Daxxify vs Botox: Which Is Better?

So how are Daxxify and Botox different? Daxxify lasts significantly longer than Botox, with results lasting an average of six months, compared with three to four months for Botox. But does that mean it’s automatically the better choice for you?

Keep reading to learn more about Daxxify and Botox, including how they compare with other neurotoxins on the market, health and medical uses, risks and side effects, interactions, and more.

“Daxxify and Botox are brand names for a type A injectable neurotoxin, and both are used to minimize wrinkles by temporarily paralyzing muscles,” says Juliena Gigon, PA-C, with the Center for Plastic Surgery at MetroDerm in Atlanta.

But, Gigon explains, “each requires specific yet different proteins to stabilize the toxin. Botox uses a human-derived product as a stabilizer, and Daxxify uses a special peptide not derived from human or animal sources.”

Importantly, Daxxify and Botox are not interchangeable; they have different strengths. One unit of Botox does not equal one unit of Daxxify, so they shouldn’t be swapped.

How Do Daxxify and Botox Compare to Other Commercial Neurotoxins?

“In the U.S., the other brands of botulinum toxin A are Xeomin from Merz in Germany, Dysport from Galderma in Sweden, Jeuveau from Evolus in the U.S., and Letybo from Hugel in South Korea. All are botulinum toxin A, and all act similarly,” says David Goldberg, MD, director of cosmetic dermatology and clinical research at the Schweiger Dermatology Group in New Jersey.

However, there are some differences. “Botox has been around the longest and is the most used neurotoxin. It has the highest number of clinical uses approved by the FDA. Botox can be used for cosmetic purposes and to treat migraines, jaw joint pain, and excessive sweating,” says Gigon.

“Other neurotoxins have similar effects to Botox and Daxxify, but they may spread more through the injection site. Other injectables’ effects may not last as long as Daxxify,” she adds.

Here are the key differences among these brands:

• Botox is the industry standard neurotoxin and is widely used and FDA-approved for many cosmetic and medical conditions. It uses human serum albumin as its stabilizing ingredient, and its effects last for about three to four months.
• Daxxify is the longest-lasting neurotoxin, with effects lasting for an average of six months. It uses a peptide stabilizer instead of human serum albumin, and it’s a newer product, approved in 2022 by the FDA.
• Jeuveau is nicknamed “NewTox,” and its uses tend to be more cosmetic-focused. The FDA has approved it exclusively for frown lines and not for any other medical uses. Jeuveau may also last slightly longer than Botox — up to five months for some people.

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• Dysport uses the same neurotoxin as Botox, but due to a different manufacturing process, the two brands have different potencies and are not interchangeable. A handful of studies have found that Dysport has a quicker onset, lasts longer, and hurts less than Botox, but many of these studies were sponsored by the drugmaker. Dysport is approved for some medical uses beyond treating wrinkles.

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• Xeomin uses a different formulation of botulinum toxin that’s free of accessory proteins — described as “naked” or “purified.” This formulation may reduce the risk of allergic reactions or treatment resistance over time. Xeomin also costs less than Botox and has several FDA-approved cosmetic and medical uses.

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• Letybo was approved in 2024 to treat frown lines only. It may take effect more quickly than Botox.

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• Glabellar lines (frown lines between the eyebrows)
• Forehead lines
• Crow’s-feet around the eyes
• Platysma bands (raised vertical lines on the neck)

By contrast, Daxxify is only approved for glabellar lines. While companies aren’t allowed to promote drugs for unapproved uses, doctors are free to prescribe medicines for purposes that aren’t yet cleared by the FDA, a practice known as “off-label” utilization. That’s the case for both cosmetic and medical uses.

Can Daxxify Help Treat Medical Conditions Like Botox?

Botox is FDA-approved to treat many more health conditions including:

• Overactive bladder
• Urinary incontinence (poor bladder control) due to a neurological condition, such as a spinal cord injury or multiple sclerosis
• Chronic migraine
• Upper-limb spasticity
• Cervical dystonia
• Excessive sweating that doesn’t respond to other treatments
• Blepharospasm (involuntary eye twitches)
• Strabismus (crossed eyes)

Botox has a 20-year head start on Daxxify, so that gap may eventually close.

“Botox has so many indications besides aesthetic use, and I foresee that being the same for Daxxify,” says Nazanin Saedi, MD, a board-certified dermatologist at Dermatology Associates of Plymouth Meeting and a clinical associate professor at Thomas Jefferson University in Philadelphia.

“Technically, yes,” says Dr. Goldberg, “but, practically, there would be no reason to use both at the same time.” Furthermore, there are safety concerns about using two muscle relaxants at once, as highlighted in the FDA’s prescribing instructions for the drugs. “It is not recommended to use both in the same area at the same time,” says Gigon.

Instead, some people may prefer to try either one or the other first. For example, you may wish to use Botox first, as it’s shorter-lasting, and see how you feel about the results, says Joshua Zeichner, MD, an associate professor and the director of cosmetic and clinical research in the department of dermatology at Mount Sinai Hospital in New York City.

If that works for you, you might consider switching to Daxxify. “Because the effect lasts much longer, you cannot undo an outcome that you are not happy with. Once you have an established relationship with a doctor and are happy with your injection pattern, then would be the time to switch to a longer-lasting product,” says Dr. Zeichner.

“Daxxify is no different from other neurotoxins. Patients may experience the same side effects as other neurotoxins, including headaches, eyelid drooping, and facial paralysis,” says Gigon.

• Pain, bruising, redness, or swelling at the injection site
• Dry mouth
• Tiredness
• Headache
• Neck pain
• Weakness in the treatment area

Risk of Toxin Spread

Still, overall, side effects aren’t typical, and Daxxify and Botox have rarely caused any serious issues. In fact, speaking of Daxxify, Goldberg says that “side effects are generally related to lack of provider experience, not to any issues with the product.”

Gigon says she has seen no harm or issues in administering Daxxify. “The majority of my patients see a positive result from this product and are very happy with the results,” she says.

• Aminoglycosides, a class of antibiotics used for severe infections
• Muscle relaxants or paralyzing agents, such as drugs you might get during surgery
• Anticholinergic drugs, including several used to treat muscle spams or tremors, because Daxxify and Botox may increase the side effects of these drugs

Avoid taking these drugs at the same time as Daxxify or Botox if you can. The FDA advises caution and close monitoring if you must take them at once, so talk to your doctor before you make your Botox or Daxxify appointment.

The Takeaway

• Both Daxxify and Botox are injectable neuromodulating drugs that use a neurotoxin to relax certain muscles.
• To stabilize the neurotoxin, Botox uses a protein that comes from human blood, but Daxxify uses a special peptide that doesn’t come from human or animal sources.
• Both Daxxify and Botox are mainly used to minimize the appearance of wrinkles, but they’re also prescribed for some medical conditions.
• Botox has been on the market 20 years longer than Daxxify and has been approved by the FDA  for many more cosmetic and medical uses.
• Daxxify effects last longer, and the product can be stored at room temperature.

Additional Reporting by Lisa Rappaport.