Botox under eyes: Effectiveness, side effects, and alternatives

Botulinum toxin, commonly called Botox, is a medication that weakens the muscle contractions that cause wrinkles to appear.

Botox temporarily reduces wrinkles:

  • between the brows
  • in the forehead
  • at the sides of the eyes
  • around the mouth

However, the United States Food and Drug Administration (FDA) has not approved the use of Botox under the eyes for cosmetic purposes. Little research has looked into its effectiveness or side effects.

In this article, learn what we currently know about using Botox under the eyes, including possible side effects and alternatives to this procedure.

How does Botox work?

Vials of Botox contain three main ingredients: botulinum toxin type A, human albumin, and sodium chloride. The active ingredient, which has the greatest effect, is botulinum toxin A.

When injected into muscles, Botox blocks the nerve impulses that cause a particular muscle to contract. The muscle cannot move, and this reduces the appearance of wrinkles.

Botox can only reduce wrinkles in areas of the face that move. Doctors will usually use it on the frown lines between the eyebrows, called glabellar lines, as well as on lines in the forehead, and crow’s feet at the sides of the eyes.

Botox is not a permanent solution to wrinkles. In 3–6 months, it will stop blocking the nerve impulses, and the muscles will begin to contract. A person will need further injections to maintain results.

Botox has also emerged as a treatment for a number of medical conditions, from migraines to an overactive bladder.

Botox costs vary by region as well as by specialist. A person who receives Botox is paying not only for the medication, but also for the time of the person performing the procedure, the office space, and other materials used.

According to the American Board of Cosmetic Surgery, the average price of Botox injections ranges from $200 to $1,400 in the U.S. The price also varies, depending on where a clinic is located.

A person can ask for a price estimate before requesting Botox injections. A provider should also be able to give a reasonable estimate about for how Botox will be used and how much time the injections will take.

Home treatments and other injectable medications can serve as alternatives to Botox under the eyes.

It is important to consider the desired effect. For example, techniques that reduce under-eye wrinkling can be very different from those that lighten dark circles.

First, a person should examine their daily habits to determine if they may be contributing to bags and wrinkles under the eyes. The following strategies may help:

  • getting enough sleep, which is generally estimated to be 7 or 8 hours a night
  • treating seasonal allergies that cause puffy eyes with over-the-counter medications, such as antihistamines
  • refraining from smoking
  • avoiding excess sodium in the diet, which can cause the body to retain water, leading to a buildup of fluid and puffy skin
  • sleeping with the head slightly elevated, to keep fluid from collecting under the eyes
  • refraining from excess sun exposure and always wearing sunscreen in sunny weather

Some cosmetics can help to soften and smooth the skin under the eyes. For example, if eye puffiness is a concern, a person may try using an eye cream that contains caffeine. Manufacturers add caffeine because it can help to tighten skin and reduce puffiness. If dark circles are a concern, creams made specifically for the under-eye area may help.

Some people use fillers to add volume to the under-eye area. This involves injecting materials that can reduce the appearance of wrinkles and dark shadows on the face.

Laser treatment is another option. These treatments stimulate the growth of collagen in the skin, making it appear tighter. However, laser treatments can be very expensive, often costing thousands of dollars per session.


Injecting Botox under the eyes is not an approved use. Botox is intended to reduce the appearance of wrinkles in areas where there is significant muscle movement. It may be less effective when injected under the eyes than when used in the forehead, for example.

A person should thoroughly discuss the treatment, risks, and benefits with an experienced practitioner before having Botox injected under their eyes.

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