Daxxify vs Botox​: Which should you use?

Daxxify (daxibotulinumtoxinA-lanm) and Botox (onabotulinumtoxinA) are two injectable medications used to reduce the appearance of wrinkles. For years, Botox Cosmetic has been the household name, the gold standard in this category. However, a newer medication, Daxxify, has entered the scene, offering a potentially longer-lasting alternative.

Which one is right for you? Understanding the similarities and differences between Daxxify and Botox is key.

	Botox Cosmetic	Daxxify	Key Takeaway
Active Ingredient	Botulinum Toxin Type A	Botulinum Toxin Type A	Both use the same core neurotoxin.
Stabilizer	Human Serum Albumin (HSA)	Proprietary Peptide (PXT Technology™)	Different stabilizers; Daxxify's peptide is linked to longer duration.
Duration of Effect	Average 3-4 months	Average 6 months	Major Difference: Daxxify typically lasts significantly longer.
Onset of Action	Usually 1-2 days (full effects take longer)	Usually 1-2 days (full effects take longer)	Generally comparable, results are not instant for either.
Approved Uses	Glabellar lines, forehead lines, crow's feet, platysma bands	Glabellar lines (cosmetic); Cervical Dystonia (medical)	Botox has more FDA-approved cosmetic & medical uses due to its longer history.
Cost	Generally lower per treatment	Generally higher per treatment	Daxxify may be more cost-effective annually due to fewer required sessions.
Units	Units are specific to Botox	Units are specific to Daxxify	Unit measurements are not interchangeable between products.
Side Effects	Similar potential side effects (bruising, swelling, headache, eyelid/brow ptosis)	Similar potential side effects, linked to injection and toxin effect	Side effect profiles are generally comparable, related to the injection process and muscle relaxation.
Availability	Widely available	Availability growing, may be less common	Botox is more established; check with local providers for Daxxify.
FDA Approval	2002	2022	Botox has been around longer compared to Daxxify.

How Do Daxxify and Botox Work?

Both Botox and Daxxify belong to a class of drugs called neuromodulators. They are derived from botulinum toxin type A, a protein produced by the bacterium Clostridium botulinum. When injected in tiny, controlled doses into specific muscles, these neuromodulators work by temporarily blocking the nerve signals that cause those muscles to contract. As the muscles relax, the overlying skin smooths out, reducing the appearance of wrinkles like frown lines (glabellar lines), forehead lines, and crow's feet.

Botox comes in two brands (Botox and Botox Cosmetic), but Botox Cosmetic is the FDA-approved brand for wrinkles. Botox is used for certain medical conditions.

Composition

Botox Cosmetic uses human serum albumin, a protein found in human blood, as a stabilizer in its formulation. It has a long track record of safety and efficacy for various cosmetic uses.
Daxxify utilizes a novel peptide technology (Peptide Exchange Technology™, or PXT) instead of human serum albumin. This unique formulation is thought to be the reason for its longer duration of effect.

Daxxify and Botox are Used For Different Areas

Some FDA-approved uses of Daxxify and Botox overlap, while some differ. Both treatments are used to temporarily improve the appearance of wrinkles, but in some different areas.

Botox Uses

• Treatment of overactive bladder
• Treatment of urinary incontinence due to a neurologic condition
• Treatment of neurogenic detrusor overactivity
• Prevention of migraine headaches
• Treatment of spasticity
• Treatment of cervical dystonia
• Treatment of excessive underarm sweating
• Treatment of blepharospasm
• Treatment of strabismus (crossed eyes)

Botox Cosmetic Uses

Temporarily improve the appearance of:

• Moderate to severe glabellar lines (frown lines)
• Moderate to severe lateral canthal lines (crow’s feet)
• Moderate to severe forehead lines
• Moderate to severe platysma bands (neck bands)

Daxxify Uses

• Temporarily improve the appearance of moderate to severe glabellar lines (frown lines)
• Treatment of cervical dystonia

What is the Recommended Dosing for Botox Cosmetic and Daxxify?

The two treatment options are dosed in units. The amount of Daxxify and Botox you need depends on which condition you are using them to treat. Ultimately, the decision of how much medication you need depends on a conversation between you and your healthcare provider. Keep in mind that these two medications are not interchangeable, and the potency is different.

Related questions

• Does Masseter Botox work for TMJ and jaw slimming?
• How many units of Botox do I need and what will it cost?
• Where do they inject Botox for migraines?

Botox Cosmetic Dosing

• Frown lines: 4 units injected into 5 sites (total of 20 units)
• Crow’s feet: 4 units injected into 3 sites per side (total of 24 units)
• Forehead lines: 4 units injected into 5 sites (20 units)
• Neck bands: 1-2 units injected into 9 sites per side (up to 36 units)

Daxxify Dosing

• Frown lines: 8 units injected into 5 sites (total of 40 units)
• Cervical dystonia: 125 units to 250 units divided and injected into the affected muscles

How Fast Do Botox and Daxxify Work?

Onset time can depend on the individual's metabolism, muscle strength, the dose used, and the injection technique. With both treatments, it may take 1-2 days to see initial effects for wrinkles. It can take a few weeks to see the full effects of either treatment. When treating cervical dystonia, botulinum neurotoxin injections typically work within a week, but it may take up to a month for you to get the full benefits.

How Often Do You Need To Get Botox or Daxxify?

With both treatments, effects are temporary. Each injection of Botox or Daxxify can last for months:

• Botox: results typically last up to 3-4 months.
• Daxxify: results last for 6 months or longer for frown lines and cervical dystonia.

This means people using Daxxify may only need 2 treatments per year, while those using Botox may need 3-4 treatments per year.

How do Side Effects Between Daxxify and Botox Compare?

Potential side effects of Daxxify and Botox are similar, and are linked to the injection itself and toxin effects.

For frown lines, the most common side effects are:

• Botox Cosmetic: eyelid drooping (3%)
• Daxxify: injection site reactions (6%), headache (6%), and drooping eyelids (2%)

For cervical dystonia, the most common side effects are:

• Botox: dysphagia (19%), upper respiratory infection (12%), neck pain (11%), and headache (11%)
• Daxxify: headache (7-9%), injection site pain (5-8%), injection site redness (2-5%), and muscle weakness (2-5%)

How Does the Cost of Daxxify and Botox Compare?

The cost of Daxxify and Botox is calculated in part by the amount of units you need. Because Botox is more potent, patients often need less units. However, Daxxify lasts longer and therefore you may need less treatments.

• Daxxify typically costs around $448 for 100 units
• Botox costs approximately $683 for 100 units
• Botox Cosmetic costs approximately $694 for 100 units

These prices are based on the Drugs.com Price Guide for Botox, Botox Cosmetic, and Daxxify.

Pricing for Daxxify and Botox vary depending on treatment area, provider location, and insurance coverage. Insurance companies often do not cover cosmetic treatments, but they may cover medical uses of these medications. Contact your insurance company to verify your specific coverage.

Which Should You Choose?

There are several factors to consider when choosing between Botox and Daxxify:

• Desired duration and treatment frequency: This is the biggest differentiator. If you prefer the convenience of visiting your provider only twice a year, Daxxify is appealing. If you don't mind more frequent visits or prefer a shorter commitment, Botox might be better.
• Budget: Consider both the cost per session and the annual cost. Daxxify's higher upfront cost might be offset by needing fewer treatments over the year. Discuss pricing structures (per unit or per area) with your provider.
• Experience with neuromodulators: If you're new to neuromodulators, some providers might recommend starting with a shorter-acting option like Botox to see how you like the effects before committing to Daxxify's longer duration.
• Provider experience: Choose a qualified, experienced injector (like a board-certified dermatologist or plastic surgeon). Ensure they are comfortable and experienced with the specific product you are considering.
• Specific concerns: While both treat glabellar lines effectively, Botox currently has more FDA-approved cosmetic indications. Discuss your specific treatment goals with your provider.

Conclusion

Both Daxxify (daxibotulinumtoxinA-lanm) and Botox (onabotulinumtoxinA) are effective neuromodulators derived from botulinum toxin type A, designed to smooth dynamic wrinkles. Botox offers a long-established track record with results typically lasting 3-4 months. Daxxify represents a newer innovation, distinguished primarily by its longer duration of effect, often lasting 6 months or more, thanks to its unique peptide stabilizer.

The choice depends on your personal preferences regarding treatment frequency, budget, and comfort level with a newer versus a more established product. By discussing these factors and your goals with an experienced provider, you can confidently choose the neuromodulator that will best help you achieve smoother, refreshed-looking skin.

This is not all the information you need to know about Daxxify (daxibotulinumtoxinA-lanm) and Botox (onabotulinumtoxinA) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.