DAXI: What to Know About the Longer-Lasting Botox Alternative

Stocksy / Design by Cristina Cianci

Suffice to say that the FDA has been pretty busy with approvals over the last year. While this one is hardly as life-changing, for those of us who use Botox and its counterparts for reducing the appearance of wrinkles, controlling sweat, or curbing overactive muscle movement, the development set to be green-lit in the new future is still pretty exciting. DAXI is an injectable treatment that its creators promise will deliver a similar effect as Botox, Dysport, and Xeomin, but with a notably longer wear time. We’re talking a better part of a year here.

We spoke with board-certified dermatologist Dr. Bruce Katz of New York City’s JUVA Skin and Laser Center, who was involved in the clinical trials for DAXI, for more information on how it works, the difference between DAXI and its predecessors, and more. Read on to learn more.

Meet the Expert

  • Bruce E. Katz, MD is a board-certified dermatologist based in New York City. He is the director of the Juva Skin and Laser Center, as well as a clinical professor of dermatology at Mount Sinai's Icahn School of Medicine.

What Is DAXI?

DAXI is a neurotoxin treatment similar to Botox, Dysport, Jeuveau, and Xeomin in that it paralyzes the active muscle it’s injected into—preventing it from becoming active and further forming wrinkles caused by its movement. “The difference with the formulation of DAXI is that the toxin that paralyzes the muscle is attached to a protein,” Dr. Katz says. He explains that the protein helps to extend the effect that DAXI has on the muscle. The longer-lasting effect means less frequent visits to your professional for touch ups. (More on this later.)

How to Prepare For a DAXI Treatment

Arrive at your appointment with clean skin so that your doctor is able to determine placement without having to remove makeup. As you would ahead of any injectable appointment, avoid blood thinners or medications that could cause bruising (like Advil, Aspirin, Motrin, fish oil, or multivitamins) for roughly 10 days prior to your treatment. (Note, if you need to stay on blood thinners for other medical concerns, do not discontinue without speaking to your physician.) Also, avoid alcohol the night before to minimize the chances of bruises or excess bleeding.

What to Expect From a DAXI Appointment

Again, an appointment is similar to that of other injectables. “Your doctor will start by evaluating areas that would need the treatment, explain how it works, then inject it into the determined points,” Dr. Katz says. “After that, it will take about two weeks to kick in, at which point we’d schedule a follow-up appointment to ensure everything is symmetric and has settled nicely.” 

The small needle used to inject DAXI is pretty painless, if not totally sensation-less in the case that your doctor provides a topical numbing cream beforehand. Dr. Katz notes that sometimes certain muscles may not absorb neuromodulators fully if the muscle is especially active. If that is the case, he recommends waiting roughly two weeks to determine whether a touch-up injection is needed. “Once DAXI has kicked in, you’ll see that the muscles become more relaxed and that wrinkles caused by that muscle movement ultimately fade,” he adds. 


The aftercare with DAXI is pretty minimal: “In the early days of Botox, we used to tell people to limit movement in certain ways, but now, we don’t tell people to do any of those things because they ultimately didn’t affect the treatment,” Dr. Katz says. He just recommends waiting two weeks to evaluate the effects of the treatment and scheduling a follow-up appointment if a touch-up is needed.

DAXI Vs. Botox

The main difference between the DAXI and Botox (Dysport, and Xeomin) is how long it lasts. “Instead of having your treatment last about three to four months, we’ve seen that DAXI lasts a lot longer at about six to eight months,” Dr. Katz says. “Ideally, you’d be able to come in once or twice a year to get treated because of DAXI’s longevity.” 

Additionally Dr. Katz notes that, in his experience with DAXI for the FDA trials, he has noticed a smoother finish in comparison to other neuromodulators. “With some neurotoxins, there is a line of demarcation that shows you where the treatment ends relative to the surrounding areas,” he says. “DAXI seems to have a smoother transition from the treated area to the untreated area, from what I’ve been able to observe in treating patients during the trials.”

Potential Side Effects

Because DAXI paralyzes the muscle and prevents movement, Dr. Katz notes that if it is injected in the wrong area, there is a risk of ending up with a drooping eyelid or eyebrow, so it’s important to go to a practitioner who is versed in administering neurotoxins to ensure correct placement. “Some people have reported getting headaches after a neuromodulator treatment, but this is very rare, and it ultimately goes away,” he adds. 

The Cost

Though the final word on pricing will be determined once DAXI is greenlit by the FDA, Dr. Katz anticipates that it will likely be slightly more expensive than Botox to align with the longer-lasting effects—but hopefully not by much. 

Final Takeaway

If you’re familiar with Botox and its counterparts, but often wish you could stretch the time between treatments, DAXI might be a very promising option for you—especially considering that, according to Dr. Katz and the evidence presented in the clinical trials, it can be used in the same ways other neuromodulators are currently utilized. “People with a busy lifestyle who don’t have time to come in to be treated three to four times a year, as well as those who simply want a longer wear time would be great candidates for DAXI,” Dr. Katz says. 

And honestly, doesn’t that apply to most of us who have settled into a Botox routine and wish we could stretch our doctor’s masterful handiwork over a longer time frame? If you’re new to neuromodulators and injectables as a whole, Dr. Katz recommends starting with an entry-level option like Botox to see how your body reacts to the treatment before considering DAXI, which he anticipates would be the next move for those who have already tried other iterations of neurotoxins and want to upgrade their routine. 

That said, if you need us, we’ll just be patiently awaiting that FDA approval so we can go ahead and schedule our DAXI appointment. 

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