How Many Botox Units for Horizontal Forehead Lines?

I have about four forehead wrinkles that are getting deeper every day.  I call it my "washboard" forehead. How many units of Botox would I need to relax these forehead lines?

Doctor Answers 43

Botox or Dysport for horizontal forehead lines: Catch 22.

When a patient comes to me with "washboard forehead" as you call yours, my first role is to lower expectations of what Botox or Dysport may be able to do for him or her. Unfortunately, the forehead can be a Catch 22 with Botox. The people with the deepest forehead lines use their frontalis forehead muscle the most to keep the brows up while talking and often to help them see. Trying too hard to smooth all of the lines out can weaken the muscle so much that you might end up with a flat forehead and drooping brows. This can be a, luckily temporary, disaster for the wrong person. 

I always recommend trying first to support the brows from underneath with a Botox or Dysport "brow lift", which can have a secondary effect of allowing the frontalis to relax, creating fewer wrinkles there naturally, while not causing any downward pressure on the eyebrows. After this kicks in for a few weeks, a lower number of strategically placed units can be lightly scattered in the forehead to soften without weighing down. 

Please see only a very experienced physician injector if your forehead has many deep wrinkles so you don't end up with a 3 to 6 month problem.


New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

There is no hard and fast rule.

Dear Cabbie02

I am not a big fan of injecting BOTOX into the forehead. The muscle up there, the frontalis muscle is the only elevator of the eyebrows. This means that any BOTOX injected into the frontalis muscle will drop the eyebrow position.

Yes one can certainly create a glass smooth forehead (Think Marcia Cross) but the price is a fall in the eyebrow position. The aesthetic price is very high because one gets this frozen forehead and a drop in the eyebrows that screams: MY FOREHEAD IS FROZEN BY BOTOX.

However, is there an alternative? The answer is absolutely: Microdroplet BOTOX. This is my patent pending method where tiny microinjections of BOTOX are place between the skin and the muscles of facial expression that insert into the skin along the eyebrow, root of the nose and the crows feet area.

This provides a degree of control over the placement of BOTOX that has not previously existed. The muscles responsible for pulling the eyebrow down and furrowing the eyebrow and glabella can be precisely targeted.

With the eyebrow depressing muscle treated in this fashion, the tug of war between the eyebrow lifting muscle and the eyebrow depressing muscles shifts to favor the brow elevator, the frontalis. This means that the frontalis muscle does not need to work so hard.

The eyebrow comes up and at the same time the lines in the forehead diminish without a bit of forehead freeze. This is one of the most popular BOTOX treatments in Los Angeles- the actors love it because they retain facial expression while at the same time having a very natural improvement in their appearance.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Forehead wrinkles

The typical forehead and 11's will require about 40 units for treatment. The forehead by itself could be treated with 20 units.  The crow's feet can require 5 to 10 units. It depends on the the size of the face and the muscular strength.

Botox is ideal for forehead wrinkles

I love injecting Botox into the forehead! It has such wonderful and beautiful results. Proper placement and skill is needed in this area to prevent your eyes from appearing droopy.  Please consult a board certified dermatologist who has many years of experience in injecting Botox.

Botox needed for forehead lines depends on sex

This would depend quite a bit on which sex you are. Males require many more units than females. The general configuration of your forehead lines would also be important. If your forehead lines extend all the way around and curve around the frontal region you would require a few more units to avoid the Dr. Spock look (for us SF fans), sometimes called the Jack Nicholson look (for Laker fans).

There has been a marked tendency among dermatologists and plastic surgeons to decrease the number of units in the forehead. In fact, the recent guidelines, as outlined by Dr. Lupo, one of the superior contributors on this site, recommend far fewer units than previous guidelines. Injecting fewer units decreases the chances of a brow drop.

I also feel it gives patients a much more natural look and avoids the deer in the headlight look....or the zombie-ish appearance that our VP Joe Biden gave us all during the debates (can't this man find a good PS or Dermatologist...first the weird hair transplant then the botched Botox job!).

I feel that 6-14 units in a female (if glabellar injections are given simultaneously) and 14-22 units in a male is the range I use. If need be more can always be injected as the physician and patient see fit.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

How Many Botox Units for Horizontal Forehead Lines?

Thank you for your question , it will be good to send photo with your question to evaluate your case however 1 to 2 cc should be enough for your forehead.

Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 80 reviews

Botox for Horizontal Forehead lines

Botox for Horizontal Forehead Lines has marginal benefit. For many patients, it will not be cost effective. The Horizontal Forehead lines generally requires 20 to 60 units of botox. Consult with an experienced and expert physician injector to ensure that the treatment would provide you sufficient benefit for the cost.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

Botox Dose for Forehead Lines

To soften up the forehead lines whilst at the same time still allowing some movement of the frontalis muscle, I will typically use 10-12 units.  Hope this information helps.  Wishing you treatment success.

Botox for forehead lines

The three most common sites to have Botox are the frown lines, squint lines, and horizontal forehead lines. The number of units required to soften these lines can vary depending on what is required and the strength of each muscle group. On average, 30 units of Botox used in the frown lines, 30 units of Botox are used in the squint lines to raise the lateral brow, and 15 units of Botox is used in the horizontal forehead lines to soften the wrinkling.

David A. F. Ellis, MD
Toronto Facial Plastic Surgeon
4.0 out of 5 stars 7 reviews

How many units of Botox do I need for my Forehead

In average, about 10 units of Botox will do it. There is no absolute rule and it depends on how much muscle activity you have and how much brow laxity you have. You don't want to use too much Botox if your brow laxity is too much because you may end-up with heavy looking brows, etc.
The best is to try a small amount first and see what result you get. You may also need superficial injections with an HA filler like Belotero for the edge lines in your forehead if they are as deep as you say. Botox works great for dynamic wrinkles, but those present at rest are better treated with a combination of neuromodulators and fillers. Hope this was helpful. Good luck!

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.