How long does Botox last?

Botox is an effective way to combat wrinkles and other signs of aging. But it’s not permanent. This medical treatment requires consistent follow-ups to maintain the desired outcome. So, how long does botox last?

This article dives into how long Botox treatment lasts, when you can start to notice results, and how frequently Botox injections are needed. 

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Botox usually lasts 3–4 months after treatment when administered for cosmetic purposes. This includes reducing the appearance of wrinkles, crow’s feet, fine lines, neck bands, and marionette lines (lines around the corners of your mouth). However, the effects may wear off sooner or even last longer depending on the treatment site and the person’s age, as well as the muscular makeup of the face (Satriyasa, 2019).  

In addition to cosmetic procedures, Botox is also approved by the Food and Drug Administration (FDA) to treat chronic migraines, eye twitching, crossed eyes, and overactive bladder. When used for these purposes, the effects of Botox may last for 6–9 months (Padda, 2022).  

Botox is an injectable medication that a healthcare professional must administer. 

It’s actually classified as a neurotoxin because it’s made from a toxin produced by the bacterium Clostridium botulinum. After the botulinum toxin is properly isolated and diluted to the Botox medication, it is directly injected into the muscle, where it works to block certain chemical pathways that tell muscles to contract (Satriyasa, 2019; Padda, 2022). 

This promotes relaxation and temporarily paralyzes the muscle (this is why you may have a more difficult time raising your eyebrows if you receive Botox injections in your forehead) (Satriyasa, 2019; Padda, 2022). 

Since wrinkles come from repeated muscle movements, this facial muscle relaxation smooths and reduces the appearance of those unwanted wrinkles (Satriyasa, 2019; Padda, 2022). 

Botox starts working about 1–4 days after the injection, and the maximum effect is typically seen 1–4 weeks later (Satriyasa, 2019). 

Staying consistent with Botox treatments may prolong the time between treatments. 

When muscles undergo that temporary paralysis, they’re not capable of being used. So, muscle fibers shrink and get shorter. This decreases wrinkle appearance and also reduces the size of the area the toxin is targeting (Nestor, 2017).

When you read the words “toxin,” “temporary paralysis,” and “microneedle,” it’s understandable that you may feel intimidated when trying to decide whether Botox injections are right for you. 

But rest assured, overall, cosmetic Botox is a safe procedure that has been approved for use since 2002 (Satriyasa, 2019). It’s given under the supervision of a medical professional in an outpatient setting like a dermatology clinic or medical spa. 

Before getting any Botox injections, a consultation with the healthcare provider is required to review your medical and surgical history. If there are no contraindications, you’ll discuss with the provider what areas you wish to have treated, and they’ll answer any questions you have (Nestor, 2017).

Here’s what you can expect during the Botox injection (AAD, n.d):

1. Your provider will reiterate where you’ll be getting the treatment and how much of it you’ll receive.

2. They will then mark on your skin where they’ll be injecting the treatment. 

3. They will thoroughly cleanse the areas.

4. A small needle will then be injected directly into the muscle (you may need more than one injection for a treatment site).

5. The appointment length will vary depending on the number of areas being treated.

Following your appointment, no major downtime is needed to recover. Your healthcare provider will share specific instructions for you to follow (like avoiding rubbing your face or sweating) to minimize side effects.  

You may have a few side effects, but they’re usually mild and include swelling, redness, bruising, and soreness around the injection. Less frequently, Botox may affect neighboring muscles of the injection site leading to a temporary droopy eyebrow or eyelid (AAD, n.d).

Since Botox can last anywhere from 3–6 months depending on the treatment site, age, and other factors, most people receive 2–4 Botox treatments a year. The healthcare provider overseeing your Botox will have specific recommendations on the frequency of the treatments to produce the best results.

Botox treatments are not the only way to reduce wrinkles and signs of aging. Here are other options for combating wrinkles: 

• Wear sunscreen: Sunscreen protects the skin by blocking or minimizing the harmful effects of the ultraviolet (UV) rays. Sun damage to the skin may lead to premature wrinkles and loss of elasticity (Shanbhag, 2019).  

• Use a retinoid: Retinoids are a class of medications derived from vitamin A. This skincare ingredient works by increasing skin cell turnover (aka shedding old skin cells for new, healthy skin) and retaining collagen levels to improve skin texture and wrinkles (Zasada, 2019).

• Stop smoking: Smoking cigarettes has been tied to early aging of the skin as it damages collagen fibers and decreases the skin’s elasticity (Morita, 2007). 

• Try face yoga: Face yoga involves movements that target the facial muscles and skin. While research is still new and current studies remain inconclusive, these exercises may help tone and sculpt areas of the face, but not to the same extent as the other treatments mentioned here (Alam, 2018).

• Consider skin tightening procedures: These procedures include surgical (face-lifts) and non-surgical options like dermal fillers, micro-needling, ultrasound, and intense pulsed light. 

Regular Botox injections are considered a safe and effective way to reduce wrinkles. But Botox isn’t for everyone, and that’s ok. Speak with your healthcare provider about other options, and don’t forget about the daily habit of applying sunscreen to prevent some wrinkles from forming in the first place. 

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

June 03, 2022

Written by

Molly Knudsen, MS, RDN

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.