European Journal of Molecular & Clinical Medicine

Abstract

The upper face is a complex and dynamic part of the face, which conveys facial expression and
emotion. As one age, youthful dynamic facial lines on the forehead and glabella change to static
wrinkles, which remain on the face at rest. These permanent wrinkles can lead to the appearance
of fatigue and negative facial expressions such as anger, which may influence psychological
wellbeing, social confidence, and self-esteem. Forehead wrinkles are due to a combination of
genetic and environmental factors, especially damage ultraviolet light. The contributions of both
must be analysed when patients attend for treatment. Make sure too that they do not expect the
ablation of furrows as this requires carbon dioxide laser resurfacing for maximum effect.
Botulinum toxin is widely known to be an excellent treatment for smoothing out both vertical and
horizontal forehead lines. Patients often ask for it to be used to treat their vertical (glabellar) frown
or their horizontal lines or put in a general request for improvement.