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6 Botox® alternatives for 2023 | Curology

There are a variety of effective strategies that can help you achieve a youthful glow. Find out which may be right for your skin.

Curology Team Avatar
by Curology Team
Updated on Dec 1, 2023 • 7 min read
Medically reviewed by Erin Pate, NP-C
alternatives to botox
Curology Team Avatar
by Curology Team
Updated on Dec 1, 2023 • 7 min read
Medically reviewed by Erin Pate, NP-C
We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.

In this article

What is Botox® and what does it do?
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In 2023, Botox® has become synonymous with professionally given anti-aging treatments—but it’s not the only option on the market. In fact, it’s far from it! There are a wide variety of alternatives out there that reduce the appearance of fine lines and wrinkles, and not all of them involve injectables.

If you’re curious about the world of professional anti-aging treatments outside of Botox®, we’ve got you covered. Here, we’ll cover six alternatives that are relevant in 2023. And if you are interested in learning more about Botox® and how it works, we’ve got answers for you, too.

What is Botox® and what does it do?

The word Botox® often comes up casually when referring to professional cosmetic treatments—but what is it? Botox® Cosmetic is a brand name for a neuromodulator that can be administered by certain licensed medical providers.¹

Botox®, short for botulinum toxin, is made from the bacterium clostridium botulinum and is prevalent in plants, soil, and water.² It’s toxic in large amounts, although Botox® is typically considered safe to use.³  

To reduce the appearance of facial wrinkles, Botox® is injected into your facial muscles to reduce muscle contractions temporarily.⁴ Specifically, it blocks the release of a neurotransmitter called acetylcholine, which temporarily paralyzes the muscles around the area of the injection.⁵

The U.S. Food and Drug Administration (FDA) first approved Botox® in 2002 as an injectable to reduce lines on the face.⁶ According to Botox® Cosmetic, it’s still the only FDA-approved treatment to temporarily improve the appearance of moderate to severe glabellar lines (frown lines), crow’s feet, and forehead lines in adults.⁷ 

The Botox® pharmaceutical company says you may notice a difference in your moderate to severe frown lines within 24 to 48 hours after injection. The number of injections you receive depends on the type of lines you’re trying to treat—crow’s feet get three injections, while frown and forehead lines get five.⁸ The effects typically last three to six months.⁹

Botox® Cosmetic and the FDA have said that technically, another product cannot act as an exact substitute for Botox®.¹⁰ However, there are many alternatives out there that can help treat facial lines and wrinkles.

Injectable alternatives to Botox®

Because Botox® is an injectable, it only makes sense that some of its closest alternatives are administered in the same format. Here are a few examples you may want to consider.

Daxxify®

In September 2022, the FDA approved Daxxify® as a treatment for moderate to severe frown lines that result from muscle activity.¹¹ Daxxify® is also a form of botulinum toxin type A, meaning it’s in the same category of substances as Botox®. And just like Botox®, it needs to be injected for you to see results.¹²

Where Daxxify® differs from Botox®, however, is that its results may last longer. One study showed that the median effectiveness for patients who received one injection was 24 weeks.¹³ Plus, Daxxify® doesn’t contain any human or animal byproducts; instead, it uses a new peptide as a stabilizer.¹⁴

Dysport®

Like the other two injectables we’ve mentioned so far, Dysport® contains a botulinum toxin type A product called abobotulinum toxin-A. While Botox®, Daxxify®, and Dysport® are all considered to be effective treatments for signs of aging, Dysport® may be more cost-effective than the other two.¹⁵  

In 2009, the FDA approved Dysport® as a temporary treatment for moderate to severe frown lines caused by muscle activity in adults.¹⁶ While it works in a similar way as Botox®, its effects may spread to a broader area of the skin.¹⁷ 

Non-injectable alternative treatments to Botox®

If you’re skeptical about injectable treatments in general, they’re not the only type of professional anti-aging treatments out there. Let’s take a look at a few other options. 

Fractional lasers

Fractional laser resurfacing (using fractional lasers in skincare) can be used to treat signs of photoaging. These lasers penetrate deep layers of skin tissue to increase collagen production, tissue contraction, and tissue remodeling.¹⁸ 

There are different types of fractional lasers, but carbon dioxide lasers were the first type to be created. They can help improve the appearance of fine wrinkles, around the eyes or mouth in particular, by stimulating new collagen. Clinical trials show that modern carbon dioxide lasers may improve wrinkles by as much as 45%. However, they can come with side effects like oozing, bleeding, crusting, and necessary downtime.¹⁹   

The more modern Er:YAG laser works similarly to the carbon dioxide laser but may be slightly less effective at tissue tightening. However, it may produce fewer side effects than a carbon dioxide laser. In some cases, these two types of lasers are used together to help improve the appearance of wrinkles with minimal side effects.²⁰

Microcurrent treatments

These treatments involve electrical stimulation at subsensory levels—meaning the level of stimulation is so low that we can’t feel it.²¹ However, microcurrent treatments have been found to reduce the appearance of wrinkles effectively.

One study found that microcurrent treatments are the most effective at improving forehead wrinkles and the least effective at improving wrinkles in the nose and mouth areas.²²

Microneedling

Microneedling, or percutaneous collagen induction, is a minimally invasive technique that stimulates collagen production underneath scars and wrinkles. However, it keeps the outer layer of the skin intact, so you can resume your normal activities the next day.²³ 

If you’re looking for an anti-aging treatment that isn’t very painful or uncomfortable and has fewer side effects than fractional lasers, you may want to consider microneedling. Studies show that it can significantly improve the appearance of fine lines and wrinkles.²⁴ But as with any treatment you’re considering, it’s a good idea to consult a professional, like a licensed dermatology provider at Curology.

Tretinoin

The least invasive of all these treatments, tretinoin is a topical retinoid, meaning it’s a vitamin A derivative. It can improve fine and coarse wrinkles by preventing collagen from breaking down and helping your skin form new collagen. One study showed that the most significant changes occurred after patients used tretinoin daily for six months.²⁵

If appropriate for you, Curology can prescribe tretinoin. To learn more about this treatment and if it may be right for your skin, consult a licensed dermatology provider at Curology.

Sunscreen

Sunscreen may not be a professionally administered treatment, but that doesn’t mean it’s not an effective anti-aging product. Not only can sunscreen help prevent signs of photodamage, but it may even reverse current signs of photodamage, including skin texture and clarity.²⁶

If you’re looking for a broad-spectrum sunscreen with SPF 30 that protects against UVA and UVB rays, we’d recommend The Sunscreen. Formulated with zinc oxide, it melts into all skin types while minimizing white cast.

And don’t forget your lips! To help protect your lips from signs of photoaging, try a broad-spectrum SPF 30 Lip Balm.

Find the right anti-aging treatment for you

Although nothing can replicate Botox® exactly, there are tons of alternatives you can try. The one you choose ultimately depends on your skin type and treatment preferences.

Get your personalized skincare routine with Curology.

Get your personalized skincare routine with Curology.

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Need a little help figuring out what direction to go in? Curology is here to help. Not only can our licensed dermatology providers prescribe a custom formula with tretinoin if it’s appropriate for you, but they’re also here to answer any questions about anti-aging treatments. And when you sign up with Curology, they’ll curate your personalized treatment plan within three days. To get started, claim your offer* today.

FAQs

How can I reduce my forehead wrinkles without Botox®?

You may want to try several alternative treatments, including other injectables and non-injectables like fractional lasers, microneedling, microcurrent treatments, and tretinoin. To help figure out which treatment is right for you, consult a board-certified dermatologist.

What is the closest thing to Botox® over the counter?

While there is no replica for Botox®, tretinoin is a topically applied ingredient that can help improve the appearance of fine lines and wrinkles. However, it requires a prescription.

For an over-the-counter option, try looking for a serum with retinol, which is a topical retinoid like tretinoin that can also help reduce fine wrinkles.²⁷

What is a natural alternative to Botox®?

Try over-the-counter products with active ingredients proven to help with signs of aging, like retinol and vitamin C.²⁸

Is there an alternative to Botox®?

In short, yes! While there is no exact substitute for Botox®, various treatments can be effective anti-aging alternatives, including Daxxify®, microneedling, and fractional lasers.

Does microneedling help forehead wrinkles?

Studies show that microneedling can significantly improve the appearance of fine lines and wrinkles, including on the forehead.

• • •

P.S. We did the homework so you don’t have to:

  1. Botox® Cosmetic. About Botox® Cosmetic. 2023.

  2. Nigam, P.K., et al. BOTULINUM TOXIN. Indian J Dermatol. (2010, January-March).

  3. Satriyasa, B. K. Botulinum toxin (Botox®) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol. (2019). 

  4. Botox® Cosmetic. Frequently Asked Questions. 2023.

  5. Satriyasa, B. K. Botulinum toxin (Botox®) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol. Ibid.

  6. Nigam, P.K., et al. BOTULINUM TOXIN. Indian J Dermatol. Ibid.

  7. Botox® Cosmetic. About Botox® Cosmetic. Ibid.

  8. Botox® Cosmetic. Frequently Asked Questions. Ibid.

  9. Satriyasa, B. K. Botulinum toxin (Botox®) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol. Ibid.

  10. Botox® Cosmetic. Frequently Asked Questions. Ibid.

  11. U.S. Food & Drug Administration. Novel Drug Approvals for 2022. (2023, September 11).

  12. Bertucci, V., et al. DaxibotulinumtoxinA for Injection has a prolonged duration of response in the treatment of glabellar lines: Pooled data from two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). J Am Acad Dermatol. (2020, April). 

  13. Bertucci, V., et al. DaxibotulinumtoxinA for Injection has a prolonged duration of response in the treatment of glabellar lines: Pooled data from two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). J Am Acad Dermatol. Ibid.

  14. American Board of Cosmetic Surgery. Daxxify® is Coming — Here’s What You Need to Know About the Newest Botox® Alternative. (2022, December 19).

  15. Scaglione, F. Conversion Ratio between Botox®®, Dysport®®, and Xeomin® in Clinical Practice. Toxins (Basel). (2016, March).

  16. Flowers, C. M., et al. Pediatric Postmarketing Pharmacovigilance Review. Food and Drug Administration. (2019, December 16). 

  17. Walker, T. J., MD., et al. Comparison and Overview of Currently Available Neurotoxins. J Clin Aesthet Dermatol. (2014, February).

  18. Carniol, P. J., et al. Current Status of Fractional Laser Resurfacing. JAMA Facial Plastic Surgery. (2015, September 17).

  19. Pressing, J., et al. Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface. Semin Plast Surg. (2012, August). 

  20. Pressing, J., et al. Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface. Semin Plast Surg. Ibid.

  21. Houghton, P. E. Clinical Trials Involving Biphasic Pulsed Current, MicroCurrent, and/or Low-Intensity Direct Current. Adv Wound Care (New Rochelle). (2014, February).

  22. Saniee, F., et al. Consider of Micro-Current's effect to variation of Facial Wrinkle trend, Randomized Clinical Trial Study. Life Science Journal. (2012).

  23. Ablon, G., MD. Safety and Effectiveness of an Automated Microneedling Device in Improving the Signs of Aging Skin. J Clin Aesthet Dermatol. (2018, August).

  24. Ablon, G., MD. Safety and Effectiveness of an Automated Microneedling Device in Improving the Signs of Aging Skin. J Clin Aesthet Dermatol. Ibid.

  25. Mukherjee, S., et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. (2006, December).

  26. Randhawa, M., et al. Daily Use of a Facial Broad Spectrum Sunscreen Over One-Year Significantly Improves Clinical Evaluation of Photoaging. Dermatol Surg. (2016, December).

  27. Kafi, R., MD, et al. Improvement of Naturally Aged Skin With Vitamin A (Retinol). Arch Dermatol. (2007). 

  28. Pullar, J. M., et al. The Roles of Vitamin C in Skin Health. Nutrients. (2017, August). 

Erin Pate is a board-certified Family Nurse Practitioner at Curology. She earned her Masters of Science in Nursing at Florida Atlantic University in Boca Raton, FL. *Restrictions apply. See website for full details and important safety information.

**Cancel anytime. Subject to consultation. Results may vary.

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Curology Team Avatar

Curology Team

Erin Pate Nurse Practitioner, NP-C

Erin Pate, NP-C

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