Botox alternatives for forehead lines? (Photo)

Question

Is there any alternative to Botox to smooth or help eliminate forehead lines? I was recently diagnosed with a neuromuscular disease & my Neuro said absolutely no botox. I asked if any other skin or wrinkle treatment were also to be avoided and he said that I only need to avoid Neuromodulator/Neurotoxin injections. I know it seems petty but I still want to feel pretty and like my old self amongst my dx. What else can I do? Pls help.

Erik Peterson, MD · Answer

Hi! Dr Peterson here – that’s a really thoughtful question and I completely understand where you’re coming from. If Botox or other neuromodulators aren’t an option, there are still treatments that can help soften forehead lines. Resurfacing lasers (like fractional CO2 or erbium) or microneedling with radiofrequency can stimulate new collagen and smooth etched-in lines over time. Chemical peels and medical-grade skincare with retinoids can also improve fine lines gradually. For deeper wrinkles, sometimes hyaluronic acid fillers or biostimulatory injectables are used very cautiously in the right patients to support the skin, but it depends on your anatomy. None of these work quite like Botox, but a skilled dermatologist can put together a plan that helps you feel refreshed without using neurotoxins.

Anil R. Shah, MD · Answer

a. Microneedling (with or without PRP)

Creates micro-injuries that stimulate collagen and elastin.

Helps smooth fine lines and improves overall skin texture.

No neurotoxin involvement.

b. Radiofrequency (RF) or RF Microneedling (like Morpheus8 or Vivace)

Uses heat energy to tighten skin and improve elasticity.

Gradually softens static forehead lines.

c. Laser resurfacing (non-ablative, like Fraxel or Clear + Brilliant)

Targets fine lines and texture without affecting muscle movement.

Great for early or moderate forehead lines.

d. Chemical peels

Light to medium-depth peels can stimulate collagen and smooth surface lines.

Ella Fedonenko, MD · Answer

Small amount of a filler(I recommend Volbella) should improve the appearance of the forehead lines. I recommend using 1 syringe of Volbella to begin with.

Behnoush Zarrini, MD · Answer

You’re absolutely not being petty &mdash; forehead lines affect both appearance and confidence, and it’s normal to want solutions. Since your neurologist advised against neuromodulators like Botox, there are still effective options.
Non-toxin alternatives include:
Morpheus8 (RF microneedling): Boosts collagen and tightens skin to soften forehead creases.
Microneedling with PRP: Improves texture and helps smooth fine lines naturally.
Laser resurfacing (CO₂, Erbium, fractional): Targets deeper etched-in lines.
Chemical peels & prescription skincare (like retinoids): Support gradual smoothing and skin renewal.
These treatments work by stimulating your skin’s own healing and collagen production, rather than relying on muscle relaxation. With the right plan, you can still achieve smoother skin and feel more like yourself.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concern. Since your neurologist has advised against Botox due to your neuromuscular condition, there are still several safe alternatives that may help soften forehead lines without the use of neuromodulators or neurotoxins:

Topical Treatments

Retinoids (such as tretinoin or over-the-counter retinol) help stimulate collagen production and improve skin texture over time.

Peptides and growth factor–containing creams may help support skin firmness.

Antioxidants like vitamin C serums can protect against free radical damage and brighten skin.

In-Office Procedures (Non-Neurotoxin Based)

Microneedling: Stimulates collagen production and improves fine lines and wrinkles.

Laser resurfacing (such as fractional CO₂ or erbium lasers): Can improve skin tone, texture, and reduce the appearance of lines.

Chemical peels: Promote skin renewal and smoothness.

Radiofrequency or ultrasound-based skin tightening (e.g., Ultherapy, Thermage): Stimulate deeper collagen remodeling.

Dermal Fillers

In certain cases, hyaluronic acid fillers can be used strategically in the forehead area to soften deep lines, though this should be done cautiously and by an experienced injector.

Lifestyle & Supportive Measures

Daily use of sunscreen to prevent further damage.

Good hydration, a healthy diet, and sleep optimization.

Avoiding smoking, which accelerates skin aging.

While Botox is the gold standard for forehead lines, these alternatives can still provide meaningful improvements and help restore confidence safely in your case.

Camille Cash, MD · Answer

There are a few alternatives you can use to help with forehead wrinkles since Botox is not an option for you.  You can concentrate on improving the skin texture with treatments such as lasers or Morpheus8.  You can also consider chemical peels.  We always recommend using medical grade skin care products such as Transform MD and wearing sunscreen every day.

Michael Chung, MD · Answer

I am very sorry to hear about your recent diagnosis. It is completely understandable that you would still want to feel like yourself and maintain your confidence. Wanting to preserve your sense of beauty is not petty in any way. It is an important part of overall well-being, and you absolutely deserve to feel comfortable and confident in your own skin.
Since your neurologist has advised you to avoid neuromodulators such as Botox, there are still a number of safe and effective alternatives that can improve forehead lines. One category is resurfacing treatments, including fractional laser resurfacing or erbium and CO₂ laser treatments, which stimulate collagen production and improve the appearance of fine lines and skin texture. Microneedling, sometimes combined with radiofrequency, can also promote collagen remodeling and provide gradual softening of etched lines.
Medical-grade skincare with topical retinoids, antioxidants, and consistent use of sunscreen can improve skin quality and slow the progression of wrinkles. Chemical peels performed by a qualified provider are another option to refresh the skin and enhance texture.
Finally, in some cases, deep forehead lines can be softened with either filler or fat grafting. In these patients, carefully placed dermal filler or fat transfer can soften deeper static lines. 
While none of these treatments are identical in effect to Botox, many patients do achieve meaningful improvement through a combination of these approaches. A consultation with a board-certified plastic surgeon who is aware of your medical history will allow for the creation of a treatment plan that is both safe and effective for you.
Sincerely,Michael Chung, MD

Botox alternatives for forehead lines? (Photo)

Answers (7)

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