Botox Cosmetic

Pronunciation: Boe-tox Coz-met-tik
Generic name: onabotulinumtoxinA
Dosage form: single-use vial (50 units, 100 units)
Drug class: Skeletal muscle relaxants

Medically reviewed by Carmen Pope, BPharm. Last updated on Mar 17, 2025.

What is Botox Cosmetic?

Botox Cosmetic temporarily improves the look of moderate to severe frown lines, crow's feet, forehead lines, and platysma bands (vertical bands that connect the jaw and neck). Tiny amounts of Botox Cosmetic are injected into the facial or neck areas requiring wrinkle reduction by a certified provider. 

This guide covers Botox Cosmetic for anti-aging treatment. See Botox Therapeutic for medical uses of onabotulinumtoxinA. 

Benefits of Botox Cosmetic treatment

Botox injections cause a relaxation of the muscles that are typically visible within 24-48 hours and peak at 2 weeks. Treatment benefits include (depending on the injection site):

• Smooth forehead lines
• A reduction in frown lines between the eyebrows
• Smoothing of crow's feet around eyes
• A softening of neck-bands
• A more refreshed appearance.

Limitations of Botox Cosmetic treatments

• Results are temporary and regular maintenance treatments are required.
• Only works on wrinkles caused by muscle movement (not sun damage or gravity).
• Must be administered by licensed or board-certified providers.
• Can have side effects like mild bruising or discomfort.

Safe Botox Treatment

Botox injections should only be given by a board-certified or licensed provider who can ensure:

• Sterile conditions
• Proper dosing and injection techniques to minimize side effects
• Comprehensive post-treatment consultation
• Detailed aftercare instructions
• Regular follow-up care.

Safety should be a priority.

How does Botox Cosmetic work?

Botox Cosmetic (onabotulinumtoxinA) is a neurotoxin that temporarily blocks nerve signals to specific facial or neck muscles. This targeted approach:

• Relaxes overactive muscles
• Smooths dynamic wrinkles
• Preserves natural facial expressions
• Provides preventative anti-aging benefits.

Botox Cosmetic wears off with time as new nerve endings sprout and gradually reconnect with muscles, allowing them to contract normally again and restore movement to the treated area, usually within 3 to 4 months.

FDA-approved indications

Botox Cosmetic is indicated in adult patients for the temporary improvement in the appearance of:

• Moderate to severe frown lines between the eyebrows (glabellar lines) associated with corrugator and/or procerus muscle activity
• Moderate to severe crow’s feet lines (lateral canthal lines) associated with orbicularis oculi activity
• Moderate to severe forehead lines associated with frontalis muscle activity
• Moderate to severe vertical bands connecting the jaw and neck (platysma bands) associated with platysma muscle activity.

Use of Botox Cosmetic for lip lines, bunny lines, or reshaping the jawline (Masseter Botox) is common, but not an FDA-approved use. 

Botox Cosmetic first gained FDA approval on December 9, 1991.

At your Botox consultation

During your Botox consultation, your board-certified provider should:

• Evaluate your facial anatomy
• Discuss your aesthetic goals
• Show before and after photos
• Explain treatment costs
• Created a customized treatment plan.

Botox Cosmetic is not recommended for use in children younger than 18.

It is not known if Botox Cosmetic is safe and effective for use more than 1 time every 3 months.

Who should not receive Botox

Do not receive Botox Cosmetic if you:

• are allergic to any of the ingredients in Botox or Botox Cosmetic. See the end of this Guide for a complete list of ingredients in Botox and Botox Cosmetic.
• have had an allergic reaction to any other botulinum toxin product such as Myobloc (rimabotulinumtoxinB), Dysport (abobotulinumtoxinA), Xeomin (incobotulinumtoxinA), Jeuveau (prabotulinumtoxinA-xvfs), Daxxify (daxibotulinumtoxinA-lanm), or Letybo (letibotulinumtoxinA-wlbg). This may not be a complete list of all botulinum toxin products
• have an infection at the planned injection site.

Tell your doctor about all your medical conditions, including if you:

• have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis or Lambert-Eaton syndrome).
• have allergies to any botulinum toxin product
• had any side effects from any botulinum toxin product in the past
• have or have had a breathing problem, such as asthma or emphysema
• have or have had swallowing problems
• have or have had bleeding problems
• have plans to have surgery
• had surgery on your face
• have weakness of your forehead muscles, such as trouble raising your eyebrows
• have drooping eyelids
• have any other change in the way your face normally looks
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed.

Pregnancy

It is not known if Botox Cosmetic can harm your unborn baby.

Breastfeeding

It is not known if Botox Cosmetic passes into breast milk.

Side effects

The most common side effects of Botox Cosmetic are temporary pain, swelling, mild bruising or discomfort where the injection was given.

Serious side effects

Rarely, Botox Cosmetic may cause serious side effects.

Spread of toxin effects. In some cases, the effect of botulinum toxin A may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism. Seek immediate medical attention if you have:

• loss of strength and muscle weakness all over the body
• double vision, blurred vision and drooping eyelids
• hoarseness or change or loss of voice (dysphonia)
• trouble saying words clearly (dysarthria)
• loss of bladder control
• trouble breathing
• trouble swallowing.

Note that there has not been a confirmed serious case of the spread of toxin effect away from the injection site when Botox Cosmetic has been used at the recommended dose to treat frown lines, crow’s feet lines, forehead lines, or vertical bands connecting the jaw and neck.

Important considerations:

• Side effects can vary depending on the treatment area and individual response
• Choosing a qualified, experienced provider is crucial for minimizing risks
• Following post-treatment care instructions helps reduce side effect occurrence
• Discussing medical history and medications with your provider is essential.

Related/similar drugs

Finding the best Botox provider

When searching for "Botox near me" consider these factors in a provider:

• Board certification and training. Ask to see their qualifications.
• Experience with Botox Cosmetic treatment. How many years have they been in business?
• Before and after portfolio
• Patient reviews and testimonials
• Facility accreditation. 

Botox cost varies based on treatment areas, number of units required, provider expertise, geographic location, and treatment frequency.

How will I receive Botox Cosmetic?

Botox Cosmetic is a prescription medicine given by a certified professional.

• Small amounts are injected into the face or neck areas requiring wrinkle reduction. 
• Your healthcare provider may change the dose until they find the best dose for you.
• Your healthcare provider will tell you how often you will receive your injections, but it is usually not more often than every 3 months.

Dosing information

Botox Cosmetic is administered by intramuscular injection.

Glabellar lines

• 20 Units in 0.5 mL.

Lateral cathal lines

• 24 Units in 0.6 mL.

Forehead lines and glabellar lines

• 40 Units in 1 mL.

Platysma bands

• 1 band on each side: 26 Units in 0.65 mL.
• 1 band on one side, 2 bands on the other side: 31 Units in 0.78 mL.
• 2 bands on each side: 36 Units in 0.9 mL.

What other drugs affect Botox Cosmetic?

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Using Botox Cosmetic with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox Cosmetic in the past. Especially tell your doctor if you:

• have received any other botulinum toxin product in the last four months.
• have received injections of botulinum toxin, such as Myobloc (rimabotulinumtoxinB), Dysport (abobotulinumtoxinA), Xeomin (incobotulinumtoxinA), Jeuveau (prabotulinumtoxinA-xvfs), Daxxify (daxibotulinumtoxinA-lanm), or Letybo (letibotulinumtoxinA-wlbg) in the past. This may not be a complete list of all botulinum toxin products. Be sure your doctor knows exactly which product you received.
• have recently received an antibiotic by injection
• take muscle relaxants
• take an allergy or cold medicine
• take a sleep medicine.
• take anti-platelets (aspirin-like products) or anti-coagulants (blood thinners).

Ask your doctor if you are not sure if your medicine is one that is listed above. Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist each time you get a new medicine.

Ingredients

The ingredients in Botox and Botox Cosmetic are the same.

Active ingredient: onabotulinumtoxinA

Inactive ingredients: human albumin and sodium chloride.

Manufacturer

Botox Cosmetic is made by AbbVie, who acquired the previous manufacturer Allergan in 2020. 

Botox cosmetic Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There are 2 for Botox Cosmetic.

Popular FAQ

More FAQ

• What is botulinum toxin used to treat?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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