Botox for Frown Lines (Glabella): Complete UK Guide (2026)

Frown lines — the vertical creases that form between your eyebrows when you concentrate, squint, or feel stressed — are caused by the repeated contraction of two small muscles called the corrugators, plus a central muscle called the procerus. Together, these muscles pull the skin inward and downward, creating the characteristic "11 lines" or "angry lines" that many patients find ageing or off-putting.

The glabella (the area between the eyebrows) was the original target for cosmetic botulinum toxin when it received FDA approval in 2002, and it remains one of the most commonly treated areas worldwide. In the UK, frown line Botox accounts for approximately 30% of all anti-wrinkle injection treatments, second only to forehead lines.

How Frown Line Botox Works

Three muscles collaborate to create frown lines:

• Corrugator supercilii (one on each side) — These fan-shaped muscles originate from the bone near the bridge of the nose and insert into the skin of the mid-eyebrow. When they contract, they pull the eyebrows together and downward, creating the vertical "11" lines
• Procerus — A small, thin muscle that runs vertically from the bridge of the nose to the skin between the eyebrows. It creates the horizontal crease across the bridge of the nose when you frown

Botulinum toxin is injected into 5 standard points across these three muscles (known as the "5-point glabella injection pattern"): one in the procerus and two in each corrugator. The toxin blocks acetylcholine release at the neuromuscular junction, reducing the strength of contraction and preventing the skin from being repeatedly creased.

Because the glabella muscles are among the strongest in the upper face — they generate enough force to create deep static lines by your mid-30s — the dose required here is typically higher than for crow's feet. Standard dosing is 20 units of Botox (Allergan) or the equivalent in Azzalure or Bocouture.

What to Expect During Treatment

A typical frown line Botox appointment:

1. Consultation (10-15 minutes) — Your practitioner asks you to frown hard while they assess the strength and pattern of your corrugator and procerus muscles. They examine whether your frown lines are purely dynamic (visible only when frowning) or have become static (etched in at rest). Static lines take longer to improve and may not fully resolve with Botox alone
2. Marking (2 minutes) — 5 injection points are marked: one centrally on the procerus and two on each corrugator supercilii, identified by palpating the muscle belly while you frown
3. Injection (5 minutes) — Using a 30-gauge needle, small volumes of toxin are injected intramuscularly at each point. Most patients feel a brief pinch. The procerus injection (between the eyes on the bridge of the nose) tends to sting slightly more than the corrugator injections
4. Post-treatment instructions — Stay upright for 4 hours, avoid vigorous exercise for 24 hours, do not rub or massage the treated area. Some practitioners ask you to practise frowning gently in the first hour to help distribute the toxin (though evidence for this is mixed)

Total appointment time: 20-30 minutes. You can return to work immediately.

Cost in the UK

| Region | Single Area (Frown Lines Only) | Two Areas (Frown + Forehead) | Three Areas (Frown + Forehead + Crow's Feet) | |--------|-------------------------------|------------------------------|----------------------------------------------| | London | £250-350 | £300-400 | £350-450 | | South East | £200-300 | £250-350 | £300-400 | | Midlands | £180-280 | £220-330 | £260-380 | | North | £150-250 | £200-300 | £250-350 | | Scotland | £150-250 | £200-300 | £250-350 |

Why treat frown lines with forehead lines? The corrugators (frown muscles) and frontalis (forehead muscle) work in opposition. If you treat the frown without the forehead, some patients over-recruit the frontalis to compensate, creating more prominent horizontal forehead lines. Conversely, treating the forehead without the frown can cause the eyebrows to drop because the corrugators (which pull the brows down) are now unopposed. Most experienced practitioners recommend treating both areas together.

The three-area package (frown, forehead, and crow's feet) offers the best value per area and creates a balanced, natural result across the entire upper face.

Results and Recovery

• Day 0: Tiny bumps at injection sites that flatten within 30-60 minutes. A mild headache is possible, particularly in the glabella area
• Days 1-3: No visible change yet. The toxin is binding to nerve terminals
• Days 3-5: You begin to notice that frowning feels weaker. The "11 lines" start to soften when you try to scowl
• Days 7-10: Significant improvement. Dynamic frown lines are substantially reduced or eliminated
• Day 14: Full effect. Your practitioner may offer a review appointment to assess the result and administer a top-up if any residual movement persists
• Months 2-3: Peak results. If you had mild static lines, you may notice them beginning to soften as the skin recovers from months of not being creased
• Month 3-4: Movement gradually returns. Book your maintenance appointment before the full effect wears off

With regular treatment (every 3-4 months for the first year, then potentially every 4-6 months as the muscles weaken), many patients find their static frown lines fade significantly over 12-18 months. The muscles essentially "unlearn" the habitual frown pattern.

No downtime. The only visible sign is possible redness at injection sites for 30-60 minutes. Bruising is uncommon in the glabella area (occurring in fewer than 5% of patients) because there are fewer superficial blood vessels here than around the eyes.

Risks and Side Effects

• Common (>10%): Mild headache on the day of treatment (more common with glabella than other areas), tiny red marks at injection sites lasting 30-60 minutes
• Uncommon (1-10%): Heaviness in the brow area (especially if the dose is too high or placed too low), mild asymmetry between sides, a feeling of restricted expression
• Rare (<1%): Eyelid ptosis (drooping) — this occurs when toxin migrates from the corrugator injection site to the levator palpebrae superioris muscle that opens the eyelid. The risk is minimised by injecting at least 1cm above the orbital rim and keeping the patient upright for 4 hours post-treatment. If ptosis occurs, it typically resolves within 2-6 weeks. Apraclonidine eye drops can partially lift the eyelid in the interim
• Very rare (<0.1%): Allergic reaction to botulinum toxin, paradoxical muscle recruitment causing new lines in adjacent areas

Eyelid ptosis is the complication patients worry about most with glabella Botox. A 2024 review of UK clinic data found the incidence was 0.8% with experienced practitioners and 3.2% with injectors who had completed fewer than 100 treatments. Technique matters — and this is a learnable skill that improves dramatically with experience.

How to Choose a Practitioner

Frown line Botox is considered a foundational treatment — one that every qualified aesthetic practitioner should be competent in. Your criteria should include:

1. Medical qualification: GMC doctor, NMC nurse, or GDC dentist. Under the new English licensing regulations, non-medical injectors must now be registered with their local authority
2. Understanding of the brow complex: The frown, forehead, and brow position are interconnected. Ask your practitioner whether they recommend treating your frown lines alone or in combination with the forehead, and why. A practitioner who does not discuss the brow complex may produce a result that looks unbalanced
3. Conservative dosing with top-up option: A good practitioner starts with a standard dose and offers a complimentary review and top-up at 2 weeks. Over-dosing the glabella creates a "frozen" look with complete inability to express concern or concentration — this is the hallmark of bad Botox
4. Medical indemnity insurance: Essential for all practitioners performing injectable treatments. See our insurance requirements guide for more on what to check
5. Clean clinical setting: Botulinum toxin is a prescription-only medicine that must be stored under controlled conditions. Treatment should take place in a clinical environment, not someone's kitchen or a beauty salon backroom

Combining Frown Lines with Other Treatments

Beyond the standard multi-area Botox package, frown lines can benefit from complementary treatments:

• Skin boosters: Micro-injections of hyaluronic acid into the glabella skin can improve hydration and texture, helping to fade static lines that Botox alone cannot eliminate
• Retinoid skincare: Prescription-strength tretinoin (0.025-0.05%) applied to the frown area accelerates collagen remodelling, working synergistically with Botox to smooth static lines
• Profhilo: Bio-remodelling treatment that stimulates collagen and elastin. Particularly useful if the skin between your eyebrows has lost its elasticity and does not bounce back even when the muscles are relaxed

The Bottom Line

Frown line Botox is a quick, reliable treatment with a strong safety record. The glabella was the first cosmetic area approved for botulinum toxin, and practitioners have over two decades of clinical experience with this specific treatment.

The key considerations are: treat the frown and forehead together for a balanced result, accept a conservative first dose with a top-up option, and choose a practitioner who understands the interplay between the muscles of the brow complex. Getting this right from the first treatment sets the foundation for long-term natural results.

If you have deep static lines that have been etched in for years, set realistic expectations — Botox will prevent them from deepening, and regular treatment combined with good skincare will gradually soften them, but complete elimination may require 12-18 months of consistent treatment.

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This guide was written by Dr. Shane McKeown, a former NHS doctor and founder of Aestheticc, a clinic management platform for aesthetic practitioners. Last reviewed March 2026.