I'm 50 and have noticed vertical thin indentations on my forehead. Running from the scalp downwards, should I be concerned?

Is this due to loss of fat under the skin in the forehead or is it something I should be concerned about. i also am a botox user.

Doctor Answers 11

Lines on forehead

Having photos would be very helpful.  It's hard to answer without knowing the source of the lines.  I think the best approach would be a consultation with a qualified cosmetic professional to give you the best advice.


San Diego Physician

Vertical Forehead Lines--Botox and fillers

This is tough to answer without pictures. This may be improved with a combination of Botox with fillers. I recommend getting a consultation with a cosmetic dermatologist. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

Newly found vertical forehead lines.

Hello rsmrachel,

Thank you for sharing you question however without a photo or more information regarding your Botox use, areas of treatment, length of time and frequency of Botox injections anything said will be pure conjecture. I would present to the professional who is doing your Botox with your concerns and the solution may be as simple as having Botox placed in a manner to "counterbalance" where you are currently receiving it. Hope this helps. 

Paul Pietro, MD
Greenville Physician
5.0 out of 5 stars 3 reviews

Vertical lines on the forehead

Thank you for your question rsmrachel. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression such as the vertical lines seen between the brows when one frowns. When I see vertical lines on the upper forehead of my patients, I tell them that Botox will not likely address them. This is because Botox relaxes muscles. Wrinkles formed by muscle contraction appear perpendicular to the fibers of the muscle. The fibers of the major muscle on the upper forehead run vertically, so the wrinkles created by them will appear horizontal. So vertical wrinkles in these areas generally can not be treated with Botox. Instead treatments such as fractional CO2 resurfacing may be used. Please consult with a doctor for specific recommendations. Good luck!

Vertical forehead lines

This is typically due to loss of fat and decreased volume.  This "exposes" the underlying structures, such as the supratrochlear and supraorbital arteries and veins, and also the lateral temporal fascial area.  Obviously without a picture I can't be more specific.  But, if it is volume loss, you can replace that volume with Sculptra or fat grafting.

Forehead lines

Vertical forehead lines are more common between the eyebrows. But yes higher vertical lines may be related to facial fat wasting or animation. You would have to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Forehead Lines

it's difficult to evaluate you or recommend treatment without a photo.  Horizontal lines are more common in the forehead and can be treated with Botox, xeomin, or dysport.  Consider a consultation in the office to be examined closely.  Good luck!

Samuel Baharestani, MD
Long Island Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

Lines on Forehead and Botox

It sounds as if these lines are from areas not treated by your Botox or compensatory lines created by Botox. Without a photo it is difficult to offer an opinion.  Please consult an expert in Botox for the best cosmetic results.  Best, Dr. Green

Sleep Lines

Your sleep position can cause lines and wrinkles to form, possibly contributing to an aged, tired look. These compressive forces can dramatically alter the surface of the skin on your face. Although Botox can help expressive lines caused by muscular movement and facial expression, your sleep lines are unique and should be handled differently.

This is addressed by an advanced dermal filler technique, with the use of cannulas.  While Botox helps the area overall, it does not address these vertical lines specifically

David Owers, MD
Vancouver Physician

Vertical line?

It's hard to say just based on your description and without photos. It would be great to see a photo of this line with and with muscle contraction. However, my best guess is that your line is originating from the contraction of the muscles in the frown area. Dysport and Botox may be able to treat these lines. I suggest you consider seeing a certified injector for an appropriate diagnosis. Best, Dr. ALDO

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 190 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.