In Ask a Dermatologist, Cosmetic, Skin Care

We have answered many questions on the blog about the cosmetic injectable Botox, a neurotoxin that temporarily blocks muscle movement to reduce wrinkles and fine lines. Many patients have asked, “How much Botox do I need?” In this article, we will answer that question and provide information about Botox and other injectables.

What is Botox?

Botox is the brand name for a neurotoxin injected into muscles to temporarily block movement and relax wrinkles. It is the original FDA-approved treatment for moderate to severe wrinkles, crow’s feet and forehead lines.

What is a neurotoxin?

Neurotoxins temporarily prevent nerve impulses from signaling muscles to contract. Repetitive facial muscle movements, like furrowing your brow or squinting, cause dynamic wrinkles to form. The neurotoxin is injected into or near certain muscles to reduce movement when making facial expressions, thereby smoothing dynamic wrinkles and lines.

What other brands do you offer?

Botox was the first neurotoxin used cosmetically, but over the years, other brands have been developed. They work similarly, but each one has slight differences in its formula. All cosmetic neurotoxins will give similar results, but your dermatologist may recommend a particular brand based on the areas you want to treat. They all last about the same amount of time, from two to four months, but it depends on the individual.

  • Botox is used to treat crow’s feet and wrinkles between the eyebrows and on the forehead. You can see results as soon as 72 hours.
  • Dysport requires more units than Botox, but the results can be seen in as little as 24 hours. It is often used to correct glabellar lines, the “elevens” or frown lines between your eyebrows. 
  • Xeomin has the same dosage as Botox and may take up to four days to begin to see results. The drug has fewer additives than Botox or Dysport, so it is sometimes called the “naked” Botox.
  • Daxxify is a new treatment recently approved by the FDA. It works like the others but has the potential to last as long as six months in some patients.

How much Botox do I need?

Botox and other neurotoxins are measured in units. Each unit contains a certain number of molecules that make the drug effective. Botox has more molecules per unit, so you need less than a brand like Dysport. Xeomin and Daxxify use about the same number of units as Botox.

Your dermatologist will ask about your history of cosmetic procedures, concerns and what you hope to achieve. The number of units you need for treatment depends on multiple factors, including:

  • The area being treated
  • The severity of your dynamic wrinkles 
  • Your history of cosmetic procedures
  • Your desired results

Treatment plans are personalized, but we can give a range that is most common for areas of the face. These are only the number of units that may be recommended – not the number of injections. For instance, one syringe can hold up to 100 units of Botox and can be injected into multiple areas of the face. 

Each area of the face has several places that can be injected to soften wrinkles, but not everyone will need injections in all areas of the muscle. Again, your treatment plan will be personalized to your needs.

The number of units listed below is for Botox, Xeomin or Daxxify for the three main areas for treatment. As mentioned, Dysport generally needs three times the amount for the same effectiveness. However, at most clinics, the cost for one unit of Dysport is lower, which makes the total cost comparable to Botox.


Injections can be made in five places of the forehead to target each muscle in the area. The number of units of Botox can start at 10 units, with some patients needing up to 50. 

Between the brows

There are five muscles of the glabella, the area between the eyebrows. The number of units averages about five units per area for a total of 25 units. Some patients may need less, while those with deeper glabella lines may need up to 50 units.

Crow’s feet

The area around your eyes is sensitive, so your dermatologist may start with fewer units for your first treatment. Six areas can be injected if needed. The average is 20 units but can be lower or higher depending on the patient.

Other uses

Botox is an effective treatment for hyperhidrosis or excessive sweating. The injections can be administered under the arms to stop sweat glands from producing too much perspiration. The results can last from nine months to one year. Botox is the only brand recommended for the treatment of hyperhidrosis.

People who have never tried neurotoxins before can opt for baby Botox, where fewer units are used to achieve less dramatic results. We also offer neurotoxin injections for other areas of the face and neck. 

Botox in Columbia

Have more questions about Botox and how it works? Turn to our board-certified dermatologists at Columbia Skin Clinic. We carry several brands of neurotoxins and will review your history and needs to see what will work best for you.

Read our blog Botox: Your Questions Answered, or call us to schedule a cosmetic dermatology appointment today. 

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