My glabellar muscles are always contracted. Is there an alternative treatment to botox?

This past month I have noticed that my glabellar muscles are always contracted! This is causing me a lot of discomfort and giving me headaches! I cant get them to relax! Is there anything that can be done for this before trying botox. I would like to try every other option first, just because with botox, it wears off and you have to keep it up. I just really want them to relax! Its uncomfortable and I don't want to have frown lines in the future!

Doctor Answers 9

Botox and Headaches in the Glabella Area

Botox is by the far the best way to treat this glabella area.  The alternative is to cut the glabella muscle surgically.  Please consult an experienced physician for the best cosmetic results.

Glabella Muscle Complex Spasm and pain options

Dear jkreighbaum:

At this time, treatment for "glabella" muscle complex spasm include:
  1. Botox and similar injectable muscle relaxers such as Dysport or Xeomin
  2. Surgical resection of the muscle(s) required to return balance to the spastic muscle bundles.
  3. meditation and hypnosis and biofeedback exercises
Not yet commonly available options to include:
  • cryotherapy of the muscle
  • neurectomy of the nerve to the muscle
  • topical muscle relaxants
Please consult with a Board Certified Plastic Surgeon, ENT Facial Surgeon or neurologist (particularly if pain control is an issue). 

I wish you the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 70 reviews

Glabellar Muscles always Contracted

There are surgical options available for this issue, but safe and reliable results can be obtained with Botox or another neuromodulator. I would actually suggest that you FIRST experiment with solving this problem with Botox because it's results are not permanent. This way you can learn if altering this area is going to be something you would want to change permanently. 

Alix J. Charles, MD
Hinsdale Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Botox, Dysport, Xeomin, or a more surgical approach.

There are cryo-destructive approaches and new radiofrequency treatments that are supposed to destroy the nerve. I actually still think injection neuromodulation is the best option, because although not permanent, if done regularly over time, often "re-trains" these overactive muscles and you do see long lasting improvement. It works best if started younger rather than older in my experience. Finally, you should try it at least once to see if you like the look before you choose a permanent option.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 14 reviews

Alternative to Botox

Botox over time will atrophy the glabella muscle  helping those frown lines look less noticeable.  Botox does wear off in 3 months.  A surgical treatment would be to remove some of the glabella muscle, thereby weakening the muscles.

My glabellar muscles are always contracted. Is there an alternative treatment to botox?

Thank you for your question. Outside of wrinkle relaxers like Botox, there is no other medication or treatment that can help provide relief from your contracted glabellar muscles. You can try and train yourself away from furrowing your brow through application of a breath-rite nasal strip to your glabella which can provide a form of biofeedback to remind you when you are contracting, but this may take a lot of training to achieve. Though I understand your apprehension to using a temporary medicine like Botox, it does work well, and is minimally invasive. I hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

My glabellar muscles are always contracted. Is there an alternative treatment to botox?

the muscle can be removed surgically, though it tends to come back, especially in people who contract it all the time.... and you then need botox again.  I have long and extensive experience in this area.  Surgery works completely and permanently in a minority of people.

The best results here are from botox or dysport





Val Lambros, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 8 reviews

Alternative to Botox?

Botox/Dysport is a great solution to your problem and if you don't like it--it wears off.  If you want a permanent fix, you may wish to have surgery or radiofrequency treatments to remove or weaken these muscles.  I would proceed with a lot of caution if you are doing a permanent treatment.  This does not constitute official medical advice.  Good luck.


Debra M. Kroll, MD
New York Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Corrugator excision

If you're planning to have a blepharoplasty, you can have those muscles excised and weakened at surgery. 

William H. Bearden III, MD, FACS
Richmond Oculoplastic Surgeon

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.