Before we talk Daxxify, let's make it clear that I'm a big fan of Botox — huge. I've been a regular user for the last six years, breaking my streak only at the height of COVID. Like most users, I love how Botox smooths my fine lines and keeps deeper wrinkles from forming, but I don't love how quickly it seems to fade as well as the two weeks I often have to wait for it to kick in. So when I heard that the FDA had approved Daxxify, a new neuromodulator that's supposed to last about twice as long as its competitors, I jumped at the chance to try it.
What's the difference between Daxxify and Botox? "Neuromodulators have an incredibly high satisfaction rate, but the number one complaint [I get from patients] is that it doesn't last longer, and that's exactly what Daxxify offers," says Elyse Love, MD, a New York City-based, board-certified dermatologist. In clinical studies, the line-smoothing effects of Daxxify — also known as Daxi — lasted an average of six months, about double that of Botox, Dysport, Jeuveau, and Xeomin. For that reason, "it's been a welcome addition to the neuromodulator community," says Dr. Love.
Ari Hoschander, MD, a board-certified plastic surgeon who has started using Daxxify at his New York City practice, credits its longevity to the peptides in the formula, though he says they don't change the way it delivers the botulinum toxin to the nerve cells to "prevent certain nerve signals from interacting with the specific facial muscles." The addition of peptides, however, does facilitate a better interaction of the treatment with those target nerve cells, says Dr. Love. Each peptide is highly positively charged and therefore binds to the negatively charged core neurotoxin as well as to the negatively charged nerve cell, ultimately leading to longer-lasting results.
Meet the experts
- Elyse Love, MD, is a board-certified dermatologist in New York City.
- Shari Marchbein, MD, is a board-certified dermatologist in New York City.
- Ari Hoschander, MD, is a board-certified plastic surgeon in New York City.
Also of note: While Botox is FDA-approved for forehead lines, lateral canthal lines (the smile lines around the eyes), and glabellar lines (the frown lines, or "11s," between the brows), so far Daxxify is only FDA-approved for the latter. But it's common practice for dermatologists to administer injectables off-label, so it's safe to assume that Daxxify is being used on forehead lines and crow's-feet, too.
To test the difference between Daxi and other neuromodulators for myself, I visited certified physician assistant Hannah Hunt, PA-C at the Westside Clinic in Los Angeles, one of the first offices in the country to offer Daxxify since its approval in September 2022. (Editor's note: Allure recommends visiting a dermatologist or plastic surgeon for procedures that go beyond the skin barrier.) "We started offering it to patients in December," says Hunt, mentioning that she first used it on herself and other office volunteers for firsthand anecdotal data. "We've only used it on repeat, well-established patients with a history of success using other neurotoxins. I also used it on people that wanted less mobility for a longer period of time, which isn't everyone," she says.
Because I'm not particularly enthusiastic about looking frozen, Hunt used a light hand on me — 26 units, to be exact — distributed between my forehead (technically an off-label use) and my 11 lines. This is only 65 percent of the FDA-approved, 40-unit dosage used to treat the area between the brows alone. It's worth noting that the FDA-approved Botox dosage for the 11 lines is half as much, or just 20 units. But the ratio of a unit of Botox or other neuromodulators to that of Daxi is not one to one in terms of strength, says New York City-based, board-certified dermatologist Shari Marchbein, MD, who explains the concentration of toxin in each product is different. So far, she's been following the recommended 40-unit protocol when treating patients with Daxi in the between-the-brows region. In other areas, however, she's been using the same dosage of Daxi as she would with other neuromodulators.
Both Dr. Marchbein and Hunt say Daxi gives a more glossy, immobile look than Botox or Dysport, which is why it's important to ask patients about their desired result before deciding which product — and how many units — to use. In my case, Hunt swapped back to Botox for my off-label lip flip, also citing the aesthetic community's general lack of knowledge about using Daxxify in that area.
- How long does it take Daxxify to work?
- What are the side effects of Daxxify?
- How much does Daxxify cost?
- What's my honest review of Daxxify?
How long does it take Daxxify to work?
Of course, there's no real-world data just yet to back up the claim that Daxi lasts for six to nine months. And with some experts telling Allure that they are often injecting less than the dosage used in the Daxi studies (instead of administering the same amount they would of Botox), it's possible patients might experience less than the average six-month longevity found in the studies.
In addition to the longevity factor, there is another potential bonus being reported by some early Daxi adopters: It can kick in much sooner than its competitors — in days instead of weeks. About 12 hours after my treatment, I noticed that I had slightly less mobility and within 24 hours, the effect was significant. My left eyebrow tends to move up my face more when I look surprised, but it was entirely relaxed by the second day. My dose of Daxxify appeared to kick in fully within about three days. Typically, it would take about 10 to 14 days for me to see the full effects of Botox.
"I've been very impressed by how quickly Daxi sets in," says Dr. Marchbein. "Much faster than any other neuromodulator I've injected, with almost-complete effect by 48 hours." Its line-smoothing peers don't reach their full effect for one to two weeks, she adds. For his part, Dr. Hoschander says his office has "found that Daxxify took longer to kick in than Dysport and about the same as Botox," adding that it’s still too early to tell definitively.
What are the side effects of Daxxify?
The potential side effects of Daxxify are nearly identical to that of Botox — bruising, headaches, and droopy eyelids with one big difference: They could last longer. “That’s why it’s so important to be very selective who your injector is and how much experience they have,” says Dr. Hoschander. “Plus, if you don’t like your results, you could be stuck with them for almost a year, rather than a few months — and there’s no way to make it wear off more quickly.”
How much does Daxxify cost?
Another downside to the long-lasting results: the price tag. While the price of Daxxify is dependent on everything from geographic location to the injector, most people can expect to pay anywhere from 50 to 100 percent more for a unit of Daxxify than for other neuromodulators like Botox. (My treatment was performed gratis with the understanding I'd be writing about my experience.) Although depending upon how long Daxxify lasts for you as compared to other neuromodulators, you could very well net out even — and save yourself the commitment of several appointments per year.
What's my honest review of Daxxify?
"The jury is still out on how effective and how long Daxxify will actually last," says Dr. Hoschander. Dr. Love echoes that sentiment and mentions the learning curve that comes with gaining real-world experience with a new product. "Many physicians, including myself, were trained on Botox when learning neuromodulators," says Dr. Love, who notes that Botox has been FDA-approved and regularly used for two decades. "This means that most physicians are more comfortable with Botox. But, as we've seen with Dysport, some providers may completely change to Daxxify while others will just keep it as an additional tool in their toolbox." Dr. Love concludes: "The most important [test of] Daxxify is still to be determined — and that is real-world experience."
All in all, I can't say if I prefer Daxxify over Botox until I can see if it lasts as long as promised, but I will say that so far I'm happy with my results — and how quickly I saw them. Watch this space for updates.
Three-month update, April 2023: I noticed that my forehead isn't as crinkly as it usually is at this point post-Botox, but my 11s are back to normal. Overall, I'm finding the longevity of Daxxify is on par with what I've experienced with Botox.
Read more about injectables:
- Is the COVID-19 Vaccine Making Your Botox Wear Off Faster?
- What's the Difference Between Botox, Dysport, and Other Injectable Neuromodulators?
- Joe Jonas Told Us All About His First Time Getting Injectables
Watch a dermatologist's entire routine:
