Treatments and supplements · Botulinum toxin

What does Botox actually do to your skin?

What we can tell you today: how thoroughly this has been studied.

Thoroughly studied

11 studies, of which 4 bring together the results of several trials in people. This is as strong as evidence gets.

5 Repeated evidence 4 studies

4 Large controlled trial 6 studies

3 Small study in people 1 study

This says how thoroughly something has been studied — not whether it works for you. What each study actually found is in the study itself, and in the plain-language write-ups we are adding.

Appears under: Skin aging

The studies

5 Repeated evidence Botulinum toxin type A for facial wrinkles.
2021 · The Cochrane database of systematic reviews · 1,471 participants
5 Repeated evidence The efficacy of various interventions as good strategies to reduce pain in botulinum neurotoxin A for wrinkles. A systematic review of the randomized controlled trials (RCTs).
2024 · Journal of cosmetic and laser therapy : official public
5 Repeated evidence Cosmetic Botulinum Toxin A Injections to the Upper Face: A Systematic Review and Meta-Analysis of Clinical Studies.
2026 · Journal of cosmetic dermatology
5 Repeated evidence Beyond Wrinkles: A Systematic Review and Meta-analysis of Off-Label Aesthetic Uses of Botulinum Neurotoxin.
2026 · Annals of plastic surgery · 1,903 participants
4 Large controlled trial Safety, Pharmacodynamic Response, and Treatment Satisfaction With OnabotulinumtoxinA 40 U, 60 U, and 80 U in Subjects With Moderate to Severe Dynamic Glabellar Lines.
2022 · Aesthetic surgery journal · 226 participants
4 Large controlled trial Efficacy and Safety of DaxibotulinumtoxinA for Injection in the Treatment of Glabellar Lines by Age and Race: Subgroup Analysis of the SAKURA Clinical Trials.
2023 · Aesthetic surgery journal · 2,785 participants
4 Large controlled trial Efficacy and safety of onabotulinumtoxinA for treating crow's feet lines alone or in combination with glabellar lines: a multicenter, randomized, controlled trial.
2015 · Dermatologic surgery : official publication for America · 306 participants
4 Large controlled trial Comparing patient satisfaction and pain control between vibration and topical anesthesia during botulinum toxin A injections: a randomized, double-blind, split-face clinical trial.
2026 · Journal of cosmetic and laser therapy : official public · 100 participants
4 Large controlled trial Long-term results for incobotulinumtoxinA in the treatment of glabellar frown lines.
2013 · Dermatologic surgery : official publication for America · 796 participants
4 Large controlled trial RimabotulinumtoxinB vs. onabotulinumtoxinA for the treatment of forehead lines: an evaluator-blind, randomized, pilot study.
2013 · Journal of the European Academy of Dermatology and Vene · 100 participants
3 Small study in people A prospective and randomized study comparing ultrasound-guided real time injection to conventional blind injection of botulinum neurotoxin for glabellar wrinkles.
2024 · Journal of cosmetic dermatology · 40 participants