Botox has been the best known antiwrinkle injection for decades, but the innovative new neurotoxin Daxxify might be changing that.
The injectable, which is often shortened to Daxi in aesthetics lingo, is the most recent neuromodulator to have been approved by the US Food and Drug Administration (FDA) for the treatment of wrinkles.
“There are now five FDA-approved neuromodulators for aesthetic treatments: Botox, Dysport, Daxxify, Xeomin, and Jeuveau,” Sachin M. Shridharani, MD, board-certified plastic surgeon at Luxurgery, tells Glamour. That said, while every injectable currently available uses the same type of toxin—botulinum toxin type A—he asserts that Daxxify differs from its predecessors.
“We say Daxxify is the first real true innovation in neurotoxin because of its peptide exchange technology, which pretty much means it's a formulation,” Dr. Shridharani explains. “The formula for it doesn't have any human albumin or animal proteins, and so just by the way that it works, it tends to stay tightly bound and last longer at that neuromuscular junction. It's really a big innovation and change in the neuromodulator world that allows for it to then last longer.”
The fact that Daxxify injections last longer than Botox plays a huge part in its increasing popularity, especially since so many injectors and patients have noticed over the past few years that Botox fading faster than usual.
Intrigued? Keep reading for everything you should know about the injection.
What is Daxxify?
As noted above, Daxxify (daxibotulinumtoxinA-lanm), or Daxi, is a new Botox alternative that's used to treat and prevent wrinkles and, more specifically, severe frown lines. “Daxxify is FDA-approved to treat moderate to severe glabellar lines, otherwise known as frown lines,” says Bare Aesthetic founder Vanessa Coppola, a board-certified family nurse practitioner and injector specializing in facial aesthetics. “These are the facial lines we commonly refer to as the ‘elevens,’ which form in between our eyebrows by the action of frowning.”
Non Cosmetic-Uses for Daxxify
While that is Daxxify's primary use for now, Coppola adds that Revance Therapeutics Inc., the Nashville-based biopharmaceutical company that produces Daxxify, has also submitted an application to the FDA-approval of Daxxify for the treatment of cervical dystonia. “Cervical dystonia is painful neuromuscular condition affecting the muscles of the neck,” she says. Having multiple uses is common for neurotoxins: While Botox is known (and FDA-approved) for wrinkle prevention, it's also FDA-approved to treat conditions like excessive sweating and migraines.
How does Daxxify work?
Daxxify is a neurotoxin or neuromodulator, like Botox and Dysport, and so it works the same way. “A neuromodulator is basically a broad class of any medication that modulates nerves, and we've taken that catchall term now and use it for neurotoxins in particular,” Dr. Shridharani says.
“Neuromodulators are designed to not allow a nerve and a muscle to communicate, so when we inject this substance in a muscle, it blocks some of the action and communication,” he says. “This is going to not allow for the muscle to contract, despite the fact that the nerve in your body is telling you to do so.” Neuromodulators temporarily paralyze and relax the facial muscles, preventing them from creating and worsening facial lines and wrinkles.
How long does Daxxify last?
The biggest difference between Daxxify and other neurotoxins is the formulation and how long it lasts. “Most neurotoxins currently on the market list an average three-to-four-month duration of efficacy, while Daxxify claims to have the potential to have an average duration of six months, or possibly longer, as demonstrated in their clinical trials,” says Coppola, adding that the alleged secret to the proposed longevity of Daxxify is its unique peptide formulation.
“The use of the property peptide allows Daxxify to be formulated without any animal or human by-products, allowing the active component of the neurotoxin to adhere better to the receptor,” Coppola says. “It makes the molecule more ‘sticky’; it will hang around longer before it will be washed out by the body’s normal processes, thereby resulting in a longer duration of effect, a median effect of six months or longer.”
Daxxify Vs. Botox: How does it compare?
Daxxify is not necessarily “better” than Botox; some patients actually prefer their wrinkle treatment of choice to fade quicker so the results are more customizable. “I had a husband and wife come in, and the husband insisted on Daxxify, while the wife said, ‘No, I don't want it to last longer; I don't mind coming in a bit more frequently,’” Dr. Shridharani says. “But his mindset was ‘It's hard for me to come in, I'm really busy, so if it kicks in a little bit stronger and lasts longer, I'm game.’ So it's interesting how even in the same household people can have differing aesthetic goals.”
That said, Daxxify pricing is usually higher than that of Botox. “Daxxify is more expensive, primarily because the product itself costs more, the innovation that goes into it,” Dr. Shridharani says. “You're doing the same type of quality of work, and it tends to last longer.”
Who is a good candidate for Daxxify?
Dr. Shridharani believes Daxxify is a good option for anyone who wants to improve the appearance of fine lines, creases, and wrinkles, and is looking for something that lasts longer than Botox. “There are pros and cons to that, as we noted, but that's our target audience, so it reaches broad amounts,” he says. “At the end of the day, neuromodulators are the world's most frequently performed cosmetic treatment.”
How much does Daxxify cost?
According to Coppola, the cost for Daxxify are typically higher than other neurotoxins like Botox, though it also varies region to region. “Costs range from $16.00 to $22.00 per unit of Daxxify,” she says. she says. For context, the FDA-approved dose of Daxxify for the glabellar region is 40 units, meaning the total could range from $640 to $880, or more.
Where to get Daxxify
“It's very important to consider provider selection in terms of the extended duration of a long-acting injectable,” says Coppola. “Unlike hyaluronic acid (HA) dermal fillers, which can be immediately reversed, the effects of a neurotoxin will wear off slowly over time, and therefore expertise in injection is key for a desirable outcome. This is a very important point to consider, as you will be living with your ‘look’ for a while and you want to ensure that it's natural and aesthetically pleasing.” Basically, be prepared for your results to last a while, and be sure to find a qualified injector who is specifically familiar with Daxxify.
“Go to someone who has already been using Daxxify and injecting it a lot, because there is so much that you learn from your first countless number of patients,” Dr. Shridharani reiterates. “This is not something that you dabble in. You have to to someone who's experienced.” While it differs state by state, dermatologists, plastic surgeons, and nurse practitioners are generally qualified to administer cosmetic injectables.
How to find a Daxxify provider
You can find qualified surgeons and injectors in your area via the American Society of Plastic Surgeons Connect Program, American Board of Cosmetic Surgery search tool, and RealSelf, and by checking local university hospitals’ directories for dermatologists and plastic surgeons.
Daxxify Risks and Side Effects
The side effects of Daxxify are also very similar to other neurotoxins currently on the market, which include headache, reaction at the injection site such as pain, swelling, itching, brushing, or redness, swelling, facial numbness, and in more serious cases, eyelid ptosis, otherwise known as drooping eyelids.
“The clinical trials conducted on Daxxify were extensive and showed no additional increased side effects or allergy profile and the candidates that would be eligible for the treatment would be very similar to the other neurotoxins like Botox,” Coppola says. “Neurotoxins overall have an excellent safety record, and there is nothing as of now to indicate that this will be any different with Daxxify.” For a full list of Daxxify risks and side effects, click here.
Daxxify Research & Studies: What's Next?
“It will be very interesting to see over time how Daxxify plays out amongst the other more well-established brands in the market,” Coppola says. “For example, Dysport, manufactured by pharmaceutical company Galderma published a study called the DREAM study which also showed clinical efficacy at the six-month mark with patients reporting a very high rate of satisfaction in only receiving two treatments per year: one every six months.”
Danielle Sinay is the associate beauty editor at Glamour. Follow her on Instagram @daniellesinay.
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