There’s no denying that when someone is seeking (near) instant gratification in a skincare procedure that will literally make wrinkles and fine lines temporarily vanish, Botox is the name on every dermatologist and cosmetic surgeon’s lips. When the popular botulinum neurotoxin is injected into the forehead and around the eyes, it works by preventing muscles from moving. This, in turn, smoothens the skin and softens or can even temporarily “remove” wrinkles such as the “11’s” between your brows or crow’s feet around the delicate, thin skin of the eye. And it isn’t just Hollywood celebs and Real Housewives getting regular Botox injections — according to the American Society of Plastic Surgeons, Botox is the most popular non-invasive cosmetic procedure, with 4.4 million procedures performed in 2020.
Even though it provides results within a few days — long before a topical treatment like retinol begins showing visible results — Botox isn’t cheap and it isn’t without some risks. Depending on where you live and the doctor or clinic you visit (hopefully a reputable one with skilled Botox injectors!), you can expect to shell out between $500 to $600 and more for results that can last up to four months.
No matter how great the results look, there’s no denying this is a whole lot of money to spend for a few months of satisfaction. That’s why skin experts and patients are flipping over a new wrinkle-smoothing treatment that can last twice as long as Botox. Here’s what you need to know about Daxibotulinumtoxin A — aka Daxxify.
What is Daxxify?
First, some science behind the new wrinkle-smoothing injection. Daxibotulinumtoxin A (Daxxify) is a botulinum toxin Type A formulated with a novel peptide excipient (RTP004), explains Dr. Elaine F. Kung, a board-certified dermatologist based out of New York City and the founder of Future Bright Dermatology. An excipient is a substance formulated alongside the active ingredient of a medication in order to stabilize it, she says. RTP004 allows Daxxify to be formulated without human serum albumin, which is what BOTOX is formulated with. It’s this RTP004 that ensures the stability of Daxxify at room temperature before reconstitution and it is manufactured without the use of animal products.
What areas of the face can you treat with Daxxify?
Here’s where things get a little tricky. The current FDA approval of Daxxify is in the glabellar region because the large-scale clinical trial (2691 subjects) published is only of the glabellar region, according to Dr. Kung. This means you can use it to treat wrinkles on the forehead, between the brows, and around the eyes, similar to what we are told Botox accomplishes. However, there are some differences. “Neurotoxins, including BOTOX, Dysport, Xeomin, and Jeuveau are only approved to be used in the glabellar area for reduction of wrinkles,” Dr. Kung explains. “However, most aesthetic providers, including myself, commonly use neurotoxins in other regions that have dynamic wrinkles.”
This means if you are currently using Botox to treat “peachy” wrinkles in the chin or to make your smile appear less gummy, Daxxify has not been tested or approved to treat these same areas.
How does Daxxify compare with Botox?
The question everyone wants to know: how does Daxxify rate when compared with Botox and is it worth the switch? Again, the answer is a little complicated because there isn’t enough data yet to properly access its similarities to Botox and other neurotoxins.
“To be fair, there is no clinical study to directly compare BOTOX and Daxxify,” Dr. Kung says. “Meaning, there is no study where half a person's forehead was treated with BOTOX and the other half with Daxxify to truly compare side by side how quickly the onset of wrinkle reduction or how long the results last between the two.”
However, we do know that the median duration of maintaining a good response in glabellar lines (lines between the brows) with Daxxify was 24 weeks (six months) according to clinical investigators and patient assessments, Dr. Kung says. “It was observed that almost 10% of study patients had a good response in glabellar lines at 36 weeks (nine months),” she adds. “I think aesthetic providers can only be confident in saying that Daxxify may last longer than BOTOX but we can't specifically say how much longer. It may be one month. It may be more. We can't say that all patients receiving Daxxify will have good results for six or more months.”
Dr. Kung adds that we look at the clinical data in the package insert for BOTOX, the severity of glabellar lines was reduced for up to 120 days. “Less than 30% of patients had noticeable improvement in glabellar lines in 120 days (four months) according to clinical investigators and the patient's own self assessment,” Dr. Kung says.
In other words: it’s too early to say for sure what kind of results you’ll get from Daxxify, but so far, it looks like patients are experiencing longer lasting results with this new injectable.
What are the limitations of Daxxify?
No skincare procedure is perfect. The limitations of using Daxxify is that aesthetic providers will have to figure out how many units of Daxxify to use on patients to have good natural appearing results without their patients feeling too stiff or tight, Dr. Kung says. “The number of units we normally use for BOTOX, Dysport, Xeomin, or Jeuveau is not interchangeable with Daxxify units,” she says. So, because it is so new, there will be a bit of a trial and error period until providers figure out how to treat their patients for comparable results.
What are the risks involved in using it?
As far as risks go, so far, the risks of Daxxify are similar to other neurotoxins, Dr. Kung says: “injection site pain, redness, and swelling as well as upper eyelid drooping,” she says. “These temporary complaints were only reported by 1-3% of the people in the original study.”
How does Daxxify’s average cost compare with that of Botox?
Finally, price. What can you expect to pay for Daxxify and how does it compare to Botox? Unfortunately, there is no one answer that will apply to everyone. Just as with Botox, the price will vary depending on the skill of the practitioner, their prices (often dictated in part by where they practice), and how many areas of the face you are treating.
“I think the pricing scheme will differ amongst aesthetic providers,” Dr. Kung confirms. “Revance, the makers of Daxxify, leave pricing at the discretion of the users. Some providers may decide to charge more because patients may be seeing them less often since Daxxify's results may last longer. Other providers may decide to keep the fees similar to the price of neurotoxins they used in the past.”
Daxxify is still relatively new and there will be more to learn as more patients choose it over Botox. Time will tell if its cost and the longevity of its results make it a true contender against Botox and other neurotoxins. But, for now, it’s one that cosmetic providers are excited about and keeping a close eye on.
