I Had Intradermal Botox and Now I Can't Move my Forehead and my Eyebrows Are Less Arched? (photo)

I had the intradermal botox which is supposed to lessen oil production and shrink pores. Now I am on day two and I can't move my forehead and my eyebrows don't have the arch they used to. It was my understanding that the intradermal botox should only affect the top layer of skin and not the muscles beneath it. Has my doctor injected the botox too deep? Or is this just a temporary side effect? My forehead is quite frozen and paralyzed and I miss the arch my eyebrows used to have. Thanks.

Doctor Answers 15

Frozen forehead and depressed eyebrow shape after Botox

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Based on your description, it's quite clear that the forehead (frontalis) muscle was affected by the Botox, whether it's intended or not. The good news is that Botox will wear off with time. The use of Botox to decrease oil production and shrink pores has limited application and at place like the forehead, the unintended effect of Botox is quite likely to show up since the muscle is right below the skin. Botox is quite effective in decreasing sweat production. There are quite a few other treatment options to shrink pores and reduce skin oil production that has far less side effects than the use of Botox for this purpose.

Give it sometime and Botox will wear off.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Botox lessens muscle movement

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Botox will affect muscle movement whether that was your reason for using it or not. The botox travels a bit from where it is put and diffuses to nerves in area. That is why we can get such a smooth effect with few injections. I would not choose this as a first line treatment for oil production as there are better ways to do this that will last longer. The good news is that this will wear off completely in 3-4 months and if you had low doses , probably sooner.

Intradermal Botox

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First, Botox is temporary, so this will last for about 3-4 months as the Botox wears off. Personally I don't think Botox is a great product to lessen oil production and shrink pores - there are much more effective solutions to this than Botox. So selling it as this, really isn't the best idea, as you've seen firsthand now. Botox injected intradermally absolutely can go into the nearby muscles and affect it. Which is exactly what has happened to you. It will wear off over time, sorry.

Botox always spreads beyond the area of injection

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There is no way to inject Botox in the dermis and prevent it from spreading to the skin 1-2 cm around it and to the muscles underneath it. The frozen forehead muscles and change in your eyebrow arch are all due to the Botox spreading to your forehead muscles. Since Botox lasts about 4 months, your forehead will be affected for that amount of time. Topical retinoids (which you  may or may not use) will help with your oily skin and pores much more than Botox, and it will not affect your forehead muscles.

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon

Droopy forehead after botox

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what youre experiencing is a very common side effect of Botox when it is injected on the forehead whether it is for forehead lines or increased sweat production. at this point you just have to wait it out as Botox will wear off in 3-4 months

Diffusion of Botox

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Botox injected intradermally will diffuse out from the site of injection and affect muscles in the area of injection.  It appears this has happened to you as your midbrow and forehead are very flat.  This is what caused the eyebrows to flatten as well.  You might want to consider another injector next time around as selling Botox as a product to lessen oil production and shrink pores is so far off the 'off label' use that I question the sales pitch.  It certainly works with sweat glands and is FDA approved for hyperhidrosis.  Otherwise stick with it for relaxaiton of selected facial and neck muscles.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Eyebrows Are Less Arched

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A unit of Botox is a unit of efficacy not a unit of measurement.  Every patient will need a different number of units to effectively weaken the corragator muscle to decease the vertical creases between the brows.  I   Botox is not an exact science.  Caution has to be used no the forehead where an over dosing of Botox will lead to dropping of the brows or a flattening.  If you eliminate the elevators the brow will drop.  It is a balancing problem.  

Intradermal Botox and Lack of Forehead Movement

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   The diffusion radius of Botox or deeper injection has caused muscle paralysis.  I do not perform this for the forehead due to the fact that the result is not predictable.

Botox and effectiveness

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It sounds like the Botox is doing what it is intended to do, stop the muscle(s) from working, and if you didn't know this was going to be part of the treatment in addition to what you expected, I would follow up with your provider for better education and understanding of what you've had done.

Botox for the forehead

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The forehead muscles lie very superficially, just under the skin, so even very superficial injections of Botox will affect the muscles.  Please return to your injector so he can see the results.  It may be possible to use fewer units or a more dilute solution of Botox to give you some improvement in the oil production without too much effect on the muscles.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

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.