10 Botox Alternatives: How This Anti-Wrinkle Treatment Stacks Up to Jeuveau, Dysport, and More

Aging is one of the universal truths in life — everyone gets older. And along with that usually comes the dreaded skin wrinkles. As we age, those wrinkles can grow deeper and more noticeable. And some people just don’t like the way they look.

Botox Cosmetic (botulinum toxin A) is one of the most common treatments for wrinkles. It’s actually a toxin produced by the bacteria Clostridium botulinum. Large amounts of the toxin can paralyze muscles throughout the body, including those you need to breathe. But small amounts injected into the muscles under your skin can take advantage of this effect and relax muscles in your face — without affecting the rest of your body. This smooths out the skin on top and decreases the appearance of wrinkles.

But if you’re not convinced that Botox is right for you, rest assured that you have options. Read on to learn more about 10 anti-wrinkle alternatives to see how they stack up against this cosmetic household name.

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1. Dysport

Dysport (abobotulinumtoxinA) was the first injectable Botox alternative to be FDA approved for use. Dysport and Botox are both made from botulinum toxin type A. In fact, all cosmetic Botox alternatives are made with this type of toxin.

Dysport and Botox differ mainly in their approved uses and how they’re manufactured. Dysport is only approved for treatment of wrinkles between the eyebrows (frown lines). Botox is approved to treat additional wrinkles, including crow’s feet and wrinkles on the forehead.

They each also have medical uses beyond wrinkles. Dysport can treat spasms of the arms, legs, and neck. Medical-grade Botox is approved to treat these types of spasms in addition to other medical conditions, including overactive bladder, migraines, and excessive sweating.

When Dysport is made, it’s broken down into smaller proteins than Botox. This may explain why it’s more likely to spread to surrounding areas, making it more desirable for treating larger areas of wrinkled skin. In addition, Dysport is less concentrated than Botox. This means that a higher dose may be needed to see the same effects as Botox.

Looking at their sticker prices, it may appear that Dysport is cheaper. But because more Dysport is needed to provide the same effect as Botox, this may make the price for treatment comparable.

2. Xeomin

Xeomin (incobotulinumtoxinA) is the second approved injectable Botox alternative. Like Dysport, the main differences from Botox are its indications and slight differences in how it’s made.

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Xeomin is approved for the treatment of multiple upper facial lines, including frown lines, forehead lines, and crow’s feet. It can even lessen these lines at the same time. It also has a more expansive list of medical uses, but these differ slightly from Botox. One medical indication that is unique to Xeomin is the treatment of chronic drooling.

The biggest differentiator between Xeomin and Botox is how they’re made. Botox and other Botox alternatives have added proteins that are thought to make the medication more stable and prevent spread to surrounding tissue. However, your body can recognize these proteins as a foreign invader and make the injections less effective. Xeomin is made without these stabilizing proteins. So, if you notice that Botox is not working like it used to, Xeomin may be a good alternative.

3. Jeuveau

Jeuveau (prabotulinumtoxinA-xvfs) is the third approved injectable Botox alternative. It works and is given in the same way as Botox. In two clinical studies, Jeuveau was compared to Botox and found to be just as effective for reducing frown lines and wrinkles at the corners of the eyes (crow’s feet). 

Jeuveau differs slightly from Botox in approved indications, how it’s made, and cost:

• Jeuveau is only approved to treat frown lines. It has no additional medical indications. 

• When Jeauveau is made, it goes through a more intense purification process than Botox. And it’s broken down into smaller proteins with the hopes of decreasing side effects and working faster. 

• Jeuveau’s limited approvals give it a slight advantage in cost. However, it’s difficult to compare prices. How much you’ll pay for your injections will depend on many factors, including where you have the medication injected on the face and how much you receive per dose.

4. Daxxify

Daxxify (daxibotulinumtoxinA-lanm) is the most recently approved injectable Botox alternative. It’s approved to treat frown lines and neck spasms. In a clinical study, Daxxify improved the appearance of frown lines better than Botox.

The biggest differentiator of Daxxify is that it can last longer than Botox. Botox usually lasts about 3 to 4 months. Daxxify can last up to 6 months. This means that fewer injections are needed throughout the year to keep wrinkles at bay.

5. Retinoid creams

Topical retinoid creams are a popular choice for minimizing wrinkles. They’re available over-the-counter and with a prescription. They don’t require a visit to a clinic to receive a dose, either — unlike Botox and its injectable alternatives. 

Retinoid creams help reduce wrinkles by removing dead skin, encouraging new skin cell growth, and preventing collagen from breaking down. 

Retinoid creams usually take longer than Botox to start working. It can take anywhere from 3 to 6 months to see improvements. They can also cause skin dryness and redness, so it’s best that you start off with applying it every other night for several weeks before increasing it to nightly use. It’s also a good idea to use a moisturizer and wear sunscreen every day to help minimize side effects. 

6. Moisturizers

There are many topical skin care products out there that claim to reduce wrinkles and other signs of getting older. Although many of them contain fancy ingredients, the moisturizers are actually the most beneficial ingredients.

Moisturizers improve the appearance of wrinkles and fine lines by hydrating the skin, replacing proteins that are important to keeping skin healthy, and filling in the cracks between skin cells. 

Like retinoid creams, moisturizers are only effective if you use them regularly. You’ll want to use them daily to see the maximum benefit.

7. Dermal fillers

Dermal fillers are an injectable medical device — not a medication. Fillers include substances that have a gel-like consistency and are injected under the skin. These injections improve the appearance of wrinkles and can plump up the skin, making it look smoother.

Like Botox, dermal fillers are temporary. The substances that are injected under the skin are eventually absorbed by your body. However, fillers can last longer than Botox — up to 2 years in some people. In addition, you can see the results of fillers as soon as you leave the office. Botox and other similar products take a little longer than that.

Lastly, dermal fillers are better for wrinkles that are present all the time. Botox is better for lines that occur when you make certain expressions, such as laughing or furrowing your brow.

Also, if you don’t like the way the fillers look, it’s immediately reversible. Medications like Botox are not reversible right away, so if you don’t happen to like your results, you’ll have to wait until it wears off.

8. Microneedling

Microneedling is a process in which fine needles are rolled over the skin. The thought is that by creating tiny injuries to the skin, this will prompt the body to make substances that promote skin growth. Microneedling also promotes collagen, a substance that supports skin thickness, elasticity, and flexibility. Together, these help reduce the appearance of fine lines and wrinkles.

Although at-home microneedling devices exist, it’s best to see a dermatologist for this procedure. If you do it at home, you could accidentally overdo it and cause unwanted side effects and damage to your skin.

Because microneedling involves puncturing the skin, you’ll likely notice some redness (in lighter skin) or darker shades (in darker skin), swelling, and discomfort afterwards. This should go away after a few days to a week. Botox can cause local injection site reactions, but the number of punctures to the skin is much less compared to microneedling. 

What’s more, you may need multiple microneedling sessions to see sustained benefits for up to a year. In contrast, Botox is given once and the effects should last up to 3 to 4 months at a time.

9. Chemical peels

Chemical peels are exactly what they sound like. A chemical is applied to the skin to make the top layer peel off. The skin underneath is usually smoother and appears less wrinkled. 

There are three different types of peels — superficial, medium, and deep peels. These vary by how many layers of skin they take off. Each one is typically done at your dermatologist or plastic surgeon’s office. At-home chemical peels are available, but they generally aren’t as strong or effective as the professional ones. 

You’ll need to follow specific skincare instructions for 2 to 4 weeks prior to your appointment. After the peel is complete, your skin will likely appear irritated and it may take a few weeks for this to resolve. You might not see the full benefits from the peel until a few months afterward. 

10. Light therapy

Red light therapy uses low-wavelength light to help improve the appearance of wrinkles. Red light is specifically used because it can pass through the skin. The thought is that red light can help your cells repair themselves.

Red light therapy has the advantage that it can be used at home with relatively few side effects. But using red light devices at your dermatologist or plastic surgeon’s office can be stronger and more effective. 

Before you start red light therapy, talk to your care team if you have sensitive skin, take medications that can make you more sensitive to the sun, or if you’re pregnant. These situations can make red light therapy more risky.

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Written by:

Rachel Feaster, PharmD, BCOP, BCPS

Rachel Feaster has over 10 years of professional experience in ambulatory, inpatient, pharmacogenomics, and oncology care. She is board certified in oncology and pharmacotherapy.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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