Anyone who gets injected with neuromodulators like Botox, Dysport, Xeomin, or Jeuveau for the treatment of fine lines and wrinkles knows you have to go back to the dermatologist every three to four months for a re-up. The smoothing effects of Botox are second to none, but the constant visits aren't exactly wallet friendly.
We have good news on that front: the FDA finally approved Daxxify, the first (and only) peptide-formulated neuromodulator with long-lasting results — six to nine months to be exact. But does it work as well as its predecessors? We spoke to board-certified dermatologist and founder of MMSkincare, Ellen Marmur, MD, FAAD — who was part of the scientific advisory board for Revance Therapeutics (the maker of Daxxify) evaluating the patients in the clinical trials — on everything to know about Daxxify. Here, we're breaking down how it works and the exact differences between this new option and Botox.
What Is Daxxify?
Daxxify (DaxibotulinumtoxinA-lanm) is a neuromodulator that, as of Sept. 8, is FDA approved for temporary improvement of moderate to severe frown lines (formally called glabellar lines) in adults. It is the first and only neuromodulator on the market stabilized with peptide technology and is free of both human serum albumin and animal-based components. What makes it a big deal, though, is that it lasts nearly double the amount of time as the other botulinum toxin options on the market.
"The new Peptide Exchange Technology (PET) complex is a peptide that extends the ability of botulinum A to stop muscle fibers from contracting," Dr. Marmur says. "The discovery of this extra duration is a fun story. The original research goal was to create topical 'tox to treat wrinkles without needle injections to avoid pain and needle phobia. According to the story, the FDA required the new molecule to be compared to the current gold standard: injectable botulinum-A. And, surprise — it was found to last longer."
While you can't get Daxxify at your dermatologist's office quite yet, according to Revance, it is following a strategic launch starting with a training and education program for doctors, followed by the broader launch of Daxxify to select doctors around the country.
How Is Daxxify Different From Botox?
"Clinically different in its molecular structure, Daxxify was found to be similar to the [other] 'tox competitors except its duration was double the time, lasting six months," Dr. Marmur says. So the biggest difference that sets Daxxify apart from Botox, Dysport, Xeomin, and Juvederm, besides that it contains peptides, is how long it lasts.
"The FDA approval and clinical trials showed the effects of Daxxify were similar to those of Botox when injected in the glabellar lines, aka the 11s between the eyebrows," Dr. Marmur says. "Some dermatologists report it did also smooth part of the forehead lines, the frontalis muscle, too. It will be intriguing to compare the nuances of Daxxify to the finer differences of Botox, Xeomin, Dysport, and Juveau."
What Areas Can Daxxify Treat?
Right now, Daxxify is only approved by the FDA to treat the glabella lines in the face. However, Dr. Marmur notes that since dermatologists are usually comfortable with treating off-label areas with the other big-name options, the same may hold true for Daxxify. "We will need to work out the proper dosage in these other areas just as we did so with other newer medicines," she says.
How Much Does Daxxify Cost?
As Dr. Marmur puts it, pricing is the big mystery currently, since it has been described as a luxury product. "Usually [price] is determined by the cost to the provider's practice and the treatment goals for a patient and therefore can vary," she says. "The cost is more expensive than competitors, and the results last longer." You can probably expect to pay a bit more per appointment than you would with Botox; however, you might find that you break even since you only need to be treated once or twice per year, as opposed to three or four.
Daxxify Side Effects
According to Dr. Marmur, Daxxify is generally safe and well tolerated with no serious treatment-related adverse events in the clinical trials and has a safety profile that is consistent with other currently available neuromodulators in the aesthetics market. Similar to other options, she says there were incidents of ptosis or drooping and headaches, but they were not greater than those of other molecules.
While it's not available yet, Dr. Marmur says she's excited to have Daxxify as an option because it's "pushing the boundaries. Daxxify is inspiring creativity in science that will benefit the entire aesthetics world of medicine."