How Long Does Botox Last? What Clinical Trials Actually Measured
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How long does Botox last? In trials, the answer was about three to four months for frown lines. Across four Phase III glabellar trials, people who responded at day 30 had a median effect of about 120 days at maximum frown[^1]. The FDA label describes improvement for up to 120 days versus placebo. Crow's feet analyses reported medians of roughly 4 to 5 months among responders[^2]. These are averages, and they don't predict how long your own results will last[^3]. Evidence: Moderate (multiple Phase 3 trials and pooled analyses; mostly manufacturer-funded).
OnabotulinumtoxinA (BOTOX Cosmetic) temporarily reduces activity in the facial muscles it's injected into. This page covers what studies measured about how long that effect lasted. It doesn't cover how a treatment should be planned. We don't give doses, units, injection points or schedules here. Ask your clinician about your own plan.
How long does Botox last? The short answer
Most of the data comes from frown lines, also called glabellar lines. In a pooled analysis of four Phase III trials, 523 of 621 people treated with onabotulinumtoxinA (84.2%) responded at day 30[^1]. Among those responders, the Kaplan–Meier median duration was 120 days at maximum frown and 131 days at rest. More than half still had some benefit at 4 months. That analysis's PubMed record doesn't state funding or conflicts of interest. We couldn't access the full text, so we haven't assumed it was free of manufacturer funding.
The FDA label's combined pivotal data show the effect fading over time. At day 30, 80% of participants were rated as having none or mild lines. By day 120, that figure was 25%. A single "average" therefore hides a lot of spread between people.
What does "how long does Botox last" mean in a study?
Trials don't measure duration as one simple number. Researchers usually use one of three approaches:
- Time to loss of response. A Kaplan–Meier median estimates when half of the day-30 responders returned to their baseline severity or lost their response.
- Responder rates at fixed visits. This is the percentage of people still rated "none/mild" or improved by at least one grade at day 30, 90, 120 or 150.
- Satisfaction over time. This tracks how long participants report feeling better about their lines while those lines remain improved[^3].
None of these approaches tells you that you'll need retreatment every set number of weeks. A trial's follow-up window can also limit what it reports. A study that ends at day 120 can't show results at day 180.
How long does Botox last for frown lines?
The first evidence came from two identical pivotal double-blind, placebo-controlled trials with 537 participants in total, mostly women. A narrative review of those trials reported that onabotulinumtoxinA beat placebo throughout the 120-day follow-up[^4]. At the day-30 peak, physicians rated 80% of treated participants as none or mild. In the same review, 89% of participants reported at least moderate improvement, and the effect was described as lasting roughly 3 to 6 months. The PubMed record doesn't state funding or conflicts of interest.
A later historical review of the glabellar indication restated a median duration of 120 days for dynamic frown lines in the initial studies[^5]. It placed the peak effect between days 30 and 60. AbbVie funded the manuscript, according to the full text.
| Source | What was measured | Duration finding | Funding / ties | Evidence |
|---|---|---|---|---|
| Pooled 4 Phase III trials[^1] | Kaplan–Meier median among day-30 responders | 120 days (max frown); 131 days (rest) | Not stated in PubMed record | Moderate |
| Two pivotal trials (review)[^4] | Superiority vs placebo through day 120 | Peak day 30; benefit through follow-up | Not stated in PubMed record | Moderate |
| Glabellar development review[^5] | Summary of initial studies | Median 120 days (dynamic) | AbbVie-funded manuscript | Expert opinion |
How long does Botox last on crow's feet and forehead lines?
Crow's feet (lateral canthal lines). Allergan plc funded a duration analysis of two multicenter, double-blind, placebo-controlled trials, and Allergan employees were among the authors[^2]. In the study with 150-day follow-up, the median response for dynamic lines was 125 days by investigator rating and 144 days by participant rating. For static lines, the medians were 137 and 148 days. In the study with 120-day follow-up, the medians were 119 to 121 days, which is close to that study's endpoint.
Other crow's feet trials focused on day-30 response rather than median duration. In a 7-month Phase 3 trial with Allergan-affiliated authors, investigators rated 54.9% (crow's feet plus frown lines) and 59.0% (crow's feet only) as none or mild at maximum smile on day 30. The placebo rate was 3.3%[^6]. Its 5-month extension tested repeat treatment and found day-30 responder rates of 56.5% to 63.6%, versus 1.1% on placebo[^7]. That shows the effect was consistent across repeat cycles. It doesn't tell you how long a single treatment lasts.
Allergan supported a Phase 3 trial in China with Allergan employees as co-authors. It reported a median duration of at least 5 months across its responder definitions[^8]. According to the full text, the Chinese investigators disclosed no financial conflicts. A Japanese Phase 3 program with Allergan employee co-authors also collected duration endpoints. Its abstract emphasized day-30 none/mild rates of 68.3% and 56.6%, versus 8.2% on placebo[^9]. Results may differ by region and population.
Forehead lines. In a dose-ranging RCT with Allergan plc affiliations, participants were assessed through day 180[^10]. At day 30, investigators rated 91.2% (higher study regimen) and 86.4% (lower) as none or mild, versus 1.7% on placebo. The abstract says the higher regimen trended toward longer benefit. This was a research comparison, so it shouldn't be read as dosing guidance. A 12-month Phase 3 trial with Allergan affiliations used day-30 response as its primary outcome. It allowed open-label retreatment after day 180[^11]. A companion development paper supported by AbbVie and Allergan confirmed that these programs met their primary endpoints[^12].
The pooled analysis of upper-face programs found that more than 42% of forehead participants were still at least one grade improved through day 150[^3]. The figure was more than 43% for frown lines and at least 32% for crow's feet. Allergan Aesthetics/AbbVie employees were among its authors, and medical writing was funded.
| Area | Representative finding | Funding / ties | Evidence |
|---|---|---|---|
| Crow's feet | Median about 119–148 days among responders[^2] | Allergan-funded; employee authors | Moderate |
| Crow's feet (China) | Median ≥5 months[^8] | Allergan-supported | Moderate (region-specific) |
| Crow's feet (Japan) | Day-30 none/mild 68.3% / 56.6%[^9] | Allergan employee co-authors | Moderate (region-specific) |
| Forehead | Day-30 none/mild up to 94.8% (mITT)[^11] | Allergan affiliations | Moderate |
| Upper face pooled | ≥32–43% still responders at day 150[^3] | AbbVie/Allergan employees | Moderate |
For background on these areas, see our guides to forehead wrinkles and bunny lines. Planned pages on botox brow lift and lip flip will cover those areas.
Does a longer-lasting toxin change how long Botox lasts?
One Phase 2 trial compared Daxxify with onabotulinumtoxinA. It reported median durations of 24 and 19 weeks in that study. Our planned daxxify vs botox page will cover it in detail. A broader planned dysport vs botox hub will compare the other neuromodulators. The BOTOX Cosmetic label warns that dose units aren't interchangeable between toxin products. Evidence: Early-preliminary (single Phase 2 head-to-head).
What can change how long Botox seems to last?
Research hints at several factors, though the evidence is Limited:
- How people perceive their results. In the Allergan-funded crow's feet analysis, participant-perceived improvement was linked with longer duration[^2].
- Sex. A narrative review across formulations reported that glabellar relapse-defined durations were often 3–5 months in women and 4–6 months in men. Most participants had relapsed by 6 months[^13]. The PubMed record doesn't state funding. That review also discusses other toxins, which belong on our planned comparison hub.
- Study regimen. Allergan Aesthetics/AbbVie funded a 48-week exploratory study in women, and AbbVie employees were among the authors[^14]. It compared above-label glabellar regimens with the labeled regimen and placebo. Some above-label groups had a median duration of at least 24.0 weeks, versus 19.7 weeks for the labeled regimen. This was a manufacturer-funded research observation and didn't change the label. Don't treat it as a recommendation. Decisions about your treatment belong with your clinician.
Claims that exercise, metabolism or particular skincare routines shorten or extend results weren't established in the abstracts we reviewed. Topical peptides marketed as "Botox-like", such as Syn-Ake or argireline, are a different category. The evidence we reviewed doesn't show they work like a neuromodulator.
Safety signals in the duration trials
A meta-analysis pooled individual-participant data from 1,678 people across six double-blind and three open-label registration studies of glabellar and crow's feet treatment[^15]. Its first author had an Allergan affiliation. Treatment-related eyelid sensory disorder occurred in 2.5% of participants, versus 0.3% on placebo. In the glabellar studies, eyelid ptosis occurred in 1.8%, versus 0%. Pivotal descriptions note that headache was common and often occurred at rates similar to placebo[^4]. The AbbVie-funded glabellar review reported that ptosis and headache tended to become less frequent with repeat treatment[^5]. Evidence: Moderate for common local side effects. Ask your clinician about your personal risks. For aftercare, see skincare after Botox.
FDA status: which areas Botox Cosmetic is approved for
We checked Drugs@FDA on 2026-11-09. BOTOX Cosmetic (BLA103000) is labeled for temporary improvement of moderate-to-severe glabellar lines, lateral canthal lines, forehead lines and platysma bands in adults. The efficacy approval dates we mapped were:
- Glabellar lines: 2002-04-12
- Lateral canthal lines: 2013-09-11
- Forehead lines: 2017-10-02
- Platysma bands: 2024-10-18
The label's effective date is October 18, 2024. The therapeutic BOTOX approval in 1991 covers different indications. Check the current label, because labeling changes.
Who funded the duration evidence?
Allergan/AbbVie funded most of the Phase 3 aesthetic programs and pooled analyses cited here, or their employees wrote them[^2][^3][^5][^8][^9][^12][^14]. The safety meta-analysis had an Allergan-affiliated first author[^15]. Several other records list Allergan affiliations even where the PubMed conflict-of-interest field is blank. When a record doesn't state funding, that doesn't mean the study had none.
Where the evidence stops
- None of the studies shows a fixed "X months for everyone." Medians describe groups of trial responders.
- Many trials ended at day 120 to 180, which caps what they could observe.
- Most of the data comes from manufacturer-sponsored trials, often with mostly female participants.
- Head-to-head duration data against other toxins is sparse in the literature we selected.
- In the abstracts we reviewed, no trial tested whether tretinoin or other skincare changes how long Botox lasts. For aftercare timing, see tretinoin after Botox.
- Our pack didn't include duration data for lip flip, brow lift or platysma bands.
FAQ
How long does Botox last on average?
In a pooled analysis of four Phase III glabellar (frown line) trials, people who responded at day 30 had a median investigator-rated effect of about 120 days at maximum frown. The FDA label for glabellar lines describes reduced severity for up to 120 days versus placebo. These figures are trial medians, not a guarantee. Some people's results fade sooner and some last longer. Most of this evidence was funded by the manufacturer (Allergan/AbbVie) or written by its employees.
How long do crow's feet results last in studies?
In an Allergan-funded duration analysis of two crow's feet trials, the median response among day-30 responders ran from about 119 to 148 days, depending on the study, the rater and whether lines were assessed at rest or while smiling. An Allergan-supported Phase 3 trial in China reported a median duration of at least 5 months. These are observations from the studies, not a promise for any one person.
How long do forehead results last?
Forehead line trials mostly measured response at day 30. Some followed participants to day 180 or for 12 months and allowed retreatment after a set window. A pooled analysis of upper-face programs found that more than 42% of forehead participants still had at least a one-grade improvement at day 150. Most forehead studies did not report a single median time to relapse in their abstracts.
When does Botox start working?
In the glabellar pivotal trials, assessments began at day 7 and the effect peaked around day 30. A manufacturer-supported review describes the peak as falling between day 30 and day 60. Timing varies, so ask your clinician what to expect for your treatment.
Does Daxxify last longer than Botox?
In one Phase 2 head-to-head trial, the median duration was 24 weeks for Daxxify and 19 weeks for onabotulinumtoxinA. That is a single Phase 2 study, and our planned Daxxify vs Botox comparison will cover it in detail. The labels also state that dose units are not interchangeable between toxin products.
Can skincare or tretinoin make Botox last longer?
None of the trials we reviewed tested whether tretinoin or any other skincare product lengthens or shortens how long Botox lasts. For questions about when to restart retinoids after treatment, see our tretinoin after Botox guide, and ask your clinician.
What side effects showed up in registration studies?
A safety meta-analysis of registration studies with an Allergan-affiliated first author found treatment-related eyelid sensory disorder in 2.5% of participants versus 0.3% on placebo. In the glabellar studies, eyelid ptosis (drooping) occurred in 1.8% versus 0%. Headache was common in pivotal reports and often occurred at rates similar to placebo. Ask your clinician about your own risks.
Is Botox FDA-approved for frown lines, crow's feet and forehead lines?
Yes. When we checked Drugs@FDA on 2026-11-09, the BOTOX Cosmetic label (BLA103000) listed temporary improvement of moderate-to-severe glabellar lines, lateral canthal lines (crow's feet), forehead lines and platysma bands in adults. The efficacy supplements were mapped to 2002, 2013, 2017 and 2024. Label details can change, so check the current label.
References
[^1]: Meta-analysis of four Phase III glabellar trials of onabotulinumtoxinA; duration among day-30 responders. PMID 23106853. Funding/COI: Not stated in PubMed record; full text not accessed. [^2]: Duration analysis of two multicenter DBPC crow's feet trials. PMID 27110893. Funding/COI: Funded by Allergan plc; Allergan employee authors; investigator Allergan consulting/grants/stock disclosed. [^3]: Pooled analysis of four pivotal Phase 3 upper facial line programs. PMID 36342250. Funding/COI: Allergan Aesthetics/AbbVie employee authors; medical writing funded. [^4]: Review of two pivotal DBPC glabellar trials (n=537). PMID 14507232. Funding/COI: Not stated in PubMed record. [^5]: Historical and clinical insights paper on the glabellar indication. PMID 37499082. Funding/COI: Manuscript funded by AbbVie; Allergan/AbbVie-supported. [^6]: Phase 3 7-month DBPC crow's feet ± glabellar trial. PMID 25485803. Funding/COI: PubMed COI absent; Allergan author affiliations. [^7]: Phase 3 5-month repeat-treatment extension, crow's feet ± glabellar. PMID 25993609. Funding/COI: PubMed COI absent; Allergan affiliations likely per program; not confirmed in record. [^8]: China Phase 3 DBPC crow's feet trial. PMID 30859038. Funding/COI: Supported by Allergan; Allergan employee co-authors; Chinese investigators disclose no financial conflicts. [^9]: Japan Phase 3 crow's feet program. PMID 28733805. Funding/COI: Allergan employee co-authors. [^10]: Multicenter dose-ranging RCT, forehead plus glabellar lines. PMID 26863598. Funding/COI: Allergan plc affiliations; PubMed COI absent. [^11]: 12-month Phase 3 forehead plus glabellar trial. PMID 33065953. Funding/COI: Allergan affiliations; PubMed COI absent. [^12]: Companion development paper, crow's feet and forehead indications. PMID 37499083. Funding/COI: AbbVie/Allergan-supported. [^13]: Narrative review of botulinum toxin duration across formulations. PMID 20369902. Funding/COI: Not stated in PubMed record. [^14]: 48-week exploratory DB study of above-label glabellar regimens in women. PMID 35704394. Funding/COI: Funded by Allergan Aesthetics/AbbVie; AbbVie employee authors. [^15]: Safety meta-analysis of individual-participant data from registration studies (n=1678). PMID 19744746. Funding/COI: First author Allergan-affiliated; PubMed COI not stated.