Botox can reduce under-eye wrinkles, but only a specific type: the lines that appear when you smile, squint, or laugh. These “dynamic” wrinkles form because a ring-shaped muscle around your eye contracts every time you make an expression. Botox relaxes that muscle, softening the creasing. If your under-eye lines are caused by thinning skin, lost volume, or sun damage, Botox won’t help much.
Why It Works for Some Wrinkles and Not Others
The key distinction is between wrinkles caused by muscle movement and wrinkles caused by aging skin. Dynamic wrinkles appear during facial expressions and fade when your face is at rest. Over time, repeated folding of the skin can turn those temporary creases into permanent lines that stick around even when you’re not moving your face. Those are static wrinkles.
Botox blocks nerve signals to the muscle fibers just below your lower lash line, reducing how strongly they contract. This smooths out the lines you see when smiling or squinting, and it can also slow the progression of dynamic wrinkles into permanent ones. But it does not erase fine lines caused by collagen loss or sun damage, and it won’t fill in hollow areas or dark circles under the eyes. The American Academy of Ophthalmology is clear on this point: botulinum toxin does not erase fine lines and wrinkles that exist independent of muscle movement.
What the Treatment Looks Like
Under-eye Botox uses very small doses. Most injectors place around 1 to 2 units per injection site, with a total of roughly 4 to 8 units per eye. For comparison, crow’s feet (the lines at the outer corner of your eye) typically require about 12 units per side. The injection goes a few millimeters below the lower lash line, targeting the lower portion of the orbicularis oculi, the muscle responsible for squinting and blinking.
One common approach targets what’s sometimes called the “jelly roll,” a small ridge of muscle that puffs out beneath the lash line when you smile. This bulge comes from muscle contraction rather than fat, so relaxing it with a tiny dose of Botox can create a smoother, less puffy look. Results typically last 3 to 4 months, though some people get 4 to 6 months of effect. First-time treatments tend to wear off faster, with longer-lasting results in subsequent sessions.
This Is an Off-Label Use
The FDA has approved Botox for crow’s feet (periorbital wrinkles, approved in 2013), frown lines between the eyebrows (2002), and forehead lines (2017). Injecting the lower eyelid area specifically is not FDA-approved and is considered off-label. That doesn’t mean it’s unsafe or experimental. Off-label use is common in cosmetic medicine, but it does mean the under-eye area hasn’t gone through the same formal approval process, and your results depend heavily on the injector’s skill and experience with this delicate zone.
Risks Specific to the Under-Eye Area
The skin and muscle around your lower eyelid are thinner and more delicate than almost anywhere else on your face, which makes precision critical. If too much Botox spreads to the wrong muscle fibers, it can weaken your ability to blink properly or cause the lower eyelid to pull downward, a condition called ectropion. In more advanced cases, the eye may not close fully (lagophthalmos), leading to dryness, irritation, and even corneal damage.
Research published in the Hawai’i Journal of Medicine and Public Health found that mild side effects, such as slight changes in blink strength, occurred in about 5% of patients receiving up to 10 units of Botox in the outer eye area. More persistent moderate complications appeared in roughly 1% of patients treated over longer than a year. Severe complications like corneal erosion were not observed in that study. All mild effects reversed within 3 to 6 months as the Botox wore off, which is reassuring but also means you’d be living with the problem for a while if it happened.
Other possible side effects include temporary puffiness, watery eyes, and a visible gap of white below the iris (called scleral show) that can make the eyes look different. These risks are why the doses used under the eye are kept deliberately low and why choosing an experienced injector matters more here than in other treatment areas.
When Fillers or Other Treatments Work Better
If your main concern is hollowness under the eyes, dark circles from visible blood vessels, or a sunken look that makes you appear tired, Botox isn’t the right tool. Those issues stem from volume loss in the soft tissue beneath the skin, not from muscle movement. Tear trough fillers, which use hyaluronic acid to restore volume under the skin, are designed for exactly this problem. They plump the hollow area, reducing shadows and the appearance of dark circles.
The two treatments address different problems entirely. Botox relaxes muscles that cause creasing during expressions. Fillers physically fill in areas where fat and bone support have diminished with age. People with thinner skin may benefit more from the volumizing effect of fillers, while those whose primary complaint is lines that appear during smiling or squinting are better candidates for Botox. Some people benefit from both, used in combination.
For under-eye wrinkles that are truly static, meaning they’re etched into the skin at rest and aren’t caused by muscle movement or volume loss, treatments like chemical peels, laser resurfacing, or microneedling that stimulate collagen production tend to be more effective than either Botox or fillers.
Cost and What to Expect
Because the dose is small, under-eye Botox is one of the less expensive treatment areas. In major cities like New York, a session runs between $250 and $600 depending on the number of units used and the injector’s experience level. Units typically cost $11 to $15 each, and most treatments use 6 to 15 units total across both eyes. A more experienced injector will generally charge $100 to $200 more per session, which is often worth paying given the precision this area demands.
You’ll typically see results within a few days, with the full effect developing over one to two weeks. Since the treatment lasts 3 to 4 months on average, most people schedule three to four sessions per year to maintain the look. The effect fades gradually as nerve signals to the muscle recover, so you won’t wake up one morning with all your wrinkles suddenly back.