Dysport, Xeomin, Jeuveau, and Botox: Which Wrinkle-Reducing Option Is Best for You?
Wrinkles are one of the most obvious indications of getting older since they are a window into your skin. As you blow out more birthday candles on the cake, it's quite normal for the lines on your face to deepen. “Wrinkles are the end result of collagen and elastin fiber breakdown,” says facial plastic and reconstructive surgeon Patrick J. Byrne, MD, chair of the Head and Neck Institute at Cleveland Clinic in Ohio. According to him, lifestyle choices like smoking and exposure to the sun's rays and pollution can hasten the appearance of wrinkles while genetics and skin type are two external elements that you have no control over. A research in the Aesthetic Surgery Journal found that sleeping with your face up can leave lines in your skin.
How Wrinkle Reducers, Like Botox, Work to Smooth Wrinkles
You might think about using Botox or any similar injectable to stop wrinkles in their tracks. Botox is a trademarked name for a generic word dermatologists frequently use to refer to injectables generated from the botulinum toxin type A produced by the Clostridium botulinum bacteria. (Yes, according to the Mayo Clinic, the bacteria also causes botulism, a disease that damages the body's nerves; however, it's uncommon for Botox injections to produce this side effect.)
The strongest neurotoxic known to man, according to Dr. Byrne. When the toxin is present in the muscle, that muscle cannot contract around the synapse because it travels into the synapses of the muscles and prevents the impulse from being transmitted to the muscle (the tiny gap between two nerve cells). These expression lines are smoothed out because the muscle is either partially or completely paralyzed. The transitory nature of the treatments can range from two to six months.
By halting expression lines, you also prevent existing wrinkles from cutting in deeper and more permanently. The patient decides when to begin treatment, but some medical professionals oppose utilizing neurotoxins as a preventative measure. Dr. Phillip R. Langsdon, a facial plastic surgeon in Germantown, Tennessee, and a former president of the American Academy of Facial Plastic and Reconstructive Surgery, states, "If a patient doesn't have a frown line and they tell me they want Botox so they'll never get a wrinkle, I don't treat them" (AAFPRS).
However, you will know that a wrinkle has developed when a line left by an expression doesn't disappear when your face is relaxed. Then, you might think about using a neurotoxin.
Botox
What It Is According to the website for Botox Cosmetic, onabotulinumtoxinA injections, also known as Botox, are FDA-approved to temporarily cure moderate to severe frown lines, crow's feet, and forehead wrinkles.
Who It's Best For According to Langsdon, "Botox works very well in the crease between the brows, in the crow's feet, in the bunny lines on the sides of the nose, and in forehead lines. The marionette lines, which run vertically from the corners of the mouth to the chin, wrinkles around the lips, and vertical bands in the neck can all benefit from Botox, according to a review that was published in Clinical, Cosmetic, and Investigational Dermatology in 2019. The review also notes that the results last for three to six months.
While Langsdon claims that Botox is effective wherever it is authorized for usage, he does warn that some persons with low eyebrows may notice a decrease in the height of their eyebrows after receiving treatment for horizontal forehead lines with any neurotoxic. "You have to leave those lines alone sometimes," he explains. You can get advice from your dermatologist or facial plastic surgeon.
Cons The results do not show up immediately, which is something you should be aware of to help control your expectations (and to appropriately schedule treatment, if you're getting ready for a large occasion). Although the manufacturer claims that benefits might show up in 24 to 48 hours, "we urge patients to give it a week or two for the full effect," says Langsdon. According to the Clinical, Cosmetic, and Investigational Dermatology analysis, males require higher doses of Botox to effectively erase wrinkles because they have more muscle mass, which is frequently double the effective dose used for women.
Dysport
What It Is According to the Dysport website, abobotulinumtoxinA, also known as Dysport, is an injectable that can reduce frown lines between the eyebrows. The time it takes for results to appear can range from two to three days to a week.
Who It's Best For Some medical professionals have abandoned Botox, including Manish Shah, MD, a board-certified plastic surgeon at Shah Aesthetic Surgery in Denver. I like using Dysport, adds Dr. Shah. He notes that it lasts for four months and only permits patients to come into the office three times a year. Dysport itself believes that the results may last even longer, up to five months in certain people.
There is also a financial benefit because it will be less expensive overall if fewer appointments are required during the year. That can actually provide greater results because in that case “patients are more comfortable dependably coming in on a routine basis,” Shah explains.
Byrne adds that Dysport might also move through tissues a little bit farther. “That gives you an advantage in certain situations like crow’s feet, where there’s a broader treatment area,” he says.
Another potential gain? Since these neurotoxin injections may interfere with the operation of sebaceous (oil) glands, according to a review published in 2021 in Toxins, there may be a decrease in facial oiliness, pore size, and acne. According to the analysis, Dysport in particular might be one of the best solutions for this. But since the FDA has not approved these injectables to treat acne, think of it as an added benefit rather than a given. Dysport injections in the forehead significantly decreased the area's oiliness for six months, according to a randomized, double-blind study with 50 participants that was published in Dermatologic Surgery in 2021. The trial subjects who received the treatment expressed great satisfaction with the outcomes.
Advantages Botox and other injectables may work better when you want to target a specific muscle, such as the frown lines between the brows, according to Byrne. That said, Dysport can still help you achieve your goals because "these differences are so subtle, I don't think it matters much," the doctor says.
Xeomin
What It Is According to the Xeomin website, incobotulinumtoxinA, also known as Xeomin, is an injection that targets moderate to severe frown lines between the eyebrows.
Who It's Best For Some individuals build up a tolerance to one of these injectables, which over time reduces the effectiveness of the therapies. What makes Xeomin stand out is that “the protein coat on the toxin molecule is much less dense than on the other neurotoxins,” says Shah. Your doctor may use Xeomin if other injectables stop working for you.
Advantages The firm claims that results start to show after three to four days and reach their peak after 30 days. Xeomin might not be right for you if you want the effects to manifest more quickly (for personal preference or a forthcoming occasion).
Additionally, despite the fact that the firm claims the advantages endure for three months, some doctors, like Shah, claim that their patients frequently report that it only lasts two. But two months seems like a decent period of time once you've developed a tolerance for the others, he adds.
Jeuveau
What It Is In 2019, the FDA approved the use of prabotulinumtoxinA, also known as Jeuveau, for the treatment of moderate to severe glabellar lines, which are the vertical "frown" lines between the brows. According to Shah, it has the same particle size as Botox (900 kDa, or kilodaltons), which is regarded as the industry standard for effectiveness. A double-blind, placebo-controlled study published in 2019 in Aesthetic Surgery Journal indicated that Jeuveau was just as effective as Botox at reducing forehead wrinkles.
The patient who is eager to test a novel injectable will be interested in Jeuveau. According to Byrne, "we have patients who strongly believe one or the other is better for them" when it comes to any of these neurotoxins. Some people think one works faster, is more powerful, or lasts longer than the other. It's a personal choice, and we allow them make that decision.
Despite Jeuveau's recent existence, Langsdon notes that "the data is limited" and that "we don't have the yars of experience that we do with Botox, Dysport, or Xeomin."
Daxxify
What It Is The most recent wrinkle-reducer to hit the market is Daxxify, also known as daxibotulinumtoxinA-lanm. It is authorized to cure mild to severe creases or lines between the brows. According to StatPearls, the corrugators and procerus muscles are located in this region, also known as the glabella. According to Joshua Zeichner, MD, an associate professor and the director of cosmetic and clinical research in the department of dermatology at Mount Sinai Hospital in New York City, these are the muscles that cause "your eyebrows to pull down as you scowl."
Who It's Best For Daxxify stands out from the other wrinkle reducers on this list because its effects are most likely to last the longest. Eighty percent of participants in studies that Daxxify's producer Revance Therapeutics (PDF) submitted to the FDA that resulted in Daxxify's approval saw improvements in facial wrinkles four months after therapy as compared to placebo. After six months, roughly half of the individuals noticed changes. After nine months, some people even continued to see effects.
This may sound desirable. But before going for Daxxify, you want to be a more seasoned injectable neuromodulator user, so you know what you’re in for, Dr. Zeichner explains.
How Much Smoother, Younger-Looking Skin Will Cost You
According to data from 2020 provided by the American Society of Plastic Surgeons, the average cost of Dysport, Xeomin, Jeuveau, and Botox is $466. The cost varies greatly based on the area being treated, the desired level of wrinkle reduction, and the quantity of the product injected (that is the most recent number; prices are likely to be higher in some places). Additionally, prices differ between different medical practices and by city or region. Daxxify's pricing hasn't been set yet because the injection won't be available in dermatologists' offices until 2023.
Generally speaking, "patient satisfaction is so high because they're so well-liked". According to Byrne, all of these compounds will be beneficial when used properly.
The Value of Consulting a Specialist When Getting Botox and Other Similar Injectables
The most crucial step, regardless of the injectable wrinkle reduction you choose, is to visit a qualified physician, ideally a board-certified dermatologist or plastic surgeon. According to Langsdon, "you need a provider who knows what they're doing, whom you trust, and who you have a relationship with." Even if someone may offer a lower price, you must take into account the potential risks to your health and safety posed by a provider's inexperience.
Alarmingly, studies highlighted in a paper published in 2018 in Plastic Surgery indicate that some patients are opting for do-it-yourself botulinum toxin treatments, self-injecting these substances using instructions and facial muscle maps accessible on YouTube and other websites. The authors caution that this is unsafe. You run the danger of injecting the muscles improperly, but there's also a potential that the substance you're using is fake. According to the American Academy of Dermatology Association (AAD), the negative effects of these home remedies, such as muscle paralysis, Bell's palsy, and eye damage, might be irreversible. It is therefore preferable to leave this operation in the hands of experts.
How to Check the Credibility of Your Dermatologist or Plastic Surgeon
Make sure the dermatologist you're visiting is board-certified by the American Board of Dermatology. The American Board of Facial Plastic and Reconstructive Surgery certifies facial plastic surgeons, and you can look up a board-certified facial plastic surgeon in your area by visiting AAFPRS.org. Additionally, the American Board of Medical Specialties' website offers a helpful search function that enables you to look for a doctor's board certifications by first and last name, city, and state.
Alternately, you can determine whether your healthcare professional is board-certified by utilizing the free "Is My Doctor Board Certified? from CertificationMatters.org's tool.
What You Should Do Before the Procedure
Your dermatologist will arrange a consultation to go over the treatment before administering it, according to the AAD. Be prepared to discuss your medical history at this session so that your provider is aware of any potential issues. Be sure to mention any prescriptions (including nonprescription pharmaceuticals) and supplements you use, if you’re pregnant or planning to become pregnant, and your surgical history.
You get the chance to ask your dermatologist any questions you may have during this visit as well. The AAD advises enquiring about the provider's experience, who is performing the injections, the price, and the anticipated outcomes. Your doctor can also discuss alternative therapies with you that might be a better choice for you, as well as whether combining different therapies would result in even better outcomes.
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