Botox injections may eliminate the appearance of lines and wrinkles around the eyes and mouth. Can they also reduce dark circles and bags under the eyes?

Botulinum toxin, commonly called Botox, is a medication that weakens the muscle contractions that cause wrinkles to appear.

Botox temporarily reduces wrinkles:

between the brows
in the forehead
at the sides of the eyes
around the mouth

However, the United States Food and Drug Administration (FDA) has not approved the use of Botox under the eyes for cosmetic purposes. Little research has looked into its effectiveness or side effects.

In this article, learn what we currently know about using Botox under the eyes, including possible side effects and alternatives to this procedure.
How does Botox work?
Botox injections are used to lessen the appearance of wrinkles.

Vials of Botox contain three main ingredients: botulinum toxin type A, human albumin, and sodium chloride. The active ingredient, which has the greatest effect, is botulinum toxin A.

When injected into muscles, Botox blocks the nerve impulses that cause a particular muscle to contract. The muscle cannot move, and this reduces the appearance of wrinkles.

Botox can only reduce wrinkles in areas of the face that move. Doctors will usually use it on the frown lines between the eyebrows, called glabellar lines, as well as on lines in the forehead, and crow’s feet at the sides of the eyes.

Botox is not a permanent solution to wrinkles. In 3–6 months, it will stop blocking the nerve impulses, and the muscles will begin to contract. A person will need further injections to maintain results.

Botox has also emerged as a treatment for a number of medical conditions, from migraines to an overactive bladder.
How effective is Botox under the eyes?

Injecting Botox to treat bags or dark circles under the eyes is an off-label use in the U.S., and the FDA have not approved it.

For this reason, researchers have conducted few studies about this use, and doctors are unsure how effective it may be.

One studyTrusted Source from 2003 sought to determine whether Botox injections under and around the eyes could reduce the appearance of wrinkles in these areas. Nineteen female participants received injections. Those who had them in the lower eyelids and crow’s feet area were more likely to report positive results than those who only received injections in their lower eyelids.

These results suggest that Botox injections can make the lower eyelid appear fuller and plumper, helping to reduce wrinkles and bagginess.

The researchers also measured the effects of varying amounts of Botox in the lower eyelid. Patients experienced the strongest results when receiving 8 units of Botox, but they also had the most intense side effects.