Can Corticosteroid Be Injected into a Hyperactive Undereye Muscle for Muscle Twitch? What About Botox?

Can corticosteroid be injected into a hyperactive undereye muscle twitch? What about Botox? I am looking for a permanent solution to a permanent problem.

Doctor Answers 6

Botox for eyelid twitch

See an ophthalmologist for evaluation of your twitch and possibly Botox will be recommended, not corticosteroid injections.  The botox may break the cycle depending on what the cause of your twitch is. The twitch may recur after several weeks to several months after botox and you may need further Botox or different treatment.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

What to do about an under eye muscle twitch

Most commonly the cause of an under eye muscle twitch is eye fatigue, but there are other causes.  I would recommend a consultation with a board-certified ophthalmologist to determine the exact cause of the twitching.

Neither steroid injections nor Botox are a permanent solution to any problem.  Both of them act temporarily.

Corticosteroid injections do not do anything for under eye muscle twitching.  In fact corticosteroids applied or injected around the eye can potentially raise intraocular pressure and should be used extremely cautiously.

Botox injections can potentially be helpful if it is strictly a muscle problem, but that can only be determined after your evaluation by an ophthalmologist.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Your symptoms are known as blepharospasm and botox is a good solution


Injection of steroids is not a good idea as it will have a thinning effect on the surrounding tissue.  Botox will helps but it will only be temporary.  I would have an experienced injector perform this.  Just know that you may have to progressively increase the amount and areas injected until you get the ideal amount of muscle paralysis.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Well first you need an appropriate assessment by an oculoplastic surgeon.

Eye twitching or blepharospasm is often a benign condition what is mildly bothersome.  However, for some it can be severe.  Depending on your circumstances, you may benefit from treatment with BOTOX or Dysport.  However, corticosteroids have no role in treating this condition.  An oculoplastic surgeon will assess your eyelid twitch and look for secondary causes for the condition such as dry eye.  These need to be treated first before injecting the muscle with botulinum toxin.  Occasionally additional testing is indicated.  Your general ophthalmologist can refer you to an oculoplastic surgeon or you can use the American Society for Ophthalmic Plastic and Reconstructive Surgery website, which maintains a geographic directory (

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Hyperactive under eye and Botox

Botox is the solution you are looking for.  An undereye muscle twitch is neurologic in origin and there is no permanent solution to this problem.  Botox is your best option and it will work very well but only for a period of 3-4 months and then need to be repeated.  However, with that being said, there are many patients, that after receiving this treatment, receive a biofeedback mechanism that can reduce the return of the twitch in the long run.  Essentially, you retrain that muscle to not react in that manner.  So with repeat treatments you may actually find that this lasts longer and longer.  I see this routinely in patient's who are overactive eye brow archers, or squinters around the eyes, or furrowers of their brows.  Repeat treatments prevent patient's from performing those actions and you eventually stop them all together.  I have patient's that start with very deep creasing and wrinkles and after 2-3 treatments they are entirely gone and then they come and see me every 6 months or 8 months at the earliest.  Visit with someone comfortable treating this problem.  You would likely need no more than about 8 units per side to treat this disorder.  Hope that helps!  Dr. Shep

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

Hyperactive Undereye Muscle Twitch

First, neither of these is a permanent solution. Cortisteroid will be absorbed by your body over time, and this is not a good use for it anyway. Botox could work in this area, but it does only last 3-4 months average, so you will need to do it repeatedly. I would suggest you visit a highly experienced injector or perhaps an ocular specialist for evaluation and options, as undereye muscles require very specific injection levels and technique.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.