Featured Expert
Dr. Jody Comstock, a board-certified dermatologist in Tucson, Arizona
I first heard about Daxxify, the latest in a string of Botox competitors to hit the market in recent years, back in 2022, and as a beauty editor and aesthetics nerd, I couldn’t help but feel excited about the new injectable. Although I had been getting Botox for years and had no complaints with my results, I knew how quickly my body metabolized the neuromodulator—by the three-month mark, the effects had routinely worn off, and my full movement was restored. So, when I learned that Daxxify not only promised to kick in faster and look more natural than other toxins but was also said to last up to twice as long and have a gradual fadeout, I was convinced I had to try it.
After years of development and a lengthy FDA approval process, the injectable finally arrived in doctors’ offices in early 2023, and when I was invited to try Daxxify firsthand last February, I jumped at the opportunity. The doctor I saw began injecting my glabellar lines, between my brows, as well as my upper forehead and crow’s feet. She raved about the results she’d seen so far with Daxxify and explained how, despite the higher price tag (roughly 50% more than traditional neurotoxins), her patients were rushing to try the new product.
What my first Daxxify treatment was like
I left the office eager to see my injections in action, and although I wasn’t expecting to see any effect until five days or so in, to my surprise and delight, the Daxxify started to kick in the following day. In the weeks that followed, after it reached its full effect, I was increasingly happy with my results. I had that same familiar paralysis of my muscles, while still maintaining a natural look and some movement, and my skin even appeared smoother.
But my initial satisfaction with Daxxify soon turned to disappointment when it began wearing off about a month and a half after my treatment. By mid-April, the Daxxify had disappeared completely, meaning that it not only fell short of its lofty six-month claims but it didn’t even last the three months I’d historically gotten out of Botox, Dysport, and Jeuveau.
Just as my high hopes for Daxxify faded into oblivion, so too it seemed did those of the larger aesthetics industry, as patients and providers grew weary of its claims to last longer and concluded that it was not worth the higher price tag. Revance Therapeutics, the pharmaceutical company behind Daxxify, took note. In the year since the neurotoxin came to market, its focus has completely shifted, and there’s now a whole new approach to both its marketing and its actual injection. While the makers of Daxxify still claim it’s “long-lasting and keeps frown lines smoother with the convenience of as few as two treatments per year,” they have made sure to better clarify what this means.
Daxxify’s claims, explained
Unlike other popular neurotoxins, which tend to have an overnight fadeout and wear off seemingly all at once, Daxxify slowly softens over time, a difference that may have contributed to some of the disappointment patients felt when trying it for the first time.
“When you’re familiar with other neuromodulators, your expectations are set by those,” explains Dr. Jody Comstock, a board-certified dermatologist and paid Revance consultant in Tucson, Arizona, and the top user of Daxxify in the country. “So, when people tried [Daxxify] for the first time, they were thinking in those terms around when they expected it to kick in and how it would behave, and with the early messaging that it was going to last longer, patients and clinicians expected it to be in full effect for that time.”
When some of Dr. Comstock’s Daxxify patients came in for follow-up appointments three and four months after treatment, many thought that it had worn off, but when she compared their movement to their expression photos take prior to injection, it seemed the toxin had actually just worn off slightly, roughly 25 to 50%. “What we noticed that was so different was that while Botox and other products have a steady nosedive of going away, Daxxify would sort of plateau at three to four months and oscillate for another few months,” she adds.
There’s also been renewed focus on Daxxify’s effect on skin texture, its quick kick-in time, its ability to increase facial symmetry, and even its peptide formulation, a departure from most neurotoxins’ use of human or animal byproducts. “Daxxify, more than the other neuromodulators, makes brows symmetric, and what we noticed in our expression photos of patients was that even when you were only injecting the glabella area, the other muscles on the face softened, almost like there’s a communication between them that when you don’t have to pull so much on one side, you don’t have to pull so much on the other,” Dr. Comstock says. [Editor’s note: No studies have been done to show that Daxxify outperforms other neuromodulators in regard to achieving facial symmetry.]
However, even with these advantages, Revance was very aware of the uphill battle Daxxify faced to convince patients and providers, to give it a second chance. That’s why it removed the foremost barrier to entry: its higher price tag. As of November, the injectable is now sold to clinicians at the same price as Botox and other neuromodulators. And while the eventual cost for the patient varies from provider to provider, depending on factors like their location, expertise, and demand, most doctors say they are offering Daxxify for the same price as other toxins.
Why I gave Daxxify a second chance
After hearing about all these changes in recent months, I decided to give Daxxify another try. In late February, I once again had the neurotoxin injected into my glabella, forehead, and crow’s feet, hoping for the best. As she placed injections around my face, Dr. Comstock stressed just how much technique matters when it comes to Daxxify and how it will perform. When injected at the head and tail of the corrugator, the C-shaped muscle around the eyebrow, notably a bit lower than other neuromodulators, Daxxify will last noticeably longer, she told me. But less than half of providers were consistently using this technique in the neurotoxin’s early months. “That was really an aha moment,” says Dr. Comstock. “But a lot of people have since been able to change their technique to ensure patients are getting the best possible results.”
About a day and a half after my treatment, I was thrilled to notice I couldn’t move my eyebrows more than a centimeter or so, and in the days and weeks since, the effect has only increased. My skin has an overall smoother look, but my movement remains natural-looking, and I still have ample room to emote and react without looking frozen. Although it’s still too soon to say whether this go-around with Daxxify will last longer than last year’s attempt, I remain cautiously optimistic—and more importantly, my expectations for the toxin have shifted considerably to take into account the many differences between it and Botox. And with the same price tag as all the other neuromodulators, it feels like there’s really nothing to lose by giving it a shot.
