How many Botox sessions are needed to see hair regrowth?

The use of botulinum toxin type A, better known as Botox, has expanded beyond wrinkle treatment to occupy an unexpected place in scalp dermatology. In recent years, several studies have explored its application in combating hair loss, particularly in cases of androgenetic alopecia (commonly known as male or female pattern baldness).

However, a common question many ask before considering this treatment is clear: how many Botox sessions are needed to see hair regrowth?

What we know so far: results are possible, but not immediate

Current evidence suggests that Botox may contribute to hair regrowth in certain patients, but this effect is neither immediate nor guaranteed for everyone. Most clinical studies have shown that multiple sessions are required before any improvement becomes noticeable, and that the timing between sessions also affects the outcome. However, it is important to clarify that there is no fixed or universal timeline. The response to the treatment varies widely between individuals.

In 2010, dermatologist Simon Z. Williams conducted a pilot study involving 50 men with mild to moderate androgenetic alopecia. Over the course of 24 weeks, Botox was injected at 30 points on the scalp, with one session every six weeks. Results indicated that by the third session, participants began to notice reduced hair shedding and a modest increase in hair density. These outcomes were measured using standardized photographs and hair counts in pre-marked areas. By the end of the study, 75% of the participants reported a 15% to 20% increase in hair density. However, the study lacked a control group, which limits the strength of its conclusions.

Why might Botox help with hair growth?

Although Botox is widely known for its ability to temporarily paralyze muscles, its application to the scalp involves a different mechanism. The most accepted hypothesis is that by relaxing the pericranial muscles—those surrounding the scalp—blood flow in the area improves. Enhanced circulation may help hair follicles receive more nutrients and oxygen, supporting their function and promoting growth. This theory is particularly relevant in androgenetic alopecia, where gradual follicular miniaturization is often accompanied by poor blood supply.

Between hope and evidence: what the studies say

A 2017 study led by Dr. K.V. Dhurat in India supports the idea that Botox might benefit hair regrowth. This was a randomized, placebo-controlled clinical trial involving 60 men aged 30 to 45 with androgenetic alopecia. Participants were divided into two groups: one received Botox injections at 30 scalp points every three months for one year, while the other received a placebo. **Evaluations were conducted through trichoscopy, standardized photographs, and daily hair fall counts. Starting from the sixth month—after two sessions—the Botox-treated group showed a significant reduction in hair loss and a notable increase in hair density. **

However, the study focused solely on men, which limits its applicability to female patients. In 2022, another study was published in the Journal of Cosmetic Dermatology, this time focusing on women. The research team led by Dr. Rasha Kadry examined the effects of Botox on 20 women with mild androgenetic alopecia. For six months, participants received bimonthly injections in the parietal region of the scalp. Results were assessed using clinical photographs and self-evaluation. Although the number of participants was small, the study found a visible improvement in hair density in several of the treated women. Still, its small sample size and open-label design (with no placebo control) limit the statistical strength of the findings.

How many sessions are needed: is there a magic number?

There is no definitive consensus on how many Botox sessions are needed to stimulate hair growth. However, the available studies show a trend: at least two to four sessions, spaced six to twelve weeks apart, seem necessary to begin seeing visible changes. This means results may start to appear between the third and sixth month, depending on the individual. These figures must be interpreted with caution, as the response to treatment varies according to age, alopecia type, overall health, and other individual factors. Most importantly, there is no standardized timeline that works the same for everyone.

Is this an officially approved treatment?

As of now, the U.S. Food and Drug Administration (FDA) has not approved the use of Botox for treating alopecia. Its use in this context is considered "off-label," meaning outside its officially approved indications. **This does not mean the treatment is illegal or necessarily unsafe, but it does mean it should only be performed under the supervision of a qualified medical professional. In the hands of experienced dermatologists or aesthetic medicine practitioners, Botox may represent a valid alternative as part of a personalized approach to hair loss treatment. Conclusion: it’s not immediate, but it might be worth considering **

User Experiences: How Many Botox Sessions Are Needed to See Hair Regrowth?

Botox (botulinum toxin A) is emerging as a novel treatment option in the hair loss space, but community feedback on Tressless reveals a mixed picture when it comes to its efficacy and the number of sessions required to see regrowth. While a 2010 pilot study suggested that two cycles of Botox injections across 60 weeks (each cycle lasting 24 weeks) could lead to an 18% increase in hair count for men with androgenetic alopecia, the Tressless community reveals more nuanced outcomes in practice. Users generally report mild or unclear results and often combine Botox with other therapies like finasteride, minoxidil, or PRP. One commenter preferred Botox due to its non-hormonal mechanism, seeking doctors in the U.S. who offered it specifically for hair loss. However, they also admitted to limited visible regrowth and were looking to try other options afterward.

A 2023 thread comparing PRP and Botox showed a clear user preference for PRP, with multiple commenters calling Botox “not worth it” unless combined with more proven treatments. A few did note improvements in scalp tension or reduced headaches, but not direct hair thickening. Another relevant thread pointed out how Botox might play a role in reducing scalp tension or altering muscle tone in the scalp, which some theorize could improve blood flow and indirectly support regrowth, but again, users saw it more as a supportive measure, not a core treatment.

So, while Botox may require multiple sessions over several months (in line with research timelines of 24–60 weeks), the majority of Tressless users either saw minimal improvement or used it only as part of a more comprehensive routine. The community consensus leans toward Botox being an expensive, secondary intervention—not a reliable standalone for hair regrowth.

For now, the most reliable treatments remain finasteride, minoxidil, ketoconazole, and microneedling—commonly known as the "Big 4." Botox may have a place in future regimens if protocols become better defined or if specific scalp conditions are involved, but evidence and experiences are still limited.

Returning to the initial question: how many Botox sessions are needed to see hair regrowth?

The most current evidence suggests that a minimum of two to four sessions, applied every six to twelve weeks, is required to observe improvements in hair density. These effects are typically gradual, not guaranteed, and highly dependent on individual patient characteristics. Although not formally approved by institutions like the FDA, Botox is emerging as a potentially therapeutic tool in the fight against hair loss, provided it is prescribed and applied responsibly.

References

Williams, S. Z. (2010). Botulinum Toxin for the Treatment of Androgenetic Alopecia: A Pilot Study. Dermatologic Surgery, 36(8), 1246–1253. https://doi.org/10.1111/j.1524-4725.2010.01602.x)

Dhurat, K., Sukesh, M., Avhad, G., Dandale, A., Pal, A., & Pund, P. (2017). A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study. International Journal of Trichology, 9(1), 1–6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362406/

Kadry, R., Maher, N., & Gawdat, H. (2022). The effect of botulinum toxin type A on female pattern hair loss: A pilot study. Journal of Cosmetic Dermatology, 21(1), 156–162. https://pubmed.ncbi.nlm.nih.gov/34693917/

U.S. Food & Drug Administration (FDA). (2023). BOTOX® (onabotulinumtoxinA) [Prescribing Information]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/103000s5300lbl.pdf

National Institutes of Health (NIH). (2023). Alopecia Areata. https://www.niams.nih.gov/health-topics/alopecia-areata Reddit user discussion. (2021, March 18). Has anyone found any US Doctors willing to do Botox injections for hair loss? Tressless. https://reddit.com/r/tressless/comments/m7u7hx/has_anyone_found_any_us_doctors_willing_to_do/

Reddit user discussion. (2023, August 23). Botox vs PRP What's the better option? Tressless. https://reddit.com/r/tressless/comments/15ypy56/botox_vs_prp_whats_the_better_option/

Reddit user discussion. (2021, July 26). The theory that explains everything - First Evidence of Hair regrow attributed to upregulating 3aHSD. Tressless. https://reddit.com/r/tressless/comments/osb15i/the_theory_that_explains_everything_first/