Botox

Neurotoxin injectables are the most popular nonsurgical facial treatment because they provide impressive results with minimal recovery time. (Photo: Ladanifer/Shutterstock)

By Sarah Hicks

Medical review by Anna Carlisle, MSN, APRN, FNP-C

In the beginning, there was Botox.

In 2002, Botox was granted FDA approval for combating wrinkles, and since then the popularity of neurotoxin treatments has grown dramatically. In 2023, medical providers in the U.S. administered 9.45 million neurotoxin injections, including Botox, Dysport, Xeomin, Jeuveau and Daxxify.

Our comprehensive neurotoxin treatment guide is a great way to explore these options. It provides the information you need to make an informed decision with your medical provider and to understand which treatment could be a good fit for you.

Understanding how neurotoxin treatments work requires a short science lesson.

Botulinum toxin type A is an injectable neurotoxin — a substance that acts on the nervous system. Botox, Dysport, Xeomin, Jeuveau and Daxxify are the brand names of these injectables.

These neurotoxin treatments block nerve signals to a muscle or gland, temporarily paralyzing it and causing it to relax. When the muscles targeted in a facial treatment relax, the overall facial expression becomes softer.

Neurotoxins, also called neuromodulators, are primarily used to smooth dynamic wrinkles, which are wrinkles that form as a result of consistent daily facial movements such as squinting, smiling and frowning.

These dynamic wrinkles are a natural part of aging, but that doesn’t mean you have to like them.

Forehead lines and other wrinkles respond extremely well to neurotoxin treatments because the toxins relax the muscles. (Photo: ISKANDAR CITA/Shutterstock)

There are several specific areas where repetitive muscle contractions show up on the face, including:

• glabellar lines, the vertical wrinkles or “elevens” that appear between the brows
• crow’s feet at the edges of the eyes
• forehead creases
• wrinkles at the corners of the mouth
• a “cobblestoned” or “orange-peel” chin, so called because its texture resembles the peel of an orange

Injecting small quantities of neurotoxin into these areas relaxes the muscles, smoothing out the texture of the skin, reducing wrinkles and creating an overall refreshed appearance.

The majority of neurotoxin treatments are used to reduce wrinkles, but Botox also has FDA approval for treatment of other medical conditions, such as chronic migraine, bladder dysfunction, muscle disorders and excessive sweating.

Active ingredient: Botox, Dysport, Xeomin, Jeuveau and Daxxify all contain the same active ingredient, botulinum toxin type A.

Purpose: All are designed to address the same types of wrinkles and cosmetic concerns, and they all work by blocking nerve signals to facial muscles, leading to relaxation.

FDA approval: All five products are FDA-approved and have a history of safe and effective use.

Formulation variations: Though these neurotoxin treatments contain the same toxin, they are created differently, which affects dosage speed of results and other factors.

• Botox, Dysport and Jeuveau are formulated with accompanying proteins, which are nontoxic proteins that protect the active neurotoxin and may enhance its effects. Dysport has the most accompanying proteins, while Botox and Jeuveau contain similar but lesser amounts.
• Xeomin has minimal to no accompanying proteins. Daxxify contains a peptide instead of a protein and contains no human or animal byproducts. Because of these differences, these neurotoxin treatments are sometimes referred to as “cleaner” neurotoxins.

Dosage and potency: All brands are not measured the same unit measure because some are more potent than others. For example, Dysport is less potent per unit than Botox. Most studies of the two products follow a ratio of 2.5:1, meaning 25 units of Dysport have roughly the same action as 10 units of Botox, as Drugs.com explains. Jeuveau, Xeomin and Daxxify are equivalent in units to Botox.

Spread or reach: Some injectors prefer using certain products for specific areas because they tend to spread differently once injected. For example, providers at Maningas Cosmetic Surgery in Missouri prefer to use Dysport to treat larger areas like forehead lines and Botox for smaller, precise areas like crow’s feet.

Onset of results: The time it takes to see results varies.

• Dysport shows results in three to four days.
• Xeomin takes between four and seven days.
• Jeaveau takes about a week.
• Botox and Daxxify can take up to two weeks.

Duration of results: Most neurotoxin treatments last around three to six months, but results will vary between patients.

• Daxxify is formulated to last from six to nine months.
• Dysport lasts four months or longer.
• Jeaveau and Botox last three to four months.
• Xeomin lasts two to three months.

Potential for resistance: With long-term use, some patients may develop resistance to the accompanying proteins found in Botox, Dysport and Jeaveau. Xeomin and Daxxify may be better options for these patients because the formulas don’t include those proteins.

A neurotoxin treatment doesn’t take long, but your preparation for it should be thorough. (Photo: Ruslan Malysh/Shutterstock)

Before you undergo any medical procedure, do your homework and make sure you are aligned with your provider.

Though neurotoxin injections are nonsurgical treatments, they are still medical procedures. Look for trained professionals with a proven background in cosmetic medicine and substantial experience administering botulinum toxin injections.

If you are new to a practice, ask to see before-and-after photos, read reviews and learn more about the medical provider’s qualifications.

The initial consultation is an opportunity to discuss your goals, ask questions and share your medical history — including sharing any medications you take, especially blood thinners, but even things like aspirin. Making the most of your consultation will pay off in the long run.

It’s also a good time to start learning about the treatment process. Neurotoxin treatments are done in the medical spa or office and don’t take long to administer, but they may involve the use of a topical anesthetic.

Common side effects are mild, typically including redness, swelling and bruising.

Results are not immediate, but you’ll start to see improvements in just a few days. (See the information above about typical onset of results times for each treatment option.)

Many providers take a conservative approach in the initial treatment, which means follow-up  treatments may be needed to achieve results that solve your problem and look natural.

The goal is “to soften the muscle, but not to knock out its movement entirely,” as Dr Wassim Taktouk, an advanced aesthetic doctor who specializes in Botox-type injections, explains to Dazed Digital.

Cosmetic neurotoxin treatments are a popular and effective way to reduce dynamic wrinkles and other aesthetic concerns. They provide a safe, nonsurgical way to refresh your appearance and feel younger.

But remember: It’s important to consult with a qualified and experienced provider. No two people are the same, and a consultation with an expert is the best way to make sure you’re getting the toxin that’s best for your needs and goals.

Take the first step toward a more natural-looking, rejuvenated you and schedule a consultation with a SHINE expert today.

Sarah Hicks is an editor and writer with expertise in health, wellness and science.