By Dr. Sachin S. Parikh
Injectable wrinkle relaxers such as BOTOX and Dysport are neuromodulators that reduce muscular contractions. They all work basically the same way, but in order to gain a share of this multi-billion-dollar market, companies developing new neuromodulators are looking for ways to differentiate their products and claim better results.
“Better results” could mean faster onset of action, greater patient tolerance, longer-lasting results, a smoother transition from treated areas to non-treated areas…anything that appeals to customers and gives them a reason to try something different.
New Brands In Development
Dermatox, Jeuveau, and DAXI are some of the new brands being developed. There have been some whispers about Allergan developing a new version of BOTOX, but I haven’t been able to confirm anything…but it’s smart business to release updates that allow them to claim enhanced results or “newness,” just like their competitors do!
As far as the other brands, Jeuveau uses a slightly different form of the neurotoxin in their formula and markets it as having a higher level of purity, so it’s less likely to cause issues or sensitivity for patients.
Dermatox and DAXI both contain the same neurotoxin, but their manufacturers have found a benefit in adjusting the properties of the protein complex that’s attached to the neurotoxin in their formulas.
As I understand it, the protein complex in Dermatox has a higher molecular weight – 900 kDA (kilodaltons) – than the naturally-released proteins (around 150 kDA), and that appears to protect the neurotoxin from degradation in the body, so its muscle-relaxing effects last longer.
DAXI incorporates a proprietary protein designed by their manufacturer, which also supports lasting results for their formula. The FDA is supposed to decide whether to approve DAXI in September of this year. (It was supposed to be approved earlier, but there were some issues with getting the manufacturing facility approved.)
Details aren’t available at this point, but I can hypothesize that new “extra-strength” Jeuveau might utilize the same thinking, somehow adjusting the protein attached to their neurotoxin in order to claim enhanced results.
I haven’t had experience with these new products yet. The patients at my practice have been very happy with their results, so I’m not in a rush to put every new option on the menu. I always seek out meaningful innovation, but in the case of neuromodulators, I prefer to be cautious…
Much Depends on the Skill of the Injector
Injected neuromodulators aren’t like vaccines. Much of the success and satisfaction with these products comes from the skill and precision of the injector administering them! A great practitioner will adjust their injection method and the dosage to deliver a better, more customized result than a less skilled one, no matter what formula is being used. It doesn’t make sense for patients to look for an “edge” based on the exact product being used if they’re going to an inexperienced injector who isn’t well trained on the wide range of variations that can exist in facial anatomy.
The Downsides of Longer-Lasting or “Stronger” Neurotoxins
In addition, the advantage of being longer-lasting or “stronger” can have a downside. For first-time neuromodulator patients who don’t like the effect of the treatment, or for anyone who experiences a side effect like a droopy brow…it will take longer to wear off or resolve. This increases the risks of these new variations, particularly in the wrong hands.
How To Get the Best Results
My best advice is, until there’s a strong history of one of these newer products having a significant advantage over another, patients should optimize their results by making sure they’re going to an experienced, well-trained injector, who can precisely customize the treatment to their exact needs. (You should NOT book an appointment at a medical spa based on their advertised cost per unit…this is definitely not the time to bargain-shop!) The right nurse or aesthetic provider using an FDA-approved, clinically-proven neuromodulator is the magic combo for maximum patient satisfaction.
If you’re interested in treating lines and wrinkles, book a consultation with one of our experienced providers.