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—and each has pluses and minuses in terms of effectiveness, how often they're needed, and more.

Injectable Botox alternatives include:

  • Myobloc (rimabotulinumtoxinB)
  • Dysport (abobotulinumtoxinA)
  • Xeomin (incobotulinumtoxinA)
  • Daxxify (daxibotulinumtoxinA)
  • Bellafill (dermal filler)
  • Juvederm (hyaluronic acid gel)

The benefits of Botox last about four months. Some of these have longer periods between recommended treatments, which may be attractive for both cost and convenience concerns.

Laser resurfacing is a cosmetic treatment for wrinkles that lets you avoid needles entirely. And various types of cosmetic surgery procedures may help you achieve your goals. It's important to know that simple lifestyle changes can make your skin appear smoother too.

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


All of the injected neurotoxins work by paralyzing specifically targeted muscles to smooth out fine lines and wrinkles. Among the common effects of neurotoxin injection is that people often can't move their face normally, which can make you appear less expressive than usual. Most of the time, this is not extremely obvious, but sometimes the lack of normal facial expression is noticeable.

You might consider other neurotoxins besides Botox if you’re one of the rare people who has developed an “immunity” to Botox.

Myobloc (rimabotulinumtoxinB)

Myobloc is 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. 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 prescribe it off-label to reduce wrinkles.

Dysport (abobotulinumtoxinA)

Dysport 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)

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.

Daxxify (daxibotulinumtoxinA)

Daxxify is approved by the FDA to treat glabellar lines (frown lines) in adults. As a neuromodulator, it works similarly to Botox; however, there are differences at the cellular level.

Botox and Daxxify both contain botulinum toxin type A as their core ingredient, but Botox uses proteins for stabilization, whereas Daxxify uses peptides. The peptides in Daxxify make it more effective, with results lasting an average of 6 months (compared to 3-4 months for Botox and other neuromodulators).


Fillers work by injecting a small amount of material under the skin to make it appear fuller.
Fillers are not usually considered a replacement for a neurotoxin because they work differently, so you might choose a filler instead of a neurotoxin if it serves your needs better. But don't expect it to have the same effect.

Bellafill (Dermal Filler)

This semi-permanent filler tends to be a mixture of collagen and polymethyl methacrylate (PMMA) microspheres. Bellafill is FDA-approved for treating acne scars, and 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.


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

This is man-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 skin and the area directly underneath are heated, which destroys old tissue and stimulates the production of new collagen. The newly formed tissue is firmer, which results In a smoother appearance.

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


Minimally invasive surgical procedures can be very effective. However, you may still have to deal with wrinkles and marks that develop from repeated facial movements post-surgery.

  • Facelift: During a facelift, a surgeon makes incisions along the edges of the face. The muscles and connective tissue under the skin are tightened. Fat may also be removed and excess skin is trimmed off.
  • Brow lift: Also known 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.

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.

Which Cosmetic Procedure Is Right For You?

There are many things to consider if you are thinking about having a cosmetic procedure.

Cost is a factor, and surgery is generally the most expensive option. Other factors that affect the cost include where you are having the procedure, how much of a change you are looking for, and which product you are having injected. Some cosmetic clinics may have different prices for different products, depending on how often they use them.

Contraindications are another factor. People who have health conditions that could make surgery or anesthesia risky might be advised to steer away from surgery or any major procedure. Additionally, if you are taking blood thinners, it might increase your risk of bruising from an injection, and you may need to stop taking it before having a procedure with a higher likelihood of bleeding.

You and your provider will also need to discuss which method will be most likely to achieve the results you are looking for, how long the effect is expected to last, recovery time, and the most common risks.

Comparing Different Cosmetic Procedures
  How it works How long it lasts Recovery Time Risks
Botox Paralyzes muscles Approximately four months Irritation or redness may last for a few hours Minimal risk of nerve damage or scarring Botox resistance
Myobloc Paralyzes muscles Approximately four months Irritation or redness may last for a few hours Minimal risk of nerve damage or scarring
Dysport Paralyzes muscles Approximately four months Irritation or redness may last for a few hours Minimal risk of nerve damage or scarring
Xeomin Paralyzes muscles Approximately four months Irritation or redness may last for a few hours Minimal risk of nerve damage or scarring
Daxxify Paralyzes muscles Approximately six months Irritation or redness may last for a few hours Minimal risk of nerve damage or scarring
Bellafil Injected material filler Up to five years Irritation or redness may last for a few days Bruising, skin irregularity 
Juvederm Injected material filler Nine to 12 months Irritation or redness may last for a few days Bruising, skin irregularity
Laser resurfacing Stimulates new tissue production Years Pain and swelling for days May cause scars
Surgery Reshaping skin, muscle, and tissue Years Bruising can take days or weeks to heal Surgical complications or scars  

Lifestyle Changes: A Natural Option

Lifestyle changes that help you maintain healthy skin are always recommended, whether you opt for a cosmetic procedure or not.

As standalone approaches to smoothing skin, they may not be as effective as medical or surgical 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
  • Get adequate rest and sleep

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 the skin in a variety of ways.


Alternatives to Botox include different types of injectable neurotoxins and fillers, laser resurfacing, and cosmetic surgeries. 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.

7 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. Daxxify label.

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

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

  6. 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

  7. 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