How many units of Botox do people usually need?
Each product's FDA label sets a dose for each area it is approved to treat, and the forehead is labeled to be treated together with the frown lines between the brows. Units of one brand are not units of another, so a unit count only means something next to the brand name. The dose a person actually needs depends on their muscles and goals, and it is set at a consultation.
What a unit is
A unit is a measure of biological activity, not of weight or volume. one unit of Botox Cosmetic corresponds to the calculated median intraperitoneal lethal dose (LD50) in mice, measured with a potency assay specific to the manufacturer's products (source, verified ). Each manufacturer measures its own product with its own assay, so the results are not on a shared scale.
That is why every label carries a warning about units. the Botox Cosmetic label states that its units are specific to its own preparation and assay method and cannot be compared to or converted into units of any other botulinum toxin product (source, verified ). the Dysport label states that its units are not interchangeable with other preparations of botulinum toxin products (source, verified ). the Xeomin label states that its units cannot be compared to or converted into units of any other botulinum toxin product (source, verified ). the Daxxify label states that its potency units are not interchangeable with other preparations of botulinum toxin products (source, verified ). A unit count means nothing on its own; it means something only next to a brand name. Botox and Dysport compared.
The labeled doses, area by area
The FDA-approved prescribing information for each product gives a dose for each area it is approved to treat. These are the doses tested in the registration trials. They are a reference point, not a prescription for any one person.
Frown lines between the brows
This area, the glabella, is the one every product is approved for, which makes it the clearest comparison.
- Botox Cosmetic. the labeled Botox Cosmetic dose for glabellar lines is 4 units into each of 5 sites, two in each corrugator muscle and one in the procerus, for a total of 20 units (source, verified ).
- Dysport. the labeled Dysport dose for glabellar lines is a total of 50 units, given in five equal injections of 10 units (source, verified ).
- Xeomin. the labeled maximum Xeomin dose for glabellar lines is five injections of 4 units, 20 units in total (source, verified ).
- Daxxify. the labeled Daxxify dose for glabellar lines is a total of 40 units per session, given as five equal injections of 8 units (source, verified ).
The numbers differ because the units differ, not because one product is stronger or weaker than another.
Forehead lines
Forehead lines come from the frontalis, the muscle that lifts the brows. Relaxing it on its own can let the brows sit lower, which is why the labels pair it with the frown lines. the Botox Cosmetic label says to treat forehead lines together with glabellar lines to minimize the potential for brow ptosis, at 20 units in the forehead plus 20 units in the glabellar area, a recommended total of 40 units (source, verified ). the Xeomin label also says to treat horizontal forehead lines together with glabellar lines to minimize the potential for brow ptosis, with a maximum of 20 units in the forehead and 40 units for the two areas (source, verified ).
Crow’s feet
These lines come from the orbicularis oculi, the muscle that closes the eye. the labeled Botox Cosmetic dose for lateral canthal lines (crow's feet) is 4 units into each of 3 sites per side, 12 units per side and 24 units in total (source, verified ). the labeled Xeomin dose for lateral canthal lines is 4 units into each of 3 sites per side, 12 units per side and 24 units overall (source, verified ).
Which products are approved for which areas
Dysport's cosmetic indication is moderate to severe glabellar lines in adults less than 65 years of age (source, verified ). Daxxify's cosmetic indication is moderate to severe glabellar lines in adults; its other indication is cervical dystonia (source, verified ). Using either of them for forehead lines or crow’s feet is off-label in the United States. A prescriber may order an off-label use, and should tell you when that is the plan.
All three upper-face areas at one visit: when Botox Cosmetic is given for forehead, glabellar and lateral canthal lines at the same visit, the labeled total is 64 units (source, verified ). the maximum recommended Xeomin dose for treating glabellar, forehead and lateral canthal lines at the same session is 64 units (source, verified ).
Why real doses vary
A labeled dose is a fixed figure given to every subject in a trial. Real faces are not fixed. A review of how these products work in aesthetics describes the muscles of facial expression as varying greatly in size, mass and strength between individuals, names sex, muscle mass, facial structure, age and genetics among the factors that affect the response, and concludes that each muscle needs its own dosing plan.
Sex is the clearest example in the data. in an exploratory analysis of the Botox Cosmetic glabellar line studies at the labeled 20 unit dose, investigators rated 85% of 334 women and 59% of 71 men as responders at day 30 (source, verified ). Men tend to have larger facial muscles, and a 2025 review describes a 2005 study of 20, 40, 60 or 80 units of onabotulinumtoxinA in 80 men with glabellar lines, in which response rates and duration kept improving as the dose increased, with no clear ceiling dose; the review's writing support was funded by Botox's manufacturer (source, verified ). Dosing for men has its own considerations and is covered separately.
Dose also relates to how long the effect lasts. the same review describes a study of 226 women comparing 40, 60 or 80 units with the labeled 20 units for glabellar lines, in which week 24 responder rates were 16% with 20 units and over 30% with each higher dose; that study used a higher concentration than the label specifies (source, verified ). Doses above the label are off-label, and the same review says the dose is for the clinician to decide in partnership with the patient.
Other things move the number in practice:
- What you want. Some people want little movement left; others want lines softened while keeping expression. The goal changes the plan.
- Previous treatment. How you responded before, with which product and at what dose, is useful information. Bring it if you have it.
- Which areas. Treating several areas at once adds up, and the forehead is planned together with the frown lines for the reason above.
None of this can be judged from a photograph or a phone call. In Arizona a new patient has a Good Faith Exam before any treatment, and the plan, including the dose, is set with the delegating prescriber and the injector after it. What a Good Faith Exam is.
What units do and do not say about cost
Neuromodulators are commonly priced per unit, so the total depends on how many units are in the plan. Two cautions follow from the rest of this article.
First, per-unit prices cannot be compared across brands, because the units are not the same size. A plan with more units of one brand is not necessarily more treatment than a plan with fewer units of another. Compare whole plans, not unit prices.
Second, the labeled doses above are not a quote. A plan that uses fewer units than the label may cost less and also do less, and a plan that uses more may suit stronger muscles. The useful question at a consultation is what the plan is meant to achieve, and how many units of which product that takes. How long the effect lasts. The patient guide to neuromodulators.
Sources
- BOTOX Cosmetic (onabotulinumtoxinA) for injection, Prescribing Information (revised 10/2024) , AbbVie Manufacturer Accessed
- DYSPORT (abobotulinumtoxinA) for injection, Prescribing Information (revised 1/2023) , U.S. Food and Drug Administration Regulator Accessed
- XEOMIN (incobotulinumtoxinA) for injection, Prescribing Information (revised 06/2026) , U.S. Food and Drug Administration Regulator Accessed
- DAXXIFY (daxibotulinumtoxinA-lanm) for injection, Prescribing Information , DailyMed, U.S. National Library of Medicine Regulator Accessed
- Why Dosing Matters, A Closer Look at the Dose-Response Relationship With OnabotulinumtoxinA , Journal of Cosmetic Dermatology (PubMed Central) Peer-reviewed Accessed
- The mechanisms of action and use of botulinum neurotoxin type A in aesthetics, Key Clinical Postulates II , Journal of Cosmetic Dermatology (PubMed Central) Peer-reviewed Accessed
Questions readers ask
Can I ask for fewer units to keep some movement?
You can raise it, and it is a reasonable goal to discuss. Whether a lighter plan makes sense depends on the muscles involved and what you want to keep. The plan is agreed at the consultation, not chosen from a number.
Why did a friend need a different number of units than me?
Faces differ in muscle size, strength and the way lines form, and a friend may have had a different brand or different areas treated. Two plans can both be appropriate and still use different totals.
Is it safer to start low and top up later?
Not necessarily. The dose-response review cited here found no evidence that underdosing reduces the risk of side effects. A cautious first treatment is still a common choice, and the reasons for or against it are worth discussing openly.
Should I keep a record of my units?
Yes. Note the date, the brand, the areas and the units for each treatment. It makes the next plan easier to compare and adjust, especially if you see a different injector or change products.
Will I need more units every time?
The labels do not describe a need for rising doses with repeat treatment. If a dose seems to work less well than it did before, that is worth raising, because it is a reason to review the plan rather than simply add more.
Revision history (1)
- update First version, written from FDA prescribing information and peer-reviewed literature Editorial team