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What Are the Best Botox Alternatives?

Not so sure I want to try Botox.  Are there good alternatives that will help me get rid of wrinkles on my forehead the same way Botox does? 

Doctor Answers 78

While there are no medication alternatives to Botox,...

While there are no medication alternatives to Botox, there are procedures which can be done as alternatives to Botox treatment for the lines between the eyebrows.

Lines between the brows can be divided into those that are present at rest or even after Botox administration and those that are created with frowning (muscle motion). Botox will paralyze the muscles and stop the lines created with muscle motion and soften the lines present at rest due to resting tone of the muscles.

For those lines which are present even with Botox administration or at rest, there is an alternative in the Surgiwire procedure. These lines are created by adhesions between the skin and deeper structures. By releasing these adhesions, the lines can be softened or even erased.

Lines between the brows which are created with frowning are due to two muscle groups in the forehead - the procerus and corrugator muscles. An alternative to Botox is removal of these muscle groups which can be accomplished through an upper eyelid incision. While a surgical procedure, it can produce permanent results and end up being cheaper than repeated Botox administration.

Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Botox alternatives are Dysport, PureTox, Myobloc

There are no real alternatives to Botox except other forms of Botulinum toxin A (the active ingredient in Botox).

Botox and Botox Cosmetic is made and distributed by Allergan, Inc. The vials contain the identical medication. There are medical conditions that benefit from Botox.

However, insurance companies don’t pay for cosmetic treatment. To keep things simple, Allergan elected to market a product that was clearly labeled cosmetic to keep things straight. In France, Allergan markets Botox Cosmetic under the name Vistabel.

Medicis Pharmaceutical Corporation, the maker of Restylane and Perlane, will soon be bringing to the United States market a Botulinum toxin A product called Reloxin, currently available in Europe as Dysport. This product has not received FDA approval, which is expected soon. When it is received, Reloxin will compete directly with Botox in the US market.
A third company, Mentor Corporation, is investigating another Botulinum toxin A product under the name Puretox. It is not known when this product will reach the market.

There is also a Botulinum toxin B product available in the United States under the name Myobloc and elsewhere as NeuroBloc. This product is distributed by Solstice Neurosciences and is primarily used for medical conditions and not cosmetically.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.5 out of 5 stars 21 reviews

Best Botox Alternatives

Dysport, which has a similar molecular structure to Botox is considered to be an altenative. It works in much the same way, but keeping muscles in a relaxed state so that they not contribute to the development of wrinkles.

Based on your question, though, it seems that you may want to also consider dermal fillers to minimize the appearance of wrinkles on the forehead. Instead of targeting the nerves and the muscles, dermal fillers like Juvederm and Radiesse will fill in the lines. These are particularly helpful for deeper lines.

If you are a candidate for Fraxel Repair or Fraxel Dual, you may want to consider cosmetic lasers for fine to moderate lines that are etched into the skin. Lasers apply heat energy to help your skin create new collagen fibers. Collagen contributes to the overall firmness of the skin.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 27 reviews

Alternatives to Botox

The biggest competitior, at the moment,  to Botox, manufactured by Allergan, is Dysport, manufactured by Medicis.  Both are injectable neurotoxins.   Dysport has been shown to have a quicker onset.  It may last longer, as well.  Brow lifts, a procedure generally done by plastic surgeons, are also available but are considerably more invasive.  If you have a lot of sun damage and loss of skin elasticity, sometimes addressing the skin texture results in improvement of the forehead lines.  You moved your forehead when you were younger but the skin snapped back so you likely did not have lines on your forehead at rest.  That's because the skin was more elastic.

Dina D. Strachan, MD
New York Dermatologist
3.5 out of 5 stars 10 reviews

Radiofrequency Nerve Relaxation referred to as No-Tox is an alternative

Botulinum Toxins such as Botox and Dysport work by stopping nerve transmission signals to the muscles which produce frowning and wrinkles.  In eyelid surgery and brow lift surgery, methods are used to interrupt the nerve transmission and produce similar results.  Our clinic uses a minimally invasive procedure to soften the wrinkles of the entire forehead region by  applying a small needle to weaken the nerve transmission to the muscles.  

This procedure lasts between 1-2 years when performed properly for the right candidate.  Our clinic has success with over 100 patients treated to date from many different states and countries.  The procedure can be performed in the clinic with mild sedation or as an adjunctive procedure with eyelid or facelift surgery.  

James Newman, MD
Bay Area Facial Plastic Surgeon
3.5 out of 5 stars 7 reviews

There is no substitute for Botox or Dysport

When it comes to wrinkles/lines that are created from muscle movement such as we see on the forehead and in the crow's feet area, there really is no substitute for Botox. Nothing else can relax the muscles that causing the problem.

I hope my answer was helpful.

Steven E. Rasmussen, MD, FAAD
Austin Dermatologist
5.0 out of 5 stars 3 reviews

Botox Alternatives: Dysport and Xeomin. NOT fillers.

Botox, Dysport, and Xeomin all work the way Botox does, because they are all the same botulinum toxin A protein, wrapped in different carrier proteins. This is the only injectable treatment that will allow the muscles under the skin to relax so the wrinkles can soften over time. No cream can achieve the same result, and no filler like Restylane or Juvederm should be used in the forehead. 

The only other option for smoothing forehead wrinkles is a surgical brow lift, which involves a plastic surgeon or facial plastic surgeon using general anesthesia to lift, trim, and reattach the forehead surgically. This is a significant surgical procedure so I recommend having many consultations before proceeding.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
5.0 out of 5 stars 42 reviews

Alternatives to Botox for the Forehead lines

Forehead lines develope early in life for most of us. A portion of the activity is related to expression, especially when we are younger. As we begin to age the heaviness builds up along the upper eyelid area, a lot of people will begin to raise their brows in an attempt to lift the heaviness off of the eyelid. This can result in alot of forehead lines. In these patients being evaluated by a cosmetic surgeon will help to determine if a brow lift or upper eyelid blepharoplasty is helpful. For the younger patient with expression lines, a filler may be helpful in softening the lines. The hyaluronic acid fillers are the most common choice for this purpose. The end result is generally improvement, but will not achieve the smoothness that occurs with a botulinum toxin.

 Laser resurfacing may be an option as well, a surgeon can explain the pros and cons and if it would be an appropriate treatment for you.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Botox wrinkle reduction alternatives

Dysport is an alternative to Botox which does basically the same thing. It does require injections like Botox so if your not wanting injections, this will not fit your need. But, you can go to the Botox main website and see the Botox Treatment Visualizer to get an idea how you might look with Botox.

Fernando G. Serra, MD
Clermont Plastic Surgeon
4.0 out of 5 stars 8 reviews

Botox and its alternatives

Hi there-

Botox and Dysport, the newest FDA approved neurotoxin, are both effective ways to reduce the muscle movement and therefore smooth the wrinkle that is present or prevent further wrinkling.

Botox has been FDA approved since the early 90's and is the most common cosmetic procedure performed worldwide. It has a 98% satisfaction rate.

This statistic is reassuring because if there were significant associated risks it would not be used with the frequency that it is.

Laser resurfacing is another option that can smooth existing wrinkles. Fractionated co2 laser resurfacing (we use the Mixto) is a relatively quick and easy procedure that will soften existing wrinkles.

Laser will not prevent further wrinkling but can increase collagen production to help keep them softer looking. The recovery time is about a week.

There are NO creams or exercises that will give you a similar improvement.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.