Aside from Botox, what treatments might help calm my forehead tension? (Photo)

I am only 21 years old, but have significant facial tension that contributes to headaches and generally feeling self conscious about looking older than my peers. I am reluctant to maintain Botox but have tried it- I received 5 units, which helped with the headaches, but not the appearance of my furrow. I have been looking into a derma-roller and regularly massage my forehead for the pain. Any suggestions or alternative methods? Thank you!

Doctor Answers 10

Improving Tension in Forehead

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5 units of Botox into the glabellar lines is very low. You need to have at least 15 units into this area for Botox to smooth out the wrinkles. Please consult with your treating physician. 

Summit Emergency Medicine Physician


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For treating the migraine headaches and the creases between your brows, the easiest more convenient treatment is Botox , or other Botulinum toxins like Xeomeen and Dysport, you may need more than 5 units, to treat efficiently them, in average 12 units are needed and the results may last from 3 up to 6 months. Other procedures are more invasive, like an endoscopic or transpalpebral transection and resection of the corrugator muscles that can also help with the migraines. You will need to have a complete evaluation by the neurologist and plastic surgeon to determine if the surgery will be a good option for you.

Aside from Botox, what treatments might help calm my forehead tension?

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Hello fhat,

5 units of Botox to the glabella would not be expected to do much of anything.  The usual starting dose to help with the vertical 1s there is about 20 units depending on your anatomy.  Other medications in the same class include Dysport and Xeomin.  Other than this, nothing else will really improve the lines that develop with activity.  I'd recommend you consult with a core aesthetic physician injector (facial plastic surgery, plastic surgery, dermatology) for your future treatments to receive an appropriate treatment.

I hope this helps and good luck. 

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

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Calming Forehead Tension with Increased Botox Dosage

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Dear fhat:

For optimal results with regards to softening and calming forehead lines, I would recommend increased doses of Botox in the range of 15-20 units.  Please use sun protection when appropriate.  All the best.

Multi-tasking with Botox for forehead lines and headaches

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Botox is the best way to reduce forehead lines and it may take a series to get the results that you want. In addition, I find that a combination of lasers or RF, sculptra for collagen building, microneedling/prp, ultherapy can help with skin rejuvenation and some of the tension you're describing. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Botox for headache

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For tension headaches, especially ones that originate from the forehead, Botox or Xeomin is the best choice.  5 units if not very much, you may get more effect from a higher dose.

Alternatives include massage as you mentioned, taking a Magnesium supplement, staying hydrated, taking a minute or two to just close your eyes throughout the day.

Best of luck,

Dr Rodman

Regina Rodman, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Improving tension in forehead

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5 units of Botox is very low and not enough to treat glabellar lines. It needs to be 15 or more to have an effect. There is no other treatments which lessen the muscle tension other than biofeedback or yoga.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Botox and forehead

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5 units is a very small dose and since you have a problem with headaches as well as the appearance of the forehead Botox would be best.  Fillers in this area can be done but they do not look as good as the results with Botox

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 7 reviews

Botox to glabella

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You likely need a higher dose to address furrows. 5 units is on the rather low side for treatment of the glabellar complex. I would expect a great response at a total dose of 12-14 units. Best of luck!

Elizabeth Damstetter, MD
Chicago Dermatologist

Facial Tension

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Most facial tension results from excessive tonic muscle activity.  It's unusual for the skin to remain tight and to cause this much discomfort.

Aside from Botox, Dysport, Xeomin, etc. there is the option of using muscle relaxers to alleviate the tension.  These have to be taken orally and there are known side effects from these medications however.

Reza Tirgari, MD
San Diego Physician
5.0 out of 5 stars 4 reviews

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.