When it comes to neurotoxins, Americans aren’t just thinking about crow’s feet and forehead lines. A new study from Avinity Health, a medical aesthetics practice in Scottsdale, AZ, found that “jaw Botox” (neurotoxin injections into the masseter muscle) is one of the most-searched Botox-related search terms in the country. The study analyzed search, provider and interest data across all 50 states.
Masseter Botox, which can slim the lower face and ease clenching and grinding, draws about 74,020 estimated searches a month, making it the second-most-searched term among the 31 the study tracked. Because “Botox” is often used as shorthand for all neurotoxins, the search terms may reflect interest in several brands—such as Xeomin, Daxxify, Dysport and Jeuveau—and using them in the masseter is an off-label use in the U.S.
That search volume is one piece of a bigger picture. Avinity’s “Botox Obsession Index” ranks every state by population-adjusted search demand, provider density and overall interest, and found about 508,000 estimated Botox-related searches a month nationwide. New York took the top spot with a score of 84.1, narrowly ahead of Colorado at 84.0. California, Florida and Massachusetts rounded out the top five.
“Colorado beating California is only visible because we divided everything by population before ranking anything,” says Emily Dawson, DHA, MBA, MSN, RN, co-founder and clinical director of Avinity Health.
The results also split clearly by region. Nine of the top 10 states are in the West or Northeast, and Florida is the only exception. No Midwestern state made the top 10. North Dakota, South Dakota, Indiana and Iowa all landed in the bottom 10, along with Arkansas, West Virginia and Mississippi, which came in last. New York’s per-resident search rate was 2.3 times Mississippi’s.
Income doesn’t predict interest as reliably as you might expect. Maryland has the third-highest median household income in the country but ranks 18th. Alaska ranks 11th for income but 41st on the index. Florida ranks fourth despite a below-median household income.
The study also found that the places with the most interest in neurotoxins aren’t always the locations with the most providers. “Attention and access do not sit in the same places,” Dawson says. Search demand outpaces provider density most in New York, Virginia, Illinois, Washington, Texas and Minnesota. Provider density outpaces demand most in Florida, Idaho, Arizona, Colorado, New Hampshire and Montana.
How the Index Was Calculated
Each state’s score is weighted 50 percent on estimated monthly Google searches across 31 Botox-related terms per resident. Another 35 percent is provider and clinic density, based on the national NPPES clinician registry and mapped aesthetic clinic locations. The remaining 15 percent is relative interest from Google Trends over the past 12 months. The data was collected in August 2026 and adjusted using U.S. Census Bureau population estimates. Washington, DC, was measured but not ranked.
The study notes that it measures interest and market presence, not the number of procedures performed or money spent. That means the most “obsessed” states are the ones searching for Botox most, not necessarily the ones getting the most injections.
