Botox Under The Eyes: Cost, Effectiveness, And Side Effects

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Is Botox an Effective Treatment for Under-Eye Wrinkles?

Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Kristeen Cherney — Updated on September 29, 2018

How it works
Procedure
Results
Cost
Efficacy
Side effects
Alternatives
Bottom line

Overview

Botox (Botulinum toxin type A) is a type of drug that’s injected directly into the skin. The primary effect is muscle weakness that can relax the surrounding skin.

The primary uses for Botox include:

blepharospasm (twitching eyelids)
dynamic wrinkles (wrinkles that appear when you make facial expressions, such as smile lines around the eyes, commonly referred to as crow’s feet)
cervical dystonia (neurological disorder that causes neck twitches)
primary focal hyperhidrosis (excessive sweating)
strabismus (crossed eyes)

Botox directly for the under-eye area hasn’t been widely studied. However, the overall goals are the same: to relax muscles in the area to smooth out wrinkles.

How Botox works

Botox injections are applied directly underneath your skin. As an anti-aging procedure, Botox works by relaxing muscles in your face. These muscles contract when you smile, talk, or laugh, which can lead to wrinkles and other skin changes over time. Botox reduces these effects, making your skin smooth.

What to expect

All Botox injections should be performed in a doctor’s office. They may be administered by a dermatologist, plastic surgeon, or a physician or doctor specially trained in Botox injections.

Your doctor may first apply an anesthetic to the injection site. This helps to ease any pain or discomfort. They’ll then inject a small amount of Botox.

Perhaps one of the greatest benefits of Botox is the lack of down time needed post-injections. Since this isn’t surgery, you can get back to your normal activities immediately.

How soon you’ll see results

According to the American Academy of Ophthalmology (AAO), you’ll start noticing the effects from Botox injections within a week. Your facial muscles may start relaxing after three days.

Still, these effects aren’t permanent. According to the American Osteopathic College of Dermatology, you can expect your Botox treatment to last between four and six months. After this time, you’ll need to go back to your doctor for more shots if you want to maintain the results of previous injections.

How much you’ll pay

Unlike for surgery or dermatological treatments such as dermabrasion, the costs related to Botox can vary significantly. This is because you typically pay for each unit/injection, rather than for just the procedure itself. Some doctors may charge you based on the area being treated instead.

Costs for Botox can range between $200 and $800 per session, sometimes more. These costs aren’t covered by insurance.

Is it effective for the under-eye area?

Overall, Botox is considered an effective treatment for certain types of wrinkles. Some people seek temporary treatment for:

crow’s feet
forehead lines
frown lines (between eyebrows)

Botox cosmetic has been used for these types of wrinkles since the late 1980s. Still, not enough research has been done to rule Botox effective for wrinkles and bags directly under the eyes.

Your doctor might first determine whether the wrinkles under your eyes are dynamic wrinkles or fine lines. According to the AAO, Botox is ineffective for fine lines. These shots work better on deeper, dynamic wrinkles.

Side effects to be aware of

While Botox may help with bags and wrinkles under your eyes, the injections aren’t without risks. Temporary effects such as droopy eyelids and fat bulges near the injection site are possible. You may also experience mild pain shortly after the injections.

Other possible side effects of Botox injections include:

bruising
dizziness
headaches
swelling (usually right around the injection site)
temporary muscle weakness
tears or hollowness under the eyes

There’s also the possibility of more serious side effects from Botox. Talk to your doctor about these rare side effects:

blurry/double vision
breathing difficulties
changes in your voice, such as hoarseness
facial asymmetry
incontinence (bladder control issues)
loss of muscle use in the face
swallowing difficulties

If you experience any of these symptoms after a Botox injection, call your doctor immediately. A severe reaction to the injections could cause allergy or asthma-like symptoms, such as hives and wheezing.

Also, Botox is not recommended for women who are pregnant or nursing. It’s unclear how the injections may affect your baby.

Alternatives to Botox

If you’re concerned about the safety or efficacy of Botox for under-eye wrinkles or bags, you might consider talking to your doctor about other options. There are many ways to reduce bags under the eyes. Alternatives to Botox include:

allergy medications (for bags)
chemical peels
cool compress treatments
eyelid surgery (blepharoplasty) for bags
laser treatments
over-the-counter wrinkle creams
skin resurfacing
wrinkle fillers, such as Juvederm

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The bottom line

Overall, Botox cosmetic is considered effective for some facial wrinkles. Still, the jury’s out when determining the benefits for the under-eye area. Talk to your doctor about concerns you have with wrinkles and bags in this region so you can assess all your options. They may recommend Botox or perhaps another anti-aging treatment altogether.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Botox Cosmetic: Approved uses and importantsafety information. (n.d.).https://www.botoxcosmetic.com/#isi
Botox injections. (n.d.).https://www.aafprs.org/media/media_resources/fact_botox.html
Boyd R. (2017). Botulinum toxin (Botox) forfacial wrinkles.https://www.aao.org/eye-health/treatments/what-is-botox-facial-wrinkles
Cosmetic surgery. (n.d.).https://www.aad.org/media/stats/cosmetic-treatments/cosmetic-surgery
Djurisic, S. (n.d.). Botox injections.https://en.dermatim.net/aesthetic-dermatology/botox-injections/
Mayo Clinic Staff. (2014). Bags under eyes.https://www.mayoclinic.org/diseases-conditions/bags-under-eyes/basics/definition/CON-20034185
Cosmetic surgery pricing. (n.d.).https://www.americanboardcosmeticsurgery.org/pricing-calculator/

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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Kristeen Cherney — Updated on September 29, 2018

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