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Dermal Fillers

How Many Units Botox Forehead?

Botox treatment has specific guidelines about its usage, like any other medical procedure. This article discusses botox units for the forehead, including; uses, what causes forehead lines and what is a unit of botulinum toxin injection.

Botulinum toxin injectionhas been the most popular cosmetic treatment since the first FDA approval for treating deep frown lines and forehead wrinkles. Today, it is among the most preferred non-invasive cosmetic procedures worldwide. Forehead wrinkles may result from normal aging or sun damage forming due to constant muscle movements. These make the skin stretch and create permanent grooves. Botulinum toxininjections treat wrinkles and fine lines and smooth out facial creases by causing temporal freezing of muscle cells. The amount of botulinum toxininjections needed for forehead lines depends on various factors a cosmetic doctor assesses before beginning the procedure. The stronger or larger the facial muscles, the more botulinum toxin units a patient needs.

What Is Botox, and How Does It Work?

Botox is a trading name for Botulinum toxin-A, derived from the bacterium Clostridium botulinum (C. botulinum). It is found in the natural environment, such as lakes, forests, soil, or the intestinal tracts of animals. Botulinum toxin is a highly poisonous substance. However, when used in limited quantities, it is safe and effective. Botulinum toxin injections disrupt the functions of the neuromuscular system. According to Spinu et al. (2020), “the mechanism of action blocks acetylcholine at the neuromuscular junction, which prevents the transmission of the nervous impulse with secondary flaccid freezing.

Uses of Botox

Sunil et al. (2015) stated that botulinum toxininjections are widely used for skin rejuvenation and the elimination of facial wrinkles. The non-invasive procedure appeals to patients who want to reduce the appearance of facial wrinkles and maintain a youthful look without undergoing any surgical procedure. Nestor et al. (2020) claimed that botulinum toxin injections temporarily freeze muscle cells preventing contraction from dynamic facial movements. Botox reduces wrinkles from constant muscle contraction, making the skin appear young and refreshed. According to Satriyasa (2019), botulinum toxintreatments reduce glabellar frown lines, crow’s feet at the side of the eyes, horizontal forehead creases, wrinkles around the mouth, nasolabial folds, and smoothing out neck and chest or cleavage wrinkles. It is also used to elevate eyebrows and treat conditions such as hyperhidrosis, lichen simplex, pompholyx, and acne vulgaris; it cannot be used to prevent other aging signs such as skin drying and pigmentation.

According to Padda &Tadi (2021), botulinum toxininjection is an FDA-approved treatment for wrinkles and facial lines, and other medical conditions such as:

  • Chronic migraine
  • Cervical dystonia
  • Blepharospasm
  • Hemifacial spasms
  • Urinary incontinence
  • Strabismus
  • Hyperhidrosis

Some patientsget botulinum toxin injections for off-label indications that are less known. According to Lewandowski (2022), “there are numerous promising reports based on off-label botox usage, indicating its potential effectiveness in other diseases, which remains unknown to many. Among them are dermatological conditions, such as rosacea, annal fissure, Raynaud phenomenon, hypertrophic scars and keloids, and hidradenitis suppurativa, which are being investigated.

What Causes Forehead Lines?

The forehead is the first area of the face that shows aging signs. This is where many facial expressions are made to show when clients are sad, happy, surprised, angry, or worried. Forehead lines are caused by the normal aging process, sun damage, too much smoking, genetics, and excessive facial expressions.

What Is a Unit of Botox?

A Botox unit measures the amount of botulinum toxin treatment injected into the muscles.Kazerooni& Watanabe (2021) claimed thatbotulinum toxin injections come in dosages between 50 and 100 units per vial.

How Many Units of Botox Do I Need for Forehead Wrinkles?

Patients should start with low botulinum toxin injections for forehead lines if they use the treatment for the first time.Satriyasa (2019)states that the optimal dose of botulinum toxin injection is 20 units. Borba et al. (2021) claimed that some aestheticians recommend 10 to 50unitsof botox treatment for deep horizontal lines depending on the severity of the wrinkles. According to Page (2022),glabellar lines in male patients have been well-studied with a recommended starting dose of 40 units of Botulinum toxin injections. The study above also suggested that some male patients may require up to 80 units for adequate results. Male patients have stronger facial muscles than their women counterparts. Therefore, they need more units to achieve the same results.

Frequently Asked Questions about Botox for Forehead

Does Botox Permanently Eliminate Forehead Wrinkles?

Botulinum toxin injections do not have permanent effects. Multani et al. (2019) claimed that botox results last up to 3 to 4 months, depending on the severity of your wrinkles, age, and individual metabolism, among other factors.

How Much Is Botox for Forehead Lines?

Harvie et al. (2020) stated that a single unit of botulinum toxin injection costs $10 to $15. This depends on several factors the area being treated, the location of a cosmetic doctor, and the units required for the procedure.

What Other Areas of the FaceCan Be Treated with Botox?

The Food and Drug Administration has only approved Botulinum toxin injections for crow’s feet, lateral canthal, and glabellar lines. Other non-approved indications of Botulinum toxin treatments include lip wrinkles, smile lines, nasal glabellar lines, jawline contour, and chin wrinkles (marionette lines).

How Soon Do I See Botox Results?

Unlike facial fillers, botulinum toxin injections do not show their results immediately. The toxin takes time before it fully settles in the neuromuscular junctions to relax the muscle cells. According to Yokoyama et al. (2020), most patients begin noticing changes 3 to 5 days after having botulinum toxin injections.


The FDA approves botulinum toxin injections as a safe treatment to moderate forehead lines. Patients should choose a highly qualified and skilled aesthetic practitioner to perform the procedure. Depending on the severity of your wrinkles, a cosmetic doctor determines the number of units needed for smooth-looking skin. Prior thorough research is also required for the cost, risks, and other considerations. However, botulinum toxin treatments are not permanent. Patients can go for touch-ups when the effects fade.


Borba, A., Matayoshi, S., & Rodrigues, M. (2021). Avoiding Complications On The Upper Face Treatment With Botulinum Toxin: A Practical Guide. Aesthetic Plastic Surgery, 1-10.

Flynn, T. C. (2007). Botox In Men. Dermatologic Therapy, 20(6), 407-413.

Harvie, H. S., Amundsen, C. L., Neuwahl, S. J., Honeycutt, A. A., Lukacz, E. S., Sung, V. W., … & Thomas, S. (2020). Cost-Effectiveness Of Sacral Neuromodulation Versus OnabotulinumtoxinaFor Refractory Urgency Urinary Incontinence: Results Of The ROSETTA Randomized Trial. The Journal Of Urology, 203(5), 969-977.

Kazerooni, R., & Watanabe, J. H. (2021). Comparison Of Botulinum Toxins For Treatment Of Movement Disorders: Real-World Utilization And Cost Analysis In A National Medicare Population. Journal Of Managed Care & Specialty Pharmacy, 27(4), 478-487.

Lewandowski, M., Świerczewska, Z., &Barańska-Rybak, W. (2022). Off-Label Use Of Botulinum Toxin In Dermatology—Current State Of The Art. Molecules, 27(10).

Multani, I., Manji, J., Hastings-Ison, T., Khot, A., & Graham, K. (2019). Botulinum Toxin In The Management Of Children With Cerebral Palsy. Pediatric Drugs, 21(4), 261-281.

Nestor, M. S., Arnold, D., & Fischer, D. (2020). The Mechanisms Of Action And Use Of Botulinum Neurotoxin Type A In Aesthetics: Key Clinical Postulates II. Journal Of Cosmetic Dermatology, 19(11), 2785-2804.

Padda, I. S., &Tadi, P. (2021). Botulinum Toxin. In Statpearls [Internet]. Statpearls Publishing.

Page, A. A. (2022). AHM Botulinum Toxin: Botox Clinical Indications.

Satriyasa, B. K. (2019). Botulinum Toxin (Botox) A For Reducing The Appearance Of Facial Wrinkles: A Literature Review Of Clinical Use And Pharmacological Aspect. Clinical, Cosmetic And Investigational Dermatology, 12, 223.

Spinu, A. D., Bratu, O. G., Diaconu, C. C., Stanescu, A. M. A., Bungau, S., Fratila, O., … &Mischianu, D. L. D. (2020). Botulinum Toxin In Low Urinary Tract Disorders‑Over 30 Years Of Practice. Experimental And Therapeutic Medicine, 20(1), 117-120.

Yokoyama, O., Honda, M., Yamanishi, T., Sekiguchi, Y., Fujii, K., Nakayama, T., … & Kawahara, M. (2020). Onabotulinumtoxina (Botulinum Toxin Type A) For The Treatment Of Japanese Patients With Overactive Bladder And Urinary Incontinence: Results Of Single‐Dose Treatment From A Phase III, Randomized, Double‐Blind, Placebo‐Controlled Trial (Interim Analysis). International Journal Of Urology, 27(3), 227-234.

Marie Salbuvik