How does Daxxify compare to Botox?

Sometimes, brand names become a generic term. You probably have asked for a Kleenex instead of a tissue when you sneeze, a Coke, not a soda when thirsty or a Band-Aid when you need a bandage after a scrape. Some names of products become representative of an entire category. Are there different brands, even generics, available? Of course, and yet many people still call an item by a brand name instead of a generic term, even when not using or consuming that exact product.

In a way, that is the story of Botox as well. Botox® is the brand name of a specific neuromodulator drug derived from botulinum toxin. However, numerous cosmetic botulinum toxin injectables address facial lines and wrinkles, including Dysport®, Xeomin® and Jeuveau®. While many of these injectables are essentially interchangeable, Botox remains the most common term for botulinum toxin.

Today, a new neuromodulator is in town, and it is looking to dethrone the king. How does the newest injectable for lines and wrinkles – Daxxify® – compare to the competition?

What is Daxxify, and how is it different?

On September 7, 2022, the U.S. Food and Drug Administration approved the drug Daxxify. DaxibotulinumtoxinA-land, or Daxxify, is a new type of neuromodulator derived from botulinum toxin. It was approved to treat the appearance of glabellar lines or the lines that develop between the eyebrows that many refer to as the "angry 11s". However, physicians also use the product off-label to treat other areas of the face.

How is Daxxify different from the other neuromodulators on the market today?

"Botox, Dysport, Xeomin, Jeuveau, those all have some sort of proprietary associated proteins on them which come as part of the manufacturing process that doesn't have any real biologic activity," said Sara Dickie, MD. "The difference with Daxxify is that it has a proprietary peptide. It's a shorter chain than a protein. This peptide has some activity to it."

While the science behind injectables may not be the first thing that interests prospective patients, the science matters.

"The peptide is vegan and non-derived from any kind of human source, so that is probably the most significant difference," said Katerina Gallus, MD, FACS.

The peptide exchange technology in Daxxify sets it apart from other botulism derivatives that use human albumin or animal proteins. Not only is the product vegan, but the unique peptide formula has an active purpose, as explained by Dr. Dickie, which also gives the injectable a few distinct benefits over rivals like Botox.

Daxxify vs Botox: How does Daxxify compare?

The chemistry of the products is one of many differences between traditional neuromodulator injectables and the new kid on the block.

"It lasts longer," said Dr. Gallus. "They both offer similar results. Daxxify actually kicks in faster. The onset of action is in one to two days, whereas Botox can be ten to 14 days in terms of onset."

Research indicates that due to the active peptide in Daxxify, the diminishment of glabellar lines can last as long as four to six months, sometimes even longer.

"On average, the other four botulinum toxins on the market – Botox, Dysport, Jeuveau and Xeomin – all last for around three months on average," said Dr. Dickie. "With Daxxify, the average duration of effect is 24 weeks, so around six months."

Not only is the onset of activity faster with Daxxify, but the product's effects last longer than those of the other botulinum toxins in use today. Dr. Gallus pointed out that because of the faster onset of activity, Daxxify is sometimes the better option for patients who procrastinate before a big event and want results quickly.

Does Daxxify sound like a dream product? In many ways, it is. It is changing and, in some ways, revolutionizing the injectable game. However, there are a few other things that individuals should keep in mind when talking to their doctor about which product is right for them.

Pros and cons of Daxxify

The benefits of using Daxxify are apparent. It kicks in faster, giving you nearly immediate results, and those results last longer, meaning you can stretch the time between doctor visits a little more. Yet, when you talk to your doctor about which neuromodulator meets your needs, there are other things to consider.

Botox has been on the market for decades. Plastic surgeons and dermatologists have had time to work with the product and understand dosing nuances. Botox is also FDA-approved for use in multiple areas of the face and body. Daxxify has only recently been FDA-approved to soften the appearance of glabellar lines on the forehead. What does that mean? This fact means that the manufacturer has only provided dosing instructions for treating that targeted area of the face.

"For people that want just between their eyebrows treated, I think that Daxxify is absolutely fantastic," said Dr. Dickie. "Very predictable. Excellent results."

However, she said she would love to see more studies and indications from the manufacturer about other dosing strategies for other areas of the face.

Currently, practitioners can use the drug off-label to treat lines and wrinkles elsewhere. However, there are no dosing or placement guidelines from the manufacturer for addressing issues on other areas. More artistry goes into using Daxxify for things like Crow's feet around the eyes, for example.

On the opposite end of the spectrum, products like Botox have been used for so long that numerous dosing and placement indications exist. These include dosing strategies like "baby Botox" that offer softer, more natural results or increasing Botox dosages to achieve longer-lasting results.

Delivering results with injectables like Botox and Daxxify is part science and part artistry.

"If you double the dose of Botox, you'll get a little bit longer longevity of the Botox," said Dr. Gallus. "It is a little bit dose-dependent up to a certain point. There are so many variables for each product that going to a board-certified plastic surgeon who understands the nuance of that is important."

Working with a board-certified plastic surgeon who is an ASPS member is the best way to understand your injectable options and learn more about which product – or combination of products – can meet your aesthetic goals.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.