Age 24. What is this vertical line going up my forehead? (photo)

Question

Hi, I am only 24 years old. I have this vertical line that goes up my whole forehead. What could be causing this? Do I need botox or filler?

Anna Chacon, MD, FAAD · Answer

The vertical line extending up your forehead is likely a glabellar crease or dynamic muscle line caused by repeated movement of the procerus or corrugator muscles, typically when frowning, concentrating, or squinting. This type of line is referred to as a "dynamic wrinkle", which can eventually become more permanent over time.

Possible Causes:
Facial expressions (frowning, squinting, thinking hard)

Underlying muscle activity in the glabella and forehead

Early collagen loss or dehydration

Genetic predisposition (some people develop lines earlier)

Treatment Options:
✅ Botox (Botulinum Toxin)
Purpose: Temporarily relaxes the muscles causing the line.

Effectiveness: Very effective at softening or eliminating early dynamic lines.

Best Time to Start: When lines are visible at rest or you want to prevent deepening.

✅ Topical Treatments (Preventative)
Retinoids, peptides, and hyaluronic acid can support skin texture and reduce early static lines.

Daily sunscreen use is critical to prevent further collagen breakdown.

✅ Filler (Only if Line Becomes Static and Deep)
Use cautiously in the glabellar region due to higher risk of vascular complications.

Often not necessary at this stage — Botox alone usually suffices.

Conclusion:
At age 24, the vertical line on your forehead is likely due to repetitive muscle movement, not aging or volume loss. Botox is the most effective and conservative treatment to prevent it from deepening, but it's not urgent if the line isn't bothersome. Early intervention can help preserve smooth skin long term.

Catherine Weng, MD · Answer

The short answer is this vertical line a glabellar rhytid, the vertical lines that are commonly treated with botox injection in the brow area.

It is a bit unusual for it to be so prominent in a 24 year old.  The frontalis muscle that goes from the scalp to the top of the brows can have different configurations in different people.  In some people it is a continuous sheet across the forehead, in others there may be a gap in the middle.  I would suspect your frontalis muscle may have a gap in it, which allows the corrugators (frown muscles under the eyebrows) to create that indentation every time you bring your brows together.

It looks like you also have a horizontal scar in the left side of your forehead.

Thanks for your question
Dr. Weng

Nelson Lee Novick, MD · Answer

A closer, in-person examination would be helpful. However, two possibilities come immediately to mind when looking at the photo. One is a line that arises from static tension of the muscles of the glabella (frown area between the eyes) region. A second possibility is a localized scleroderma condition known as "En coup de sabre.," so named because it looks like the result of a slash of a sabre
For the former condition, Botox would be helpful for relaxing the intense static muscular tension that gives rise to the line. And, if, after years of static tension, the overlying skin has become etched or creased even in the relaxed state, a low viscosity, malleable, cohesive HA filler, as a second step, can be injected to elevate and smooth the residual crease.
If this is "En coup de sabre" and has been stable for a long time, the above HA filler can be used to elevate and smooth the depression. This is precisely what I did with excellent results for my wife who has this condition.
It would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert who can both diagnose and treat these issues. Best of luck. .

Thomas Spalla, MD · Answer

The vertical line in your forehead is likely caused by a gap between the paired frontalis muscles of your forehead. There may be more of a diastasis in your anatomy resulting in this. Botox would be unlikely to improve this situation. Filler could be tried, but significant caution must be exercised with forehead filler due to severe vascular occlusion complications which can occur.

Age 24. What is this vertical line going up my forehead? (photo)

Answers (4)

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