We are frequently asked for injecting advice on administering botox for men with “tough skin”.
Men’s dermal thickness is thicker than women’s. However, this “tough skin” is more likely a phenomenon due to a difference in muscle bulk. This differs between male and female patients, as well as between individuals.
It’s common for new aesthetics practitioners to find that men have “tougher skin” where it feels as if the needle just doesn’t want to go through.
We spoke to cosmetic doctor, Level 7 Diploma graduate and clinical trainer, Dr Carol Mastropierro, for her insights on overcoming this issue.

Understanding muscle bulk is key when administering botox for men
“Administering botox to men can often be challenging for new injectors,” notes Dr Carol. “This is due to the frequent difference in dosage required to adjust to what is often described as ‘tough skin’.”
“When mentoring my students, I discuss muscle bulk as part of teaching about injecting botox for men. This can help to explain two aspects. Firstly, why some men may require a higher dose of toxin. Secondly, why you may need to adjust your standard injection techniques when treating men.”

Choose a needle that will work with a bigger muscle bulk
Dr Carol had this to say about treating male patients with an increased muscle bulk. “In my experience, using an Invisible needle doesn’t always quite get the needle deep enough into men’s glabella. Also, injecting using a small needle can create too much extrusion pressure. In this instance, it may result in the syringe detaching from the needle.”
“This is especially true when using slip-on syringes instead of Luer-locks!” she cautions.
“I had this happen to me twice at the start of my aesthetic medicine career. As a result, I always use yellow 30G needles for the glabella and frontalis in men with a bigger muscle bulk.”
“If you have the same experience and toxin spills onto the patient’s face, don’t worry. It shouldn’t result in any complications,” she reassures. “The spilled toxin is not absorbed. However, please, make sure you have eye wash available, should it spill into the eye.”
In summary…
- Ensure you have a solid understanding of facial anatomy and muscle bulk variations
- Choose the right needle for your patient
- Learn how to alter your injecting techniques when treating people with an increased muscle bulk.

Further reading
For more on this, check out the following articles…
Botox Techniques for Needle Resistance in the Lateral Corrugators
Administering Botox to Male Patients
Botox training courses for healthcare professionals
If you’re a doctor, dentist, nurse or midwife, we have a range of aesthetics training options available.
These range from entry level beginners courses, through to Master’s level Diploma options.
Find out more by scrolling to the bottom here and downloading our prospectus, arranging a call with our courses advisor, Christine Slater. Or, you can attend our next Aesthetics Careers Open Evening event.