Botox for Wrinkles: Forehead Lines, Crow's Feet and Frown Lines, What the Label Covers

Botox for wrinkles: which lines the label covers

The US label for Botox covers four areas of moderate to severe lines tied to muscle activity. [1] The BOTOX Cosmetic label says it is for adults, to improve the appearance of these lines for a time, and it links each line to the muscle involved. [1] The table below sums it up.

This article uses the word Botox because that is what people search. The full name is botulinum toxin, made by the bacterium Clostridium botulinum, which blocks muscles from contracting. [4] For names and brands, see [[botox-botulinum-names]].

The label says "temporary improvement in the appearance". It does not say the lines are cured or removed for good. [1] A 2026 review of upper-face Botox research calls it a leading non-surgical treatment worldwide for movement lines between the brows, on the forehead and around the eyes, but notes that studies differ widely in how they measure results and report safety. [6]

Forehead lines, crow's feet and frown lines: what differs on the label

Each area has its own trial data and cautions on the label. [1] Frown lines: the label describes two trials in healthy adults aged 18 to 75 who had at least moderate lines at maximum frown, with results assessed on day 30. [1]

Forehead lines: the label advises treating them together with the lines between the brows, to lower the chance of a drooping brow. [1] The section on side effects below covers brow drooping.

Crow's feet: the label says dry eye has been reported after injection in or near the orbicularis oculi muscle, and the most common effect in the crow's feet trials was eyelid swelling, 1%. [1]

Neck bands: the label updated in October 2024 includes this use. [1] It is not a facial line, but people searching for Botox for wrinkles often meet it alongside the others.

The label warns that the doctor must understand the anatomy of the muscles and structures in the area, including changes from past surgery or disease. [1]

For other areas people ask about, such as armpits, brow lift, jawline lift and nose, see [[botox-other-areas]], which separates on-label from off-label uses.

Limits of Botox for wrinkles: lines the label does not cover

Botox cannot fix wrinkles from causes other than muscle movement. [4] The Thai FDA says in a 2022 infographic that the toxin cannot correct wrinkles that come from other causes. [4] The US label likewise limits use to lines tied to muscle activity. [1] If your lines are shallow, or clearly visible when your face is at rest, ask your doctor to assess whether they come from muscle movement.

The label says that in the frown line, crow's feet and forehead line trials, response rates appeared higher in people under 65 than in people 65 or older. [1] Safety and effectiveness in children have not been established. [1] For pregnancy, the label says there are no adequate studies or post-marketing data. [1]

Labels differ by brand. The US XEOMIN label lists three upper-face lines: frown lines, horizontal forehead lines and crow's feet. [2] The US DYSPORT label lists only the lines between the brows, in adults under 65. [3]

This article uses US labels as examples because the full text can be checked. The indications registered in Thailand may differ by brand, so check the current status with the Thai FDA. [5] For Korean brands common in Thailand, see [[neuronox-nabota-aestox]].

Side effects of Botox for forehead lines, crow's feet and frown lines

The label reports drooping eyelid, drooping brow and headache, and carries a boxed warning that the effect can spread beyond the injection site. [1] The most common effects in the trials, by area: drooping eyelid 3% for frown lines, eyelid swelling 1% for crow's feet, and headache 9% with drooping brow 2% for forehead lines. [1]

A systematic review of 24 studies on injections between the brows and in the forehead found an overall complication rate of 16%, mostly mild and short-lived, such as headache, local skin reactions and facial muscle symptoms. [7] The authors say complication reporting is not standardised, and in 70% of studies the injector's training was not stated. [7]

A study that measured brow position with 3D images in two groups of adult women found that after injections in the forehead together with the frown area, the brow dropped significantly at 2 weeks and dropped less at 3 months. [8] The authors conclude the change depends on how much the forehead muscle is weakened, and that age cannot predict it. [8]

The boxed warning says the effect of Botox can spread away from the injection site and cause trouble swallowing or breathing, which can be life-threatening, and deaths have been reported. [1] If speech, swallowing or breathing is affected, get medical help at once. [1]

The Thai FDA advises against injection during pregnancy or breastfeeding and in people with muscle or nervous-system disorders, and says to tell the doctor about your conditions and medical history before deciding. [4]

Before Botox for wrinkles: what to check and what to ask the doctor

Choose a licensed facility with a doctor who injects, and ask to see the product and confirm it is licensed by the Thai FDA. [5] On 12 July 2024, after police and the Thai FDA raided a counterfeit Botox operation in Bangkok, the Thai FDA advised people to choose a licensed facility with a specialist doctor, and to ask to see the substance and check whether it is licensed. [5] The seized items included boxes and leaflets of brands sold in Thailand, such as Nabota, Neuronox and Aestox. [5]

People can check licensed health products on the Thai FDA website (www.fda.moph.go.th) or by LINE @FDAThai, and report anything suspicious on hotline 1556. [5] Botox is a procedure done by a doctor, not something to do yourself.

Questions to ask the doctor before injection:

• Are my lines caused by muscle movement or something else, and is Botox right for this kind of line? [4]
• Which brand will be used, and can I see its registration number and label? [5]
• Does this brand's label cover the area to be injected, and if it is off-label, what is the reason? [1][2][3]
• Could my brow or eyelid droop, and what happens if it does? [1][8]
• Do I have a medical condition or take medicine, or am I pregnant or breastfeeding? [4]
• Who do I contact at once if I have trouble swallowing, breathing or speaking after the injection? [1]