8 Botox Alternatives

How to Smooth Wrinkles and Look Younger Without Botox

Botox (onabotulinumtoxinA) is a popular and effective treatment for fine lines and wrinkles, but there are other options you can consider—each of which have pluses and minuses in terms of effectiveness, how often they're needed, and more.

Injectable Botox alternatives include:

  • Myobloc (rimabotulinumtoxinb)
  • Dysport (abobotulinumtoxinA)
  • Xeomin (incobotulinumtoxinA)
  • Bellafill (dermal filler)
  • Juvederm (hyaluronic acid gel)

You might seek one of these out if you’re one of the rare people who has developed an “immunity” to Botox. Some of these also have longer periods between recommended treatments, which may be attractive for both cost and convenience concerns. (The benefits of Botox only last about four months.)

Laser resurfacing is a Botox alternative that lets you avoid needles entirely, and simple lifestyle changes can make for smoother skin too. If you do try an injectable and don't get the results you seek, minor surgery may help you achieve them.

This article discusses Botox alternatives that can help smooth wrinkles and keep a more youthful appearance.

Woman getting Botox alternative facial injection
Win McNamee / Getty Images

Myobloc (Rimabotulinumtoxinb)

Like Botox, Myobloc is another type of neurotoxin. It's sometimes recommended specifically for people for whom Botox doesn't work (Botox resistance).

Myobloc is not approved by the U.S. Food and Drug Administration (FDA) for cosmetic use. Instead, it's indicated for the treatment of cervical dystonia (a painful neuromuscular condition affecting the head and neck), pediatric urinary incontinence, migraine headaches, and other medical problems.

Despite its FDA status, some healthcare providers still prescribe it off-label to reduce wrinkles.

Dysport (AbobotulinumtoxinA)

Dysport, too, is a neurotoxin, but it is approved by the FDA to treat fine lines and wrinkles. This injectable works similarly to Botox as a neuromodulator, which means that it blocks a nerve. However, there are differences at the molecular level.

While just as effective as Botox, the molecules in Dysport are smaller than the molecules in Botox. Smaller molecules allow Dysport to work faster than Botox.

However, this can also cause it to spread away from the injection site. This spread appears to be more of an issue when larger amounts of the product are used, especially in the forehead.

Dysport may be paired with Botox or another filler to corral it and prevent the risk of spreading and weakening the forehead.

Xeomin (IncobotulinumtoxinA)

Another botulinum toxin, Xeomin is approved by the FDA to treat lines between the eyebrows. (It is also approved for cervical dystonia and blepharospasm, or eye twitching.) Doctors may prescribe it off-label to reduce the appearance of crow's feet, forehead wrinkles, and frown lines.

The results are comparable to Botox, with benefits seen in about a week and lasting several months. The advantage may be a reduced risk of developing antibodies to the toxin, which means you're less likely to see Xeomin stop working compared to Botox.

Bellafill (Dermal Filler)

This semi-permanent filler tends to be a mixture of collagen and polymethyl methacrylate (PMMA) microspheres. Bellafill is FDA-approved, but for treating acne scars, so its use for wrinkles and fine lines is considered off label.

Once injected, your body absorbs the collagen. The PMMA microspheres stay in place and can plump up the skin or give it a smoother-looking appearance. Results can last up to five years.

This filler is not usually considered a replacement for a neurotoxin because it works differently, so you might choose Bellafill instead of Botox if you realize it serves your needs better. But don't expect it to have the same effect.

Juvederm

Juvederm is a brand name for another family of injectable fillers known as hyaluronic acid dermal fillers.

Made from a gel-like substance found naturally in the human body between cells, the fillers are soft when injected so they're used in places like the lips that require more flexibility.

The effects may last nine to 12 months.

Laser Resurfacing

Laser resurfacing is a professional skin treatment that can reduce lines without the use of an injectable.

Using a CO2 laser, a surgeon works on areas of the skin where you want to reduce wrinkles, tighten the skin, stimulate new collagen formation, or repair skin damage.

The full benefits of laser resurfacing may not be obvious for months or even a year, but the results can last several years.

Surgery

Other injectables, on their own, may not be satisfying alternatives to Botox. In that case, you may wish to consider a minimally invasive surgical procedure.

Combined with injectable dermal fillers, these options can be very effective. However, you may still have to deal with wrinkles and marks that develop from repeated facial movements post-surgery.

  • Facelift: In a facelift, a surgeon makes incisions along the edges of the face. The muscles and connective tissue under the skin is tightened. Fat may also be removed and excess skin is trimmed off.
  • Brow lift: Also know as a forehead lift, a brow lift reduces wrinkles along the forehead and the area between the eyes. Hooded eyes may also be treated with a brow lift.
  • Eyelid lift: An eyelid lift is medically known as blepharoplasty. This surgery can raise sagging eyelids (ptosis). It may be done for cosmetic reasons to treat age-related changes or to fix vision problems that can result from drooping eyelids.

Other surgical options target the corrugator muscle, which draws the eyebrows down and together:

  • Corrugator myotomy: The muscle is cut into, but not removed. This technique only reduces eyebrow furrowing; it does not eliminate it.
  • Corrugator myectomy: This is a more invasive procedure in which the corrugator muscle is removed. Since you will no longer be bunching up the skin with your muscle, you'll avoid developing new lines in this area between the eyebrows.

Unless the corrugator muscle is completely removed during the procedure, the results may not be permanent.

Of course, some risks come with this procedure, including decreased sensation in a small area of the forehead and a cosmetically undesirable depression between the brows. In addition, some doctors warn against this procedure, saying that it can result in the face taking on an exaggerated, artificial, perpetually “surprised” look.

Lifestyle Changes: A Natural Option

Lifestyle changes that help you maintain healthy skin are always recommended, whether you opt for one of the above-mentioned Botox alternatives or not.

When paired with another treatment, they can support the minimizing of fine lines and wrinkles. As standalone approaches to smoothing skin, they may not be as effective as medical Botox alternatives, but they can have a positive effect.

Lifestyle changes that can help you minimize fine lines and wrinkles include:

  • Stay hydrated
  • Get regular exercise
  • Reduce exposure to ultraviolet rays
  • Avoid smoking and secondhand exposure
  • Eat a well-balanced diet

These also offer the added benefits of having no side effects and improving other aspects of your health.

Research has shown that diet plays an especially important role in skin health. To maintain youthful skin, researchers suggest adding the following foods and supplements.

  • Multivitamins: Try to get adequate amounts of vitamin A, vitamin B complex, vitamin C, vitamin D, vitamin E, biotin, and the minerals chromium, iron, selenium, and zinc.
  • Resveratrol: Found in high concentrations in the skin of grapes and wine, it's also in blueberries, cranberries, and peanuts.
  • Flavonoids: These powerful antioxidants are found in green tea.
  • Turmeric: With antibacterial, anti-inflammatory, and anticancer properties, turmeric has been shown to benefit skin in a variety of ways.

Summary

Alternatives to Botox include different types of injectable neurotoxins and fillers, laser resurfacing, and cosmetic surgeries. However, diet and a healthy lifestyle can also help reduce the signs of aging.

It's important to discuss all options with your healthcare provider to be sure that medications, surgery, or changes in your diet or routine are good for your overall health.

Frequently Asked Questions

  • What is the difference between Botox and Myobloc?

    Myobloc has proved effective in people who have become resistant to Botox, although as a cosmetic tool, it is used off-label and no studies have been done on it for cosmetic purposes.

  • Does Dysport last longer than Botox?

    No. They both last several months, and it all depends on your body. They are mostly comparable in the treatment of wrinkles and fine lines.

  • What is a natural alternative to Botox?

    A facial massage is one natural option that has been shown to significantly reduce signs of aging. Other options include all-natural topical treatments such as vitamin E cream and rosehip seed oil.

  • What do celebrities use instead of Botox?

    While most celebrities tend to guard their beauty secrets, it is common to hear some of the most youthful-looking actors and entertainers talk about their commitment to good health. Exercise, avoiding UV rays, and eating well are keys to maintaining a great complexion.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Society of Plastic Surgeons. How long does Botox last?

  2. American Academy of Facial Plastic and Reconstructive Surgery. Injectables & Wrinkle Treatment.

  3. Food and Drug Administration. Bellafill summary of safety and effectiveness data.

  4. U.S. VA. Supplements for Skin Health.

  5. Garcia A, da Silva DB, Goncalves VDF, de Camargo Ferreira A. Manual therapy in the treatment of facial wrinkles and sagging: A quantitative-qualitative randomized clinical trial. Man Ther, Posturology Rehabil J. 2019;17. doi: https://doi.org/10.17784/mtprehabjournal.2019.17.772

  6. Datta HS, Mitra SK, Paramesh R, Patwardhan B. Theories and management of aging: modern and ayurveda perspectives. Evidence-Based Complementary and Alternative Medicine. 2011;2011:1-6. doi:10.1093%2Fecam%2Fnep005

Additional Reading
  • Sandoval, L., Huang, K., Davis, S., Felman, S., and S. Taylor. Trend in the Use of Neurotoxins and Dermal Fillers by US PhysiciansJournal of Clinical and Aesthetic Dermatology. 2014. 7(9):14-9.

  • Pao, K., and R. Mancini. Nonsurgical Periocular Rejuvenation: Advanced Cosmetic Uses of Neuromodulators and Fillers. Current Opinion in Othalmology. 2014. 25(5):461-9.
Originally written by Natalie Kita