What is the best treatment for forehead wrinkles?

Stirnfalten behandeln

We are often asked: “Which is actually the ONE, best wrinkle treatment?” To this we can answer quite clearly: “There is no such thing!” – And this is due to the fact that every person is an individual. Although every woman and man has a “blueprint for the body” established by evolution, each person differs in its subtleties. Skin aging may start earlier or proceed faster in one person than in another. The individual skin texture and the interaction of skin and connective tissue are also important. In addition, each person ages visually differently. In order to select the “right” wrinkle treatment, not only must all these factors be taken into account, but also the type of wrinkle – because there are differences here as well. In this article, we will devote ourselves to forehead wrinkles as well as their optimal treatment.

What are forehead wrinkles?

Forehead wrinkles have many names – they are also called thinker wrinkles or a thinker’s forehead, worry lines or transverse forehead wrinkles.

They can appear in different ways (and their interaction):

  • Facial expression
    Forehead wrinkles belong to the category of facial expression wrinkles. They occur where the skin is subjected to a lot of stress due to different movements of the facial muscles. Frown lines are provoked by wrinkling of the forehead. Every time the forehead is contracted, the indentations in the forehead can become deeper.
  • Little fatty tissue on the forehead
    Not only frequent and strong forehead muscle activity promotes the formation of the wrinkles, but also the fact that there is very little fatty tissue on the forehead. Where there is little subcutaneous fatty tissue, wrinkles become visible more quickly and more clearly. Conversely, areas where there is more fatty tissue are usually spared wrinkles.
  • Decreasing moisture/fluid reservoir
    Skin generally loses its ability to retain fluid and moisture over time. Like fatty tissue, fluid also plumps up the skin from the inside.
  • Decreasing elasticity of the skin
    In conjunction with the diminishing elasticity of the skin, the effect is lost that wrinkles caused by muscular actions remain only temporarily in the skin and then disappear. Over time, the movements become more deeply anchored in the skin as permanent and clearly visible forehead wrinkles.

Dr. Tatjana Pavicic

Dr. Tatjana Pavicic is a specialist in dermatology and venereology with her own practice in Munich. She is an internationally recognized expert in aesthetic dermatology with a special focus on dermocosmetics, botulinum toxin, fillers and lasers.

How can forehead wrinkles be treated?

We have several options available to treat forehead wrinkles. Which therapy is most suitable here depends on the severity of the patient’s forehead wrinkles, their age, skin condition and individual wishes.

Incipient forehead wrinkles: botox

Forehead wrinkles in the initial stage, so-called initial mild mimic forehead wrinkles, occur in young patients. They are not very visible at rest, i.e. without muscle activity. Furthermore, the eyebrows have not yet lowered.

In the case of incipient forehead wrinkles, the injection of botulinum toxin A (often just called Botox) such as Bocouture® is recommended. This can also prevent the wrinkles from digging deep into the skin over time. Deep forehead wrinkles are thus prevented.

Mimic forehead wrinkles without loss of volume with drooping eyebrows: ultherapy and botox

Patients who have more pronounced forehead wrinkles without loss of skin volume and whose wrinkles are accompanied by drooping eyebrows (brow ptosis) may benefit from Ultherapy ultrasound treatment. After three to four months, treatment with botulinum toxin A (often just called Botox) such as Bocouture® can follow.

Mimic forehead wrinkles with volume loss plus drooping eyebrows: ultherapy, hyaluronic acid and botox

In some patients, the interaction of mimic wrinkles of the forehead, the decreasing moisture and elasticity of the skin, and the already low fat content in this area has such an effect that they develop an inwardly curved forehead. Often, this condition is accompanied by drooping eyebrows.
In this case we recommend the use of Ultherapy with injection of hyaluronic acid for forehead augmentation. Later, this can be followed by treatment with botulinum toxin A (often just called Botox) such as Bocouture®.

Clearly visible transverse forehead wrinkles without drooping eyebrows: botox and hyaluronic acid

If the transverse forehead wrinkles are already visible at rest, but there is no brow ptosis, we can recommend Botox (BoNTA) and injection of hyaluronic acid filler directly into the wrinkles.

Very deep forehead wrinkles: combination treatment

If the wrinkles are very pronounced, the combination of different methods can help: In this case, for example, we use Botox (BoNTA), ablative lasers and injection of hyaluronic acid directly into the forehead wrinkles.

Glossary: wrinkle treatments explained in brief in this article

Botulinum interrupts the transmission of excitation from the nerve cells to the muscles at the injected areas. Thus, the contraction of the muscle is inhibited. The respective muscles relax and corresponding wrinkles are smoothed. There are different types/varieties/strengths of botulinum toxin A (e.g. Boucouture® – the pure BoNTA), which can be applied depending on the expression of the wrinkles.

Hyaluronic acid/filler

Hyaluronic acid is used when, for example, sunken tissue/volume deficits need to be plumped up. Hyaluronic acid is an active ingredient that occurs naturally in the body. It is responsible for giving the skin elasticity, volume and resilience. The body’s natural production of hyaluronic acid decreases over the years. This causes the tissue to give way and sag downward. Wrinkles develop. Injections of hyaluronic acid fillers can replenish these.


Ultherapy is an innovative, device-based treatment that uses ultrasound. The procedure can help stop the signs of time by working from the inside out. Ultherapy tightens and lifts the skin without the need for surgery like a facelift or brow lift. Micro-focused ultrasound energy stimulates the skin to produce fresh collagen and elastin deep within. The results – a younger, contoured appearance – are visible after about three to four months.

Ablative laser

Ablative laser treatment allows the superficial layers of the skin to be removed. A minimal wound is created, which starts a regeneration process: The production of collagen and new elastic fibers is stimulated. This results in a reduction of wrinkle depth with skin tightening.


In our private practice for dermatology and aesthetics in Munich, we focus on individuality – especially with regard to our treatments. We examine each patient in detail and apply a wrinkle treatment that is individually tailored to the patient. With us, there are no standardised treatments that run according to a formula. See for yourself and make an appointment with us!

Foto: © Rido81 / elements.envato.com

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