Huge vertical line down forehead - will it go away with Botox or is it something else? (photos)

Question

I have this huge line down the middle of my forehead that I've started to notice during the last year or so. I feel like it looks like I have roid rage. It seems unusual - will it go away with Botox or is it something else?

Jason Emer, MD · Answer

Neuromodulators (such as Botox, Dysport, Xeomin, and Jeuveau) and soft tissue fillers like Belotero can improve the appearance of the forehead by reducing lines, wrinkles and folds. Deeper lines and wrinkles need a combination approach with Botox, fillers, lasers, and microneedling/PRP. I recommend getting a formal evaluation with a cosmetic dermatologist to develop a treatment plan that works for you. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Hello, and thank you for your question. The line you are referring to may be a vein, which unfortunately, can’t be treated with Botox. However, a face-to-face evaluation is best in order to assess it and determine the best treatment for it. I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can do a proper evaluation, recommend the best course of action, and ensure the best possible results.

Alan Gonzalez, MD, FACS · Answer

Hello @PowerPuffy Botox is ideal to prevent and control expression lines and the vertical line you see in the forehead is probably a vein. Botulinum toxin is a substance that allow us to block the union that occurs between the nerve and the muscle so that the contraction of the muscle does not occurs, the botulinum toxin settles in that sector and does not allow the muscle contraction to continue, so the expression line or wrinkle does not form. I hope this shed some light! Best wishes! Alan Gonzalez MD FACS

Christopher Pannucci, MD, MS · Answer

Hi PowerPuffy,
The supratrochlear vein enters the subcutaneous space from the area deep to the medial eyebrow, and runs vertically above the frontalis/forehead muscle toward the hairline. This is probably a prominent supratrochlear vein in the subcutaneous tissue, and Botox would not impact it.
Hope this helps.
Best,Christopher Pannucci, MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, WA

George Yang, MD · Answer

Hi, it appears to be a forehead vein which can bulge when more blood accumulates in the vein. Usually this is seen more in people with leaner faces, but can be seen in other people. In one of the Google images, the caption asked if the vein popped out after botox. I don't think that botox will make the vein go down. If you look at the photos for Angelina Jolie Forehead veins, it also shows a few more celebrities, and they are all smiling very hard as shown in your own photo. Yet in other photos of Angelina, we don't really see the vein. When getting a blood test, the nurse will place a tourniquet on your bicep area, and ask you to pump your fist to cause the vein to pop out so it becomes easier to draw the blood. In these photos, the face is contracting hard for the smile and perhaps their is a blockage to the drainage of the forehead vein because of the facial muscle contraction. Soon after relaxing the face the vein usually goes away. It doesn't make sense to have a cosmetic procedure done for something that comes and goes for a moment in time. I hope you found this helpful. Good luck. Best, Dr. Yang

Zoran Potparic, MD · Answer

It is not clear from this photo what is causing this ridge; frequently it may be a large superficial vain. Without in person evaluation it would be difficult to give you sound advise. Consultation with a board certified plastic surgeon would help. Good luck.

Camille Cash, MD · Answer

From your photo it appears the vertical line that concerns you may be a vein, and not a typical forehead wrinkle.  If this is the case, Botox for this area will not improve it.

Douglas Taranow, DO, FACOS · Answer

It is difficult to assess if your line is caused by a superficial vein.  Normal forehead lines do not appear like this.  A physical exam would answer if Botox would help with this condition.
Dr. Taranow

William B. Rosenblatt, MD · Answer

That does not look like the normal 11 line from frowning that is helped with botulism toxin -- it looks more like a vein. You would need to be seen in person to know for sure -- but if it is a vein it is not helped with toxin.