Updated on  February 5, 2024
6 min read

What to Know About Botox Under the Eyes

12 sources cited
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Botox, also called botulinum toxin type A, is a drug that reduces the appearance of fine lines and wrinkles. While it’s a well-established injectable treatment for frown lines and crow’s feet around the eyes, Botox can also be used for under-eye wrinkles.

Botulinum toxin type A is currently approved by the Food and Drug Administration (FDA) for three cosmetic procedures:

  1. Glabellar lines (frown lines)
  2. Crow’s feet
  3. Horizontal forehead lines

Can Botox Treat the Under-Eye Area?

Yes. However, the FDA hasn’t approved Botox treatment in the under-eye area, and there’s little research on its potential side effects. 

Many dermatologists and certified plastic surgeons use Botox for off-label (not FDA-approved) procedures. These include under-eye Botox. 

A Botox injection under your eyes may help smooth the appearance of eye wrinkles and reduce under-eye bags. Botox treatments in the under-eye area are known as “jelly roll Botox.” It’s named for the “jelly roll muscle” that bulges beneath your eye when you squint.

Three pictures compared effect Before and After treatment. under eyes with problems of dark circles and wrinkles periorbital before and after treatment to solve skin problem for better skin

How Effective is Botox Under Your Eyes?

Few clinical trials or research investigated the safety and effectiveness of getting Botox injections under the eyes. However, a 2003 study of 19 women found lower eyelid Botox injections reduced wrinkles and fine lines.7

Evidence has shown that eight Botox units give the best under-eye treatment results. This amount also has the most side effects, including lower eyelid swelling.7 

How Does Botox Work?

Botulinum toxin blocks nerve signal receptors that promote muscle contraction. Botox works by temporarily weakening the facial muscles that cause dynamic wrinkles that appear with muscle movement. This leads to firmer skin and a more youthful appearance. 

The nerve-blocking action makes Botox an effective treatment for certain nerve disorders and a popular cosmetic procedure.

While too much Botox is poisonous, typical Botox injections only use small and weakened doses.

What to Expect from Botox Treatment

Botox injections are medical aesthetic treatments that should be administered by a board-certified dermatologist, plastic surgeon, or cosmetic injector. They usually occur in a doctor’s office and take less than 15 minutes.

Before getting Botox treatment, a medical professional will ask about medical history and current medications. This is to ensure Botox doesn’t cause health complications. 

People typically see results 3 to 7 days after treatment. The injections last 3 to 6 months and can be repeated when wrinkles return. 

Does it Hurt to Get Botox Injected?

A Botox injection feels similar to a pinch but doesn’t usually hurt. Some medical professionals use a topical numbing cream to reduce discomfort at the injection site.

How Many Injections Does Botox Treatment Entail? 

How much Botox you need will depend on what areas of your face are being treated. For example, crow’s feet lines usually require two to three injections, while forehead wrinkles typically require five or more. 

Recovery from Botox Procedures

After receiving Botox injections, you can resume normal activities. There is no recovery period. You will not lose any sense of feeling. 

Because Botox targets muscle contractions, it can affect natural facial expressions. With specific dosing in targeted muscles, trained professionals can minimize muscle weakness and promote a natural look. 

After getting Botox injections, you should avoid:

  • Rubbing or massaging the area
  • Strenuous physical activity (anything that raises your heart rate) for 2 hours
  • Lying down for 4 hours
  • Excessive sweating

Is Botox Safe?

There have not been any reported life-threatening side effects of Botox. Medical professionals continue to prioritize safety with continued research and medical education for those who are licensed to administer Botox.

Side Effects of Botox Under the Eyes

Some doctors avoid injecting Botox under the eye. This is because it can cause unwanted side effects, including:

  • Sagging eyelids
  • Under-eye bags
  • Trouble blinking
  • Lower eyelid swelling
  • Eye puffiness
  • Redness
  • Numbness

The skin under the eyes is also thin and fragile, so extra precaution is warranted. Although rare, some people develop antibodies (immune response) to Botox, reducing its effectiveness over time.5

Risks of Botox

Common dangers of Botox include:

  • Bruising at the injection site
  • Flu-like symptoms
  • Headache 
  • Nausea 
  • Dry mouth
  • Drooping eyelids

Who Is a Good Candidate for Botox Under the Eyes?

You must be healthy and at least 18 years old to get Botox injections. Because the FDA doesn’t approve under-eye Botox, candidacy is determined case-by-case. 

If you’re interested in Botox for under-eye wrinkles, consult an experienced injector. They’ll determine whether this treatment is best for you.

Who Should Not Get Botox?

Botox injections are not recommended for people who have:

  • Neuromuscular disease, such as myasthenia gravis
  • Facial muscle weakness
  • Deep facial scars
  • Drooping eyelids

Botox injections are also not recommended for pregnant people or those planning to become pregnant.

How Much Does Botox Cost?

Botox costs between $245 and $1,100, depending on the number of injections, clinic type, and location.11 

Insurance typically doesn’t cover cosmetic Botox injections, so people usually pay out of pocket. 

Alternative Treatments 

Botox isn’t the only way to treat wrinkles, lines, and dark circles under the eyes.

Other Botulinum Toxin Treatments

While Botox is the most popular procedure, other commercially manufactured products use botulinum toxin to reduce the signs of aging. They include:

  • RimabotulinumtoxinB (Myobloc)
  • IncobotulinumtoxinA (Xeomin)
  • AbobotulinumtoxinA (Dysport)
  • PrabotulinumtoxinA (Jeuveau)

Dermal Fillers

Dermatologists and other medical professionals commonly use hyaluronic acid fillers, also called dermal fillers, which reduce the appearance of wrinkles and fine lines under the eyes. 

While Botox freezes muscles, dermal fillers add volume and fullness to thin, loose skin, minimizing the signs of aging. 

Laser Treatments

Laser resurfacing treatments are also an alternative therapy for under-eye bags and wrinkles. However, they can be expensive. 

Lifestyle Changes

Positive lifestyle changes can slow the signs of aging and promote smoother and younger-looking skin. 

Healthy lifestyle changes that can provide a natural alternative to Botox include:

  • Drink lots of water
  • Avoid foods high in sodium
  • Get plenty of sleep
  • Apply sunscreen regularly
  • Avoid smoking 
  • Limit alcohol consumption 
  • Treat seasonal allergies with antihistamines 
  • Use anti-aging eye creams


Because under the eye Botox injections are not currently FDA-approved and have limited research on safety and effectiveness, proceed with caution. Always discuss the risks and benefits with a medical professional.

When used as specified, Botox injections reduce wrinkles and signs of aging. 


Botox is a neurotoxin called botulinum toxin type A. Botox works by temporarily inhibiting muscle contractions that cause dynamic wrinkles to appear.

Getting Botox under the eyes is not FDA-approved and lacks clinical research to determine safety and effectiveness. However, many licensed and trained medical professionals use Botox injections, including under-eye injections, for off-label purposes.

Updated on  February 5, 2024
12 sources cited
Updated on  February 5, 2024
  1. American Society of Plastic Surgeons unveils covid-19’s impact and pent-up patient demand fueling the industry’s current post-pandemic boom.” American Society of Plastic Surgeons, 2021.

  2. Myckatyn, T. “What does an FDA approval mean for cosmetic treatments and devices? American Society of Plastic Surgeons, 2018.

  3. FDA approves expanded Botox® (onabotulinumtoxina) label for the treatment of pediatric patients with spasticity.” AbbVie, 2020.

  4. Ferris, JD. “Strabismus: Botox Treatment.” American Academy of Ophthalmology, 2015.

  5. Naumann et al. “Immunogenicity of botulinum toxins.” Journal of Neural Transmission, 2013.

  6. Smaili, T. “Botox around the eyes and its results.” American Society of Plastic Surgeons, 2016.

  7. Flynn et al. “Botulinum A toxin (BOTOX) in the lower eyelid: dose-finding study.” Dermatologic Surgery, 2003.

  8. What are the steps of botulinum toxin injections?” American Society of Plastic Surgeons.

  9. Botulinum toxin therapy: FAQs.” American Academy of Dermatology Association.

  10. Boyd, K. “Botulinum toxin (Botox) for facial wrinkles.” American Academy of Ophthalmology, 2023.

  11. Cosmetic surgery pricing.” American Board of Cosmetic Surgery.Botox vs. fillers: which one is best?” Eternal Dermatology and Aesthetics, 2020.

  12. Botox vs. fillers: which one is best?” Eternal Dermatology and Aesthetics, 2020.

The information provided on VisionCenter.org should not be used in place of actual information provided by a doctor or a specialist.