forehead Botox?+
The muscle that lifts the brows is doing less work while the Botox is active. A mild heavy feeling often settles within a couple of weeks. If it concerns you, call us.
How long does forehead Botox last?+
Usually around three to four months, after which movement returns gradually. It should not be repeated more often than every three months.