Vertical Forehead Lines (11 Lines): Causes, Treatments & Prevention

Forehead wrinkles are among the earliest and most noticeable signs of facial aging. While they are often associated with aging, many people begin to notice vertical forehead lines much earlier due to facial expressions, stress, sun exposure, and individual anatomy.

These vertical lines commonly known as frown lines or “11 lines” can start as temporary creases during expression and gradually become visible at rest.

Understanding what causes them and how they differ from other forehead lines is key to choosing the most effective treatment and prevention strategies.

What Are Vertical Lines on the Forehead?

Vertical lines on the forehead are wrinkles that form between the eyebrows, often creating a furrowed or tense appearance. They are commonly referred to as frown lines, glabellar lines, or “11 lines,” and occur in the glabellar region.

These lines develop over time due to repeated facial expressions such as frowning, concentrating, and squinting. With ongoing movement, the skin folds in the same area repeatedly. As collagen and elastin gradually decline with age and sun exposure, the skin becomes less able to rebound, allowing these expression lines to deepen.

In the early stages, vertical forehead lines are usually dynamic, meaning they appear only during facial movement. With continued muscle activity and skin aging, they can progress into static wrinkles that remain visible even when the face is at rest.

Several factors can accelerate their formation, including UV exposure, genetics, dehydration, smoking, eye strain, chronic stress, and sleep compression, particularly from side sleeping.

Some people may notice a single vertical line, often related to habitual asymmetry in facial movement or persistent brow tension. In contrast, a vertical dark line on the forehead may reflect pigmentation rather than a true wrinkle, as pigment changes do not involve structural folding of the skin.

If a vertical line appears suddenly or worsens rapidly especially when accompanied by headaches or vision changes clinical evaluation is recommended.

The Anatomy Behind “11 Lines”

While skin aging contributes to vertical forehead lines, their formation is driven primarily by specific facial muscles acting repeatedly against the skin.

The corrugator supercilii muscles are the main contributors. These paired muscles lie beneath the inner eyebrows and pull the brows inward and downward when activated, creating the characteristic vertical creases that resemble the number “11.” Frequent engagement reinforces the same folding pattern over time.

The procerus muscle, located centrally over the bridge of the nose and extending into the glabellar region, also contributes by pulling the skin downward and deepening a central vertical crease.

These muscles work in opposition to the frontalis muscle, which lifts the eyebrows and smooths the forehead, as well as the orbicularis oculi, which contributes to brow descent during squinting. If this muscular balance is not carefully considered during treatment, relaxing the wrong muscles can lead to brow heaviness rather than improvement.

Repeated folding eventually creates micro-creases in the dermis. As collagen and elastin decline due to aging, sun exposure, and oxidative stress, these temporary expression lines can become permanent static wrinkles.

What Causes Vertical Forehead Lines?

Forehead wrinkles develop due to a combination of repetitive muscle movement, skin aging, environmental exposure, and lifestyle factors that gradually weaken the skin’s structure over time. While aging plays a role, many forehead wrinkles begin forming much earlier due to expression patterns and external stressors.

The most common causes include:

• Facial Expressions: Repetitive movements like frowning, raising eyebrows, or squinting activate the frontalis, corrugator, and procerus muscles, gradually etching lines into the skin.
  
• Sun Exposure: Ultraviolet (UV) rays degrade collagen and elastin, reducing skin firmness and accelerating wrinkle formation—especially in unprotected skin.
  
• Genetics: Your genetic makeup can influence how early and how deeply forehead lines appear, particularly if you inherit thin skin or strong expressive muscles.
  
• Aging: As we age, the skin produces less collagen and hyaluronic acid, leading to loss of elasticity and volume, making lines more visible.
  
• Smoking: Nicotine impairs blood flow and collagen production, causing premature skin aging and deeper wrinkles, especially around the forehead and mouth.
  
• Alcohol: Alcohol dehydrates the skin and can impair nutrient absorption, weakening skin barrier function and accelerating wrinkle formation.
  
• Dehydration: Lack of adequate hydration makes skin more prone to fine lines and reduces its ability to bounce back from expression-induced creases.
  
• Stress: Chronic stress increases cortisol levels, which can impair skin regeneration, dehydrate the skin, and intensify habitual expressions like frowning.

Single vs Two vs Middle Vertical Forehead Lines: What They Usually Mean

Single Vertical Forehead Line

Often linked to habitual asymmetry in facial movement, persistent brow tension, or favoring one side when frowning.

Two Vertical Lines (“11 Lines”)

The most common pattern, caused by strong or frequent corrugator muscle activity.

Central Vertical Forehead Line

More commonly associated with dominant procerus muscle activation and downward skin pull.

In most cases, these patterns are cosmetic and reflect individual muscle use rather than medical conditions. Sudden onset, pain, swelling, or neurological symptoms warrant medical evaluation.

Vertical Forehead Lines Treatments (Non-Surgical)

Vertical forehead lines can be treated using non-surgical options that target either muscle movement, skin structure, or a combination of both. The most effective treatment depends on whether the lines are dynamic (visible with expression) or static (visible at rest).

Neuromodulators (Botox®, Dysport®, Xeomin®, Jeuveau®, Daxxify)

Neuromodulators are the gold standard treatment for dynamic vertical forehead lines, particularly frown lines and “11 lines.” These injectable treatments relax the corrugator and procerus muscles responsible for repeated skin folding, allowing the skin to smooth and preventing lines from deepening.

Results begin to appear within 3–5 days, with full effects visible at 10–14 days. Most neuromodulators last 3–4 months, while Daxxify may last 6–9 months in some patients.

For vertical forehead lines, treatment commonly involves:

• Botox®: ~10–30 units in the forehead/glabellar area

• Dysport®: ~40–60 units (different unit scale than Botox)

• Daxxify®: clinician-dosed; unit scale differs

Cost: Most practices charge $300–$600 per treated area, with Daxxify priced higher due to its longer duration. Exact dosing and cost depend on muscle strength, anatomy, and desired outcome.

Proper dosing and placement are critical to maintain natural facial expression and avoid brow heaviness.

Dermal Fillers (Hyaluronic Acid)

Dermal fillers are used selectively for static vertical forehead lines that remain visible even when the face is relaxed. Hyaluronic acid fillers work by restoring volume beneath the crease, smoothing the skin from below.

Results are visible immediately and last 6–12 months or longer, depending on the product used and individual metabolism. Treatment is usually measured by syringe volume rather than units, commonly in 0.5–1.0 mL increments.

Cost: Approximately $500–$1,000 per syringe.

Because the forehead contains critical blood vessels, fillers in this area must be performed cautiously and only by highly experienced providers. Fillers are often used when neuromodulators alone are not sufficient.

RF Microneedling & Laser Resurfacing

RF microneedling and laser resurfacing are frequently combined as a collagen-stimulating approach for vertical forehead lines that are static, etched, or associated with poor skin texture.

RF microneedling delivers radiofrequency energy into the deeper layers of the skin to stimulate collagen and improve firmness, while laser resurfacing targets the skin’s surface to smooth fine lines and address sun damage.

Most patients require a series of 3 treatments, spaced 4–6 weeks apart, with results building gradually over several months. Maintenance treatments are often performed every 6–12 months.

Cost:

• RF microneedling: $300–$700 per session

• Fractional laser resurfacing: $800–$2,500+ per session, depending on the device and intensity

Downtime varies based on treatment depth but is generally minimal to moderate.

Chemical Peels

Chemical peels improve fine vertical lines, uneven tone, and dullness by increasing cell turnover and stimulating superficial skin renewal. They do not relax muscles and therefore do not treat the root cause of dynamic vertical forehead lines.

Peels are performed as a series of 3–6 treatments, with maintenance sessions monthly or quarterly depending on peel strength.

Cost: Approximately $150–$400 per peel.

Chemical peels are best used as a supportive or maintenance treatment, rather than a standalone solution for deeper vertical lines.

Why Choose Dr. Syra Aesthetics For Vertical Forehead lines treatment In NYC?

At Dr. Syra Aesthetics, treatment for forehead lines is approached as a balance between facial anatomy, skin health, and natural expression, rather than simply reducing wrinkles. Because the forehead and glabellar region involve complex muscle interactions and delicate vascular structures, every treatment plan begins with a careful assessment of how an individual’s face moves at rest and during expression.

Dr. Syra Hanif brings an anatomy-focused, conservative philosophy to aesthetic care, prioritizing precision and long-term skin health over aggressive correction. Whether treating early dynamic lines or more established static creases, the goal is always to soften unwanted lines while maintaining a natural, expressive appearance—never a frozen or overtreated look.

Rather than relying on a single modality, treatments at Dr. Syra Aesthetics are often strategically combined, using neuromodulators, collagen-stimulating technologies, and skin-quality treatments where appropriate. This allows results to look more natural and age-appropriate, while also addressing the underlying factors that contribute to forehead lines over time.

Patients are encouraged to take an informed, gradual approach. Treatment options, expected outcomes, and maintenance needs are discussed transparently, with an emphasis on safety and individualized care. This thoughtful, patient-centered approach reflects the practice’s commitment to results that feel authentic, subtle, and aligned with each patient’s goals.

How to Prevent Vertical Lines on the Forehead?

Preventing vertical lines on the forehead—often called frown lines or “11 lines”—focuses on reducing repetitive muscle movement, protecting the skin from external damage, and supporting long-term skin health. These lines begin with habitual expressions such as frowning or squinting and become more pronounced over time as collagen declines and the skin loses elasticity.

1. Become Aware of Facial Tension

Repeated brow furrowing or squinting activates the corrugator and procerus muscles, which over time can create permanent creases. Developing awareness of facial tension and consciously relaxing the brow throughout the day may help reduce unnecessary muscle engagement.

2. Wear Sunglasses Outdoors

Bright light often triggers squinting, reinforcing vertical forehead lines. Sunglasses reduce both UV exposure and expression-related tension, helping protect the skin while minimizing repetitive muscle movement.

3. Improve Sleep Positioning

Side or stomach sleeping can cause repeated compression of the forehead against pillows, contributing to vertical “sleep lines.” Sleeping on your back and using pillows designed to reduce facial pressure may help prevent long-term creasing.

4. Use Sunscreen Daily

UV radiation accelerates collagen and elastin breakdown, making vertical lines deeper and more permanent. Applying a broad-spectrum SPF 30 or higher daily is one of the most effective ways to slow wrinkle formation.

5. Maintain Hydration and Balanced Nutrition

Well-hydrated skin is more resilient and less prone to fine lines. Drinking adequate water and consuming a diet rich in antioxidants, vitamins C and E, omega-3 fatty acids, and other collagen-supporting nutrients helps maintain skin elasticity.

6. Use Targeted Skincare Ingredients

Preventative skincare can slow the progression of vertical lines:

• Retinoids support collagen production and skin renewal

• Peptides help reinforce skin structure

• Hyaluronic acid improves hydration and plumpness

• Niacinamide supports barrier function and reduces inflammation

7. Manage Stress

Chronic stress can increase subconscious facial tension and habitual frowning. Stress-reduction techniques such as mindfulness, relaxation exercises, or gentle facial massage may help reduce repeated muscle activation.

8. Avoid Smoking and Limit Alcohol

Smoking restricts blood flow and accelerates collagen loss, while alcohol dehydrates and inflames the skin. Reducing or eliminating these habits supports healthier skin aging.

9. Consider Preventative Neuromodulators

In some individuals, small doses of neuromodulators such as Botox or Dysport may be used preventatively to soften habitual muscle movement before static lines form. This approach is most commonly considered in the late 20s to 30s and should be individualized.

Frequently Asked Questions About Vertical Forehead Lines

Can exercise reduce forehead wrinkles?

Facial exercises may slightly improve muscle awareness and circulation, but evidence for significant wrinkle reduction is limited. In some cases, excessive or improper exercises may worsen dynamic wrinkles by reinforcing repetitive movement. Facial exercises are best viewed as a complementary practice rather than a primary treatment.

Can vertical forehead lines be improved naturally?

Vertical forehead lines can be softened through non-invasive measures that improve skin health and reduce repetitive muscle movement. Hydrating skincare, retinoids, daily sunscreen use, a nutrient-rich diet, stress management, and avoiding smoking or excessive alcohol can help slow progression. However, natural methods are unlikely to fully eliminate established lines.

Can Botox cause vertical lines on the forehead?

Botox itself does not create new wrinkles, but vertical lines may appear or become more noticeable if muscle balance is not fully addressed. This can happen when surrounding muscles compensate for treated areas, or when pre-existing static lines remain visible after muscle movement is reduced.

In some cases, uneven dosing or partial treatment of the corrugator and procerus muscles may allow certain fibers to remain active, causing lines to appear asymmetric or more defined. Skin texture, dehydration, and sun damage can also contribute to the appearance of residual lines after Botox.

These effects are typically temporary and can often be corrected with proper assessment and adjustment by an experienced provider.

Can sleeping cause vertical lines on the forehead?

Yes, sleeping can contribute to vertical forehead lines, especially if you regularly sleep on your side or stomach and your forehead presses into the pillow. In the early stages, these are often temporary “sleep lines” that fade as the skin rehydrates and rebounds.

Over time, however, repeated compression and friction—combined with collagen loss and dehydration—can cause sleep lines to become more persistent and eventually look like true wrinkles. Switching to back sleeping when possible, using a smooth pillowcase (like silk or satin), and keeping the skin well-hydrated can reduce this effect.

If the line has become etched into the skin, collagen-stimulating treatments and consistent skincare may help soften its appearance.

How can I get rid of “11 lines” on the forehead?

Dynamic “11 lines” are most effectively treated with neuromodulators such as Botox or Dysport, which relax the muscles causing the creases. Topical treatments like retinoids and peptides can support skin quality, while deeper static lines may require combination treatments.

How can I stop frowning?

Becoming aware of facial tension, managing stress, addressing vision issues that cause squinting, and practicing relaxation techniques can help reduce habitual frowning. In some cases, neuromodulators may be used to temporarily soften excessive muscle activity.

Why do I have forehead wrinkles at 13 or 14?

Early forehead lines can be caused by genetics, frequent facial expressions, sun exposure, dehydration, or squinting. In adolescents, these lines are usually dynamic and can often be improved with sun protection, hydration, and reduced facial tension.

Why Do I Still See Vertical Lines After Botox?

Vertical lines may still be visible after Botox if the treatment has not yet peaked (full results take 10–14 days), if the dose or placement did not fully match the muscle pattern, or if the lines are static rather than muscle-driven. In some cases, surrounding muscles compensate, making lines appear different. Skin texture, dehydration, and sun damage can also make residual lines more noticeable.

Do facial expressions cause vertical lines on the forehead?

Yes. Repeated expressions such as frowning and squinting create repeated folding of the skin. Over time, especially as collagen declines, these folds can become permanent vertical lines.