How to fix vertical line on forehead? (photos)

Question

I've developed this vertical line that extends from my hairline in the middle if my face to just beside my right eyebrow. I've only begin noticing it over the last couple months and it had become progressively more prominent since then. If I run my finger across the line, I can feel an indentation. Is this something that can be treated with fillers? Is this perhaps the beginning of a bigger problem like linear scleroderma (en coup de sabre)? Kind of at a loss what I should do here.

Teresa C. Cunningham, MD · Answer

While overactive corrugator and frontalis muscles can lead to the angular indentation that you see near your brow, it is very unlikely that the central depression in the superior part of your forehead is due to that, as wrinkles in that area are typically horizontal and not vertical. I would agree with discussing this with your primary care doctor and possibly seeing a dermatologist to assess the skin in that area. Early linear scleroderma/coup de sabre is definitely on the differential diagnosis list, and there is potential to halt its progression by starting on medication early. Once it is stable, it can be treated with fillers or fat injection. My recommendation would be to see a board certified/eligible dermatologist for evaluation, and if they feel you need to see a rheumatologist as well they will be able to refer you. Best of luck to you!

Robert Kearney, MD, FACS · Answer

I would put filler in that crease and maybe botox. That crease maybe coming from the muscle action as well as how you are sleeping.  A good exam would tell which one or both.

Stephen Giordano, DO · Answer

That isn's such an uncommon problem, I see it more than occasionally, and find that a combo of Neuromodulator, liek Botox or Dysport first to relax the corrugator muscles laterally and if that doesn't help then very small amounts of filler along that line might help. Remember that both are temorary, and will need to be repeated in future.  Make sure you use a experienced injector.Best of luck,Dr G

Paul E. Goco, MD · Answer

Thanks for your question and providing photos.  Vertical lines such as yours can be do to over active muscles, ie brow muscles (corrugators).  They can also be due to constant manipulation such as a sleep line. Some people during their sleep position make wrinkles appear on their face and over time they can become very deep. Botox and fillers can be used to correct these lines along with changing your sleep postion. Please see a qualified injector in your area. Good luck!

Jason Emer, MD · Answer

Botox can be used to improve forehead lines. Deeper lines need a combination approach with Botox and lasers, microneedling/prp and fillers. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Anteneh Roba, MD · Answer

Based on your photos the indentation you have could probably be amenable to Botox injections. If that doesn’t help I would see your medical Dr since you say it started recently and is progressing.

Daniel Chang, MSc, MBBS, MRCS · Answer

Dear Nildiven,
Thank you for your question. 
I agree with you, this may not be strictly a cosmetic issue.
Hence, it is best to seek a formal consult with a dermatologist who can run lab tests for a definitive diagnosis.
Hope this helps and Merry Christmas!
Dr Daniel Chang
Singapore. Korea. Asia.

Ken Dolynchuk, MD · Answer

Hi and thanks for the question and your photo. While it is possible to correct the appearance of the indented line with commercial filler or even structural fat, it is critical to make a diagnosis as well as this is not simply form over-dynamic corrugator muscle contraction. Coup de  sabre is a definate possibility. Your GP can refer you to a dermatologist or a rheumatologist to make the correct diagnosis. Although treatment is limited for scleroderma its manifestations can be assessed and better managed by these specialists. Hope this is helpful.

Bobbak (Bobby) Mansouri, MD · Answer

Please do not listen to anyone who responds stating that you need filler or Botox for this issue. In all likelihood, there is one of two things going on: 1) you may be developing linear morphea as you mentioned or 2) this may be a more prominent tract for a vein that is becoming more pronounced as it appears somewhat matted down. For either scenario, you need to see a board-certified dermatologist in your area for full consultation. Linear morphea is a serious issue that needs to be treated aggressively early on in the course of the condition. Matted down veins on the forehead have been reported to be seen in some concurrent skin conditions, including a form of hair loss called lichen planopilaris or its variant, frontal fibrosing alopecia. You need a full, in-person evaluation from a board-certified dermatologist to ensure this new skin finding is not related to something more concerning. Good luck!

Leonard Grossman, MD · Answer

I would visit a plastic surgeon near you and have them evaluate your condition and treated appropriately. Good luck from New York City

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How to fix vertical line on forehead? (photos)

Answers (11)

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