Research · For journalistsResearch · For journalistsA 50-state analysis · Avinity Health
·
New York takes the crown. Colorado beats California and Florida. And nine of the top 10 states sit in the West or Northeast, in an index built from per-capita Botox search activity, local provider and clinic density, and relative Google search interest.
The state better known for ski passes and trailheads out-scores California, Florida and every other state but New York, missing the crown by seven hundredths of a point. Colorado has the second-densest treatment market of any state, a fraction behind Florida, alongside the fourth-highest search demand.
Colorado 84.0 · New York 84.1Nine of America's ten most Botox-obsessed states are in the West or Northeast. Florida is the only state from anywhere else to break in. Not one Midwestern state makes the top 10, and four sit in the bottom 10.
5 West · 4 Northeast · 1 SouthSome of America's wealthiest states fall surprisingly far down the ranking. Maryland has the third-highest median household income but ranks 18th for Botox obsession, while Alaska, eleventh for income, ranks 41st. Florida, meanwhile, ranks fourth on an income below the median state.
Maryland · 3rd in income, 18th in obsessionAmericans search for masseter, or jaw, Botox an estimated 74,020 times a month. It is the second most searched term in the entire study, ahead of every traditional wrinkle-treatment term we measured.
masseter botox · est. 74,020 searches a monthScored 0 to 100, combining search demand, providers and clinics, and relative interest, all per resident.
Select and copy. Free to republish with attribution.
Rank State Score Searches/100k Providers+clinics/100k ---- ------------- ----- ------------- ---------------------- 1 New York 84.1 202.2 35.0 2 Colorado 84.0 183.9 44.5 3 California 80.9 187.4 39.4 4 Florida 75.6 157.4 44.6 5 Massachusetts 74.2 184.9 35.5 6 Arizona 69.8 160.5 40.5 7 Washington 60.0 173.5 29.8 8 New Jersey 59.0 163.4 29.8 9 Nevada 58.8 156.3 35.1 10 Connecticut 56.9 158.0 33.1
Botox Obsession Index, Avinity Health. Scores 0 to 100. Data collected August 27, 2026. Searches per 100k is estimated average monthly Google searches across 31 Botox terms per 100,000 residents. Providers + clinics per 100k combines registry clinicians and mapped clinic locations. The full 50-state dataset is a CSV download.
Tap or hover any state. Darker means more obsessed.
Search interest relative to local provider and clinic density. A positive gap means residents search for Botox faster than the local market has grown to meet them.
Search demand runs furthest ahead of local provider and clinic density.
Provider and clinic density runs furthest ahead of search demand.
Expert commentary
Co-founder and Clinical Director, Avinity Health
“The states at the top of this list are not the biggest states. They are the states where Botox attention runs highest relative to how many people live there. Colorado beating California is only visible because we divided everything by population before ranking anything.”
On what a per-capita ranking shows
“Attention and access do not sit in the same places. New York generates more estimated Botox searches per resident than any other state while ranking seventh for providers and clinics per resident, the widest gap in the index where searching runs ahead of supply. That gap is the most useful thing in the data.”
On the gap between demand and supply
“The single most surprising number in the study is masseter Botox. It draws an estimated 74,020 searches a month, second only to the word botox itself, ahead of every classic wrinkle term. That tells you what people are curious about, and it is not foreheads.”
On jaw Botox
Emily Dawson brings a clinician's perspective to the data. She works directly with patients receiving aesthetic treatments and can speak to the questions behind the search trends: why patients seek Botox, what first-time patients are concerned about, how treatment preferences are changing, and why online interest does not necessarily translate directly into procedures performed.
She can also provide context on differences between consumer interest, provider availability and actual treatment demand, including what the state rankings can, and cannot, tell us about Botox use across the country.
For journalists: access the full dataset, graphics, methodology and interview requests
Americans run an estimated 508,000 searches a month across the 31 Botox-related terms in this study, and they are not spread evenly. Adjusted for population, New York searches for Botox at more than twice the rate of Mississippi. And the states that search hardest are not always the states with the most providers.
The Botox Obsession Index ranks all 50 states on per-capita Botox search activity, local provider and clinic density, and relative Google search interest. Search and supply are measured per resident, which is why population size does not decide the ranking. Colorado finishes second ahead of 19 states with larger populations.
Click any heading to re-sort.
| # | State | Obsession score | Demand | Supply | Interest | Searches /100k | Providers + clinics /100k |
|---|---|---|---|---|---|---|---|
| 1 | New York | 84.1 | 100.0 | 66.9 | 71.1 | 202.2 | 35.0 |
| 2 | Colorado | 84.0 | 83.9 | 99.6 | 48.0 | 183.9 | 44.5 |
| 3 | California | 80.9 | 86.9 | 82.2 | 57.6 | 187.4 | 39.4 |
| 4 | Florida | 75.6 | 60.5 | 100.0 | 69.2 | 157.4 | 44.6 |
| 5 | Massachusetts | 74.2 | 84.7 | 68.7 | 51.9 | 184.9 | 35.5 |
| 6 | Arizona | 69.8 | 63.2 | 86.0 | 53.8 | 160.5 | 40.5 |
| 7 | Washington | 60.0 | 74.7 | 49.2 | 36.5 | 173.5 | 29.8 |
| 8 | New Jersey | 59.0 | 65.8 | 49.0 | 59.6 | 163.4 | 29.8 |
| 9 | Nevada | 58.8 | 59.6 | 67.3 | 36.5 | 156.3 | 35.1 |
| 10 | Connecticut | 56.9 | 61.1 | 60.5 | 34.6 | 158.0 | 33.1 |
| 11 | Hawaii | 56.1 | 68.6 | 53.3 | 21.1 | 166.6 | 31.0 |
| 12 | Utah | 54.9 | 55.3 | 58.0 | 46.1 | 151.5 | 32.4 |
| 13 | Illinois | 50.2 | 63.8 | 37.4 | 34.6 | 161.2 | 26.4 |
| 14 | Virginia | 50.0 | 64.2 | 36.3 | 34.6 | 161.6 | 26.1 |
| 15 | Texas | 47.8 | 58.2 | 35.2 | 42.3 | 154.8 | 25.7 |
| 16 | Oregon | 47.6 | 49.9 | 49.8 | 34.6 | 145.3 | 30.0 |
| 17 | Rhode Island | 46.4 | 51.7 | 48.8 | 23.0 | 147.4 | 29.7 |
| 18 | Maryland | 44.7 | 44.3 | 53.6 | 25.0 | 139.0 | 31.1 |
| 19 | New Hampshire | 43.5 | 41.8 | 57.0 | 17.3 | 136.2 | 32.1 |
| 20 | Wyoming | 42.6 | 35.7 | 27.9 | 100.0 | 129.3 | 23.6 |
| 21 | North Carolina | 36.5 | 43.6 | 32.1 | 23.0 | 138.2 | 24.8 |
| 22 | Tennessee | 34.6 | 36.7 | 30.7 | 36.5 | 130.4 | 24.4 |
| 23 | Georgia | 34.4 | 37.9 | 34.4 | 23.0 | 131.7 | 25.5 |
| 24 | Minnesota | 34.3 | 45.1 | 27.1 | 15.3 | 139.9 | 23.4 |
| 25 | Idaho | 33.7 | 22.2 | 49.9 | 34.6 | 113.9 | 30.0 |
| 26 | Pennsylvania | 32.6 | 36.3 | 31.3 | 23.0 | 129.9 | 24.6 |
| 27 | South Carolina | 29.4 | 30.7 | 30.4 | 23.0 | 123.5 | 24.4 |
| 28 | Michigan | 28.8 | 31.2 | 28.8 | 21.1 | 124.1 | 23.9 |
| 29 | Montana | 27.8 | 22.5 | 36.6 | 25.0 | 114.3 | 26.2 |
| 30 | Delaware | 27.6 | 34.0 | 27.9 | 5.7 | 127.3 | 23.6 |
| 31 | Louisiana | 27.4 | 28.2 | 25.7 | 28.8 | 120.7 | 23.0 |
| 32 | Maine | 26.2 | 35.3 | 21.2 | 7.6 | 128.8 | 21.7 |
| 33 | Vermont | 24.2 | 30.5 | 22.4 | 7.6 | 123.3 | 22.0 |
| 34 | Ohio | 23.6 | 28.6 | 20.0 | 15.3 | 121.2 | 21.3 |
| 35 | Kansas | 23.5 | 25.9 | 20.4 | 23.0 | 118.1 | 21.4 |
| 36 | Nebraska | 22.7 | 31.2 | 13.8 | 15.3 | 124.1 | 19.5 |
| 37 | Missouri | 21.7 | 23.2 | 22.9 | 13.4 | 115.1 | 22.2 |
| 38 | Kentucky | 21.5 | 24.9 | 11.1 | 34.6 | 117.0 | 18.7 |
| 39 | Wisconsin | 20.1 | 22.9 | 20.5 | 9.6 | 114.7 | 21.5 |
| 40 | New Mexico | 18.8 | 19.4 | 18.5 | 17.3 | 110.7 | 20.9 |
| 41 | Alaska | 18.8 | 17.0 | 26.0 | 7.6 | 108.0 | 23.1 |
| 42 | North Dakota | 18.2 | 22.5 | 13.4 | 15.3 | 114.2 | 19.4 |
| 43 | Oklahoma | 18.2 | 20.1 | 15.1 | 19.2 | 111.5 | 19.9 |
| 44 | Alabama | 17.2 | 20.9 | 7.0 | 28.8 | 112.4 | 17.5 |
| 45 | South Dakota | 14.8 | 14.2 | 17.9 | 9.6 | 104.9 | 20.7 |
| 46 | Indiana | 11.4 | 15.2 | 10.9 | 0.0 | 106.0 | 18.7 |
| 47 | Arkansas | 9.8 | 10.0 | 7.1 | 15.3 | 100.0 | 17.6 |
| 48 | Iowa | 8.1 | 11.8 | 3.9 | 5.7 | 102.1 | 16.6 |
| 49 | West Virginia | 7.7 | 13.4 | 1.3 | 3.8 | 103.9 | 15.9 |
| 50 | Mississippi | 0.5 | 0.0 | 0.0 | 3.8 | 88.6 | 15.5 |
The Botox Obsession Index ranks all 50 states on per-capita Botox search activity, local provider and clinic density, and relative Google search interest.
Estimated average monthly Google searches for a fixed set of Botox terms in each state, divided by population. Consumer behavior carries the most weight because it is the clearest signal of intent.
Clinicians listed under relevant medical taxonomy codes, plus aesthetic clinic locations, per capita. Large treatment ecosystems develop where there is sustained demand.
Google Trends interest in Botox in each state over the past 12 months, as an additional read on public attention.
Search demand and provider supply are converted to per-capita rates. Google Trends is already a relative-interest measure, so it is used as published. Each of the three resulting measures is then rescaled so the highest state scores 100 and the lowest scores 0, which is what makes a search figure and a clinic count addable.
States are ranked by obsession score. Where two tie, the higher search rate places first.
Displayed scores are truncated to one decimal place rather than rounded, so two states that differ only in the second decimal never appear as a tie. New York and Colorado are the closest pair in the study, at 84.12 and 84.05 before truncation, and they display as 84.1 and 84.0. Ranking always uses the untruncated figure.
Search demand. Google Ads Keyword Planner, one request per state, estimated average monthly search volume over the trailing 12 months. Google reports these as estimates in rounded bands, not exact counts.
How the terms were chosen. The candidate list was the 50 Botox-related search terms with the highest reported US search volume, drawn from Semrush, a widely used search analytics platform, in August 2026. They span the treatment itself, specific treatment areas, costs, comparisons with similar products, and background questions. When we requested state-level figures, Google reported volume for 31 of the 50 and no separate figure for the rest, typically because Google consolidates near-identical phrasings into one canonical term (a search for "how much is botox" is counted within "botox cost"). The study uses every term Google reports data for. No term was hand-picked in or out at either step: Semrush's volume ranking set the candidates, and Google's own reporting set the final 31.
Providers and clinics. Two sources added together. Clinicians listed in the NPPES national provider registry under relevant medical taxonomy codes, and aesthetic skin care clinic locations from the Google Places Aggregate API within each state boundary. One counts people, the other counts places, and we report them as a combined market measure rather than as a provider count. An NPPES taxonomy listing records a clinician's self-reported specialty. It does not by itself establish that the person currently administers Botox.
Interest. Google Trends subregion interest for "botox" across the United States over the past 12 months. Google Trends does not count searches. For each state it measures what share of all Google searches from that state were about Botox, then rescales the results so the highest state reads 100 and every other state is relative to it. It answers a different question from search volume: not how many Botox searches happen in a state, but how large Botox looms in that state's overall searching.
Population. US Census Bureau American Community Survey, 2024 one-year estimates.
All figures pulled August 27, 2026.
The District of Columbia was measured but is not ranked with the states. It is a city rather than a state, and its per resident figures are an outlier that is not comparable, so it is reported separately.
DC is included in the downloadable dataset with all of its component scores, so anyone who wants to put it back can.
This measures interest and market presence. It does not measure procedures performed, units injected, or money spent, and none of those figures are published at state level.
Google Trends is a share-of-searches measure, which makes it noisier for the least populated states. It carries the smallest weight for that reason.
Clinic counts come from business listings, which are not a licensing registry, and a listed clinic is a location rather than a practitioner. The NPPES figure is a registry of clinicians, but a taxonomy code is self-reported and does not confirm current licensure or that the clinician injects Botox.
Nothing here is medical advice or a clinical claim.
The Botox Obsession Index · Avinity Health · Data collected August 27, 2026 · Published October 5, 2026 · 50 states ranked, District of Columbia reported separately.
Avinity Health is a physician-guided health and aesthetics practice in Scottsdale, Arizona. Learn about Botox at Avinity or the practice.
Journalists: the media resources page has the dataset, the graphics and a contact who answers.
Avinity Health is a physician-guided longevity, wellness and medical aesthetics practice in Scottsdale, Arizona. The practice provides evidence-informed treatments spanning health optimization, regenerative medicine and aesthetics, with care delivered by licensed clinicians under physician oversight.
The Botox Obsession Index is a market analysis, not a clinical study. It measures interest and provider presence, and makes no claim about treatment outcomes. Avinity Health published it because the same question comes up in the clinic every week: is everyone doing this, or is it just here?
The full dataset, including every component score, is free to download and free to republish with attribution: botox-obsession-index-2026.csv.
The interactive map can be embedded on any site. Attribution is built in:
Press inquiries and interview requests: info@avinityhealth.com.