What Are Glabellar Lines?
Glabellar lines, also called frown lines, are the vertical wrinkles that form between the inner ends of the eyebrows. They develop as skin thins with age and the muscles between the brows contract again and again.
Glabellar lines are usually a cosmetic concern, not a health problem, because most wrinkles come from normal aging changes in the skin. In 2002, frown lines became the first cosmetic use of botulinum toxin approved by the U.S. Food and Drug Administration (FDA).
Glabellar Lines at a Glance
| Also called | Frown lines, glabellar wrinkles |
|---|---|
| Cause | Repeated frown-muscle contraction plus age-related skin thinning |
| Where they appear | Between the eyebrows |
| Are they serious? | Usually not. Wrinkles aren't usually a cause for concern unless they appear at an early age. |
| Diagnosis | An exam of the face at rest and while frowning |
| Main treatment | Botulinum toxin type A injections (FDA-approved) |
| Other options | Dermal fillers, chemical peels, laser resurfacing and topical retinoids |
What Do Glabellar Lines Look Like?
Glabellar lines look like vertical creases between the eyebrows. Facial muscles attach to the skin, so it creases when they tighten. The corrugator supercilii, procerus and depressor supercilii muscles draw the brows inward and down, creating vertical folds.
- Dynamic lines appear only when the muscles contract, as when you frown.
- Static lines stay visible when your face is at rest.
What Causes Glabellar Lines?
Glabellar lines are caused by repeated muscle contraction plus age-related thinning of the skin's deeper layer (dermal atrophy). Common causes of wrinkles include:
- Normal aging changes in the skin
- Genetics (a family history of wrinkles)
- Frequent or prolonged sun exposure
- Smoking or exposure to cigarette smoke
How Are Glabellar Lines Diagnosed?
Glabellar lines are diagnosed with a face exam. A clinician checks your lines at rest and while frowning, and looks for uneven brows, drooping eyelids or trouble raising the eyebrows. Be ready to share all medicines, herbs and vitamins you take, past surgeries and cosmetic treatments, and whether you are pregnant or plan to become pregnant.
How Are Glabellar Lines Treated?
The treatment of choice for glabellar lines is botulinum toxin type A injected into the frown muscles to relax them.
Botulinum Toxin Injections
The toxin blocks nerve signals that tighten the muscle, so the overlying skin smooths out. FDA-approved products include Botox, Dysport, Xeomin and Jeuveau.
- The visit: one office visit. Botox Cosmetic's FDA label calls for 5 injection sites between the brows, 2 in each corrugator muscle and 1 in the procerus.
- Afterward: most people resume everyday activities and makeup right away. Don't rub the area, and wait two hours before strenuous exercise.
- Results: most people see results within 3 to 7 days, with the full effect at about 2 weeks. Results last about 3 to 4 months, and sometimes longer.
- Evidence: a 2021 Cochrane review of 65 trials (43 on frown lines) found onabotulinumtoxinA (20 units) probably has a higher success rate than placebo for frown lines.
Static lines improve more slowly and may need two or three treatments in a row. Deep ones may need injections combined with other treatments.
Other Options for Deep Lines
- Dermal fillers: gel-like substances injected under the skin, FDA-approved for moderate-to-severe facial wrinkles in people 22 and older. The glabella is a higher-risk site: in a review of 98 cases of vision changes after filler, 38.8% involved the glabella.
- Resurfacing: chemical peels and laser resurfacing work well for early wrinkles.
- Topical products: tretinoin or creams with alpha-hydroxy acids such as glycolic acid.
Risks and Who Shouldn't Have Injections
Side effects of botulinum toxin are usually mild: swelling, redness, soreness, bruising that lasts about a week and, less often, headache. Rarely, a nearby muscle weakens, causing a temporarily droopy brow or eyelid. Double vision, dry eyes and trouble swallowing or breathing are rare.
Injections aren't recommended during pregnancy or breastfeeding, or with a botulinum toxin allergy, an infection at the site, or a neuromuscular disorder such as myasthenia gravis. In Botox Cosmetic's frown-line trials, response rates appeared lower in people 65 and older. Never get injections in a non-medical setting such as a party or salon.
Can You Prevent Glabellar Lines?
You can help limit glabellar lines by protecting your skin from sun and smoke, though genetics and normal aging also cause wrinkles. Stay out of the sun when you can, wear hats and protective clothing, use sunscreen daily, and avoid smoking and secondhand smoke.
When Should You See a Clinician About Glabellar Lines?
See a clinician about glabellar lines if you want treatment or your skin seems to be wrinkling faster than normal for your age. After injections, get emergency care for trouble breathing, swallowing or speaking, vision changes or muscle weakness.
Glabellar Lines vs. Forehead Lines and Crow's Feet
Glabellar lines, forehead lines and crow's feet are all upper-face lines that Botox Cosmetic is FDA-approved to treat, but each forms in a different place from a different muscle.
| Where | Muscle responsible | Most common side effect in Botox Cosmetic trials | |
|---|---|---|---|
| Glabellar lines | Vertical lines between the eyebrows | Corrugator and procerus | Drooping eyelid (3%) |
| Forehead lines | Horizontal lines across the forehead | Frontalis | Headache (9%) and drooping brow (2%) |
| Crow's feet | Lines at the outer corners of the eyes | Orbicularis oculi | Eyelid swelling (1%) |
Glabellar Lines at GENEVA
At GENEVA Primary Care & Med Spa in Alpharetta, GA, a provider evaluates your glabellar lines, facial movement and health history. Based on that evaluation, your provider recommends treatment at GENEVA or a referral to a specialist.
You can read about wrinkle-relaxing injections and dermal fillers before your visit. GENEVA serves patients from Alpharetta, Johns Creek, Milton, Roswell and Cumming.
Related Terms
- Botulinum Toxin
- Botox
- Dynamic Wrinkles
- Forehead Lines (Frontalis Rhytids)
- Crow’s Feet (Lateral Canthal Lines)
- Dermal Fillers
- Wrinkle Prevention
- Bunny Lines: What They Are and How Botox Can Treat Them
Glabellar Lines FAQs
What causes glabellar lines between the eyebrows?
Glabellar lines are caused by repeated contraction of the muscles between the brows combined with age-related thinning of the skin. When the corrugator supercilii, procerus and depressor supercilii muscles tighten, they pull the brows inward and down and fold the skin into vertical creases. Normal aging, genetics, sun exposure and smoking are common causes of wrinkles. Lines that stay visible at rest (static lines) are slower to improve with treatment than lines that show only when you frown.
Are glabellar lines a sign of a health problem?
Glabellar lines usually aren't a sign of a health problem. Most wrinkles come from normal aging changes in the skin. MedlinePlus notes that wrinkles usually aren't a cause for concern unless they appear at an early age. Sun exposure and smoking make skin wrinkle sooner, and frequent sun exposure also increases the chance of skin cancer. Talk to a clinician if your skin seems to be wrinkling faster than normal for your age. Your clinician will examine your skin and may suggest a biopsy if there are abnormal growths or skin changes.
How long does Botox last for glabellar lines?
Botulinum toxin treatment for glabellar lines usually lasts about 3 to 4 months, and sometimes longer. Most people see results within 3 to 7 days, and the full effect develops in about 2 weeks. On its FDA label, Botox Cosmetic reduced frown-line severity for up to 120 days compared with placebo. The American Academy of Dermatology notes that the muscle may thin with repeat treatments, which can make results last longer. Retreatment is usually scheduled once muscle movement returns.
Is Botox or filler better for frown lines?
Botulinum toxin is the treatment of choice for frown lines because it relaxes the muscles that cause them. Dermal fillers are gel-like substances injected under the skin to create a smoother or fuller look. Botox Cosmetic is FDA-approved specifically for glabellar lines. Fillers are approved for moderate-to-severe facial wrinkles in people 22 and older, but the glabella is a higher-risk area: in a review of 98 cases of vision changes after filler, 38.8% involved the glabella. Deep static lines may need both treatments, though the FDA notes that combining fillers with Botox hasn't been evaluated in clinical studies.
What are the side effects of glabellar line injections?
Side effects of botulinum toxin for glabellar lines are usually mild: swelling, redness, soreness and bruising at the injection sites. Bruising lasts about a week, and mild headache is uncommon. In Botox Cosmetic's frown-line trials, the most common side effect was a drooping eyelid, in 3% of people, and this kind of droop is temporary. In rare cases, injections have caused double vision, dry eyes or trouble swallowing or breathing. Seek emergency care for these symptoms in the weeks after treatment.
Can you prevent glabellar lines?
Not entirely, because genetics and normal aging cause wrinkles, but protecting your skin from sun and smoke can help limit glabellar lines. MedlinePlus advises staying out of the sun as much as possible, wearing hats and protective clothing, using sunscreen every day, and avoiding smoking and secondhand smoke. Genetics and normal aging also play a role, so some lines may still appear with time. If frown lines bother you, a clinician can explain which treatments suit your lines and skin.
Can a primary care provider treat glabellar lines?
Yes, a primary care provider can evaluate glabellar lines, and clinicians with aesthetic training can treat them with botulinum toxin. At GENEVA in Alpharetta, a provider reviews your lines, facial movement, medicines and health history, then recommends treatment at GENEVA or a referral to a specialist. Injections aren't recommended during pregnancy or breastfeeding, or for people with neuromuscular disorders such as myasthenia gravis. Only get injections from a licensed clinician in a medical setting, never at a party or salon.