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Daxxify: The New Neuromodulator Promising Longer-Lasting Results Than Botox

March 15, 2025
May 14, 2025
*Photos are of models, not actual patients.

While Botox remains the dominant neuromodulator for wrinkle reduction (commanding 70% of the US market) since its accidental discovery by Dr. Jean Carruthers in the late nineties, a significant change is coming with the FDA's recent approval of Daxxify by Revance Aesthetics—expected to be available in early 2023, this new treatment promises to address the major limitation of Botox and its competitors (Dysport, Xeomin, and Jeuveau) by potentially lasting longer than the typical four-month duration, while still working through the same mechanism of blocking nerve signals to facial muscles that cause skin creasing.

Longer Lasting Botox?

Botox is the most popular non-surgical treatment worldwide.  It is in a class of drugs known as neuromodulators.  When done properly and by a skilled practitioner, nothing beats Botox.  Despite other neuromodulators joining the party Botox is still the king commanding about 70% of the market in the United States.  The reason it has dominated is because it is the gold standard having become a household word and none of the other neuromodulators had any significant advantages.  That might be about to change…

The Evolution of Neuromodulators: From Accidental Discovery to Gold Standard

Botox, like many medical discoveries, happened accidentally.  I first learned about Botox to treat wrinkles in the late nineties.  I attended a lecture given by Dr. Jean Carruthers at the annual meeting of the American Society for Dermatologic Surgery.  Dr. Carruthers, an ophthalmologist, had been using Botox to treat patients with blepharospasm.  Blepharospasm is a condition where people have uncontrollably twitchy eyelids.  Dr. Carruthers was injecting Botox into the muscles around the eye that cause the twitching.  One of her patients came back to her telling her that she was happy that her twitching was better and she was ecstatic that the wrinkles around her eyes were softer.  She begged Dr. Carruthers to inject her forehead.  As chance would have it, Dr. Carruther’s husband is a dermatologist.  Over dinner they discussed Botox and how it could be used to treat a variety of wrinkles.  When I returned to my office I treated my nurses frown lines.  The results were like magic.  Thus, a star was born.

Botox is in a class of medicines knows as neuromodulators.  Dysport, Xeomin, and Jeuveau are 3 other similar drugs currently FDA approved up until September of this year.  They all work in a similar fashion sort of like a mute button on a phone.  They block the signal from a nerve telling a muscle to contract.  Botox doesn’t act as a filler rather it acts to prevent a muscle from repeatedly folding the skin which creases the skin.  Once you stop folding the skin, the lines soften over time.  Most people receive treatment about three times per year to maintain the results.  One of the biggest downsides of these medicines is that they all last about 4 months.  That might be about to change.

Daxxify: The Game-Changing Neuromodulator Promising Extended Results

The FDA approved Daxxify by Revance Aesthetics.  Many in the aesthetic community expected this to happen a year ago and were surprised when the FDA failed to approve the drug for reasons that were not drug related but rather a wrinkle in the manufacturing process.  Many are excited to use Daxxify in our patients.  Daxxify is not currently available but will likely be available in early 2023.  As soon as it is available, we will offer this potentially longer lasting neuromodulator to our patients.

If you have been considering Botox or another neuromodulator want to explore any of these options, we are happy to help.  We look forward to seeing you soon.