• Welcome to the second installment of the Ask Our Beauty Director series. This month, Women’s Health beauty director Brian Underwood reveals all you need to know about Daxxify.
• Daxxify is a muscle relaxing injectable similar to Botox, Dysport, and Xeomin, though initial research suggests its effects may last much longer.
• Top dermatologists offer their insights on how this neuromodulator works, and what to consider before you try it yourself.

As a beauty editor for more than 15 years, I’ve allowed doctors to inject all manner of thing into my face in the name of research. I’ve tried hyaluronic acid fillers like Voluma to lift and sculpt, Kybella, a fat-dissolving acid, to send my double chin packing, and muscle relaxers like Botox, Dysport, and Xeomin to smooth expression lines. The latest addition to the latter category, called Daxxify, was approved last fall by the U.S. Food and Drug Administration to temporarily treat frown lines and—get this—according to clinical trials, it’s effects last, on average, six months—and up to nine months for some. That’s 200% percent longer than some of its competitors, which tend to promise results that stick around for three to six months.

For this reason, many cosmetic dermatologists say Daxxify is a game-changer, offering patients an alternative if they’re starting to notice that the effects of other injectables are wearing off sooner or would simply prefer to see their dermatologist less. “It’s hard to get some of my busier patients in for an appointment, and this makes that easier,” says Marina Peredo, MD, associate clinical professor of dermatology at Mount Sinai Hospital in New York and founder of Skinfluence, a cosmetic and laser dermatology practice in Manhattan, who was involved in the clinical trials for Daxxify. While I was in Peredo’s office trying the treatment for myself, she was also quick to note that fewer visits mean fewer blood pressure-elevating, perspiration-inducing moments for needle-phobes. Not a problem for me, but I can see the appeal.

Meet our experts: Marina Peredo, MD, associate clinical professor of dermatology at Mount Sinai Hospital in New York and founder of Skinfluence, a cosmetic and laser dermatology practice in Manhattan, Quenby Erickson, DO, FAAD, a board-certified dermatologist and founder of Erickson Cosmetic Dermatology, Laser, and MedSpa in Chicago, Nancy Samolitis, MD, of Comprehensive Dermatology of Long Beach in California

Before Daxxify becomes widely available later this year, I grilled Peredo and other top doctors about this new advancement, how it’s different from its better-known competitors like Botox, and everything else you may want to know.

What is Daxxify?

Daxxify, known by pros as a neuromodulator, is an injection that’s FDA-approved to help smooth moderate to several glabellar lines (those small vertical furrows that pop up between your brows). The active ingredient is a purified protein called botulinum toxin type A (the same used in other neuromodulators), which disrupts the chemical messages that cause muscles to contract. Plainly, it means you’ll no longer be able to make the expressions that can cause frown lines.

Botulinum toxin type A has been used safely for this purpose for more than twenty years, explains Quenby Erickson, DO, FAAD, a board-certified dermatologist and founder of Erickson Cosmetic Dermatology, Laser, and MedSpa in Chicago. Daxxify is administered in the same way as Botox, with five points of injection along the forehead: “Doctors can basically use it almost interchangeably,” says Dr. Erickson.

So how is Daxxify different from Botox?

See above: The biggest and most significant difference is that Daxxify has been shown to last much longer. How—and why? That’s where things get interesting: For botulinum toxin type A to do its job, it requires a special ingredient to “act like Velcro, attaching the toxin to the nerve ending where it works,” says Dr. Erickson. Unlike Botox, which uses human serum albumin, a protein derived from human blood, to act as the carrier, Daxxify utilizes a novel peptide technology to do the same. “This positively charged synthetic peptide is made up of thirty-five amino acids,” explains Dr. Peredo. “We believe it lingers longer in the neuromuscular junction because the neurons there are negatively charged, so you you have greater attraction and possibly better binding, more absorption, and longer duration.”

Revance, the parent company of Daxxify, was originally studying this peptide technology to develop a topical muscle relaxer, says board certified dermatologist Nancy Samolitis, MD, of Comprehensive Dermatology of Long Beach in California. “The original intention was to drive the botulinum toxin through the surface of the skin. That didn’t quite work, but researchers discovered that when it was injected, the results seemed to last longer much longer than other neuromodulators,” Dr. Samolitis explains.

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Another characteristic unique to Daxxify: Samolitis has noticed an overall glowing of skin post-treatment (I did too). “Some of the physicians involved in the initial studies reported that there was a difference in the way skin looked in the treated areas,” she says. “It’s hard to describe, but there’s a smoothness to the skin’s texture.”

Who is Daxxify best for?

The physicians I spoke to agree it’s a slam dunk for anyone with moderate to several glabellar lines, and they all anticipate it will also be used off-label to treat other facial wrinkles such as those around the eyes and across the forehead (a common occurrence with other neuromodulators too). One effect that’s particularly appealing to me—and that I’ve noticed myself a few weeks after treatment: “In my observation, Daxxify also gives patients a bit more of a brow lift,” says Peredo.

Additionally, our experts are unanimous in saying that Daxxify offers an appealing option for busy patients who’d prefer to see their dermatologist for injections twice a year versus three to four times annually. Erickson also notes that Daxxify is a great option for women planning to have children since the effects will likely last for the better part of the pregnancy (botulinum toxin injections aren’t generally recommended during pregnancy).

How much does Daxxify cost?

Pricing can vary significantly based upon your provider and geographic location, so it’s difficult to talk specific numbers. But you can expect to pay more for Daxxify than other neurotoxins—mostly because it lasts longer. Peredo estimates the ultimate cost of Daxxify to be one-and-a-half to two times more expensive but again, if you’re going under the needle less frequently, some of this cost may be mitigated: “It kind of works out to be about the same ultimate spend,” says Dr. Erickson.

Are there any risks to Daxxify?

Conversations about cosmetic enhancements and aesthetic tweaks have become so commonplace (generally a good thing) that many people forget that these are medical procedures—and all medical procedures come with some inherent risk. In the case of Daxxify and other similar injections, the most common ones are bruising, swelling, headaches, and, in some cases, eyelid and eyebrow ptosis (an unintended drooping of the lids or brows).

It’s important to note that these adverse effects are generally rare (Dr. Samolitis estimates a one- to five-percent incidence) and research shows that Daxxify’s longer-lasting results don’t necessarily translate to longer-lasting complications. Of course, the easiest way to avoid these complications is by selecting a skilled provider–most of the time, a board-certified cosmetic dermatologist.

Brian’s bottom line

Personally, I’ve been pleased with the results of my Daxxify treatment (though you may not know it by the look on my face). In truth, I’m sure my satisfaction has as much to do with seeing a skilled pro like Dr. Peredo as it does the product itself.

I was inspired to give it a try because I’ve recently noticed that the effects of some other neuromodulators aren’t lasting quite as long as they once did (I’ve been getting these injections for at least five years now). Experts are still split as to the reason why: Though there’s no clear-cut data to support it, some, like Peredo, believe that over time, certain people may develop antibodies to the toxin or the binding proteins that help it do its job. Could another tool in a dermatologist’s line-fighting arsenal help to address this? Erickson remains unconvinced: “I’m not exactly sure this has to do with your body building up a resistance to the toxin,” she tells me. “If you start getting injections in your mid-twenties and now, you’re forty, it probably has more to do with the fact that your skin and your body has changed.” Fair enough.

Either way, I’m thrilled to have another option that may potentially buy me some more time.

Brian Underwood is the beauty director at Women’s Health. He is an award-winning journalist with more than 15 years of experience covering beauty and lifestyle for several national media outlets and previously served as beauty and wellness director at Oprah Daily. His work has appeared in Woman’s Day, Life & Style Weekly, Good Housekeeping, and many more. He also serves as a member of the Skin Cancer Foundation’s gala committee and lives in New York City with his daughter.