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 100

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
3.9 out of 5 stars 14 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
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Botox is best for forehead wrinkles

Botox and similar products (Dysport and Xeomin) are great at improving the appearance of dynamic wrinkles on the forehead. Fillers are not a good option for this area. Laser skin resurfacing may help, but it is more useful if Botox is first injected prior to the laser treatment. There really is no substitute for these muscle relaxing agents to get rid of thick forehead lines. I hope you find this helpful.

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 138 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
4.6 out of 5 stars 32 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
3.3 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, FACS
Palo Alto Facial Plastic Surgeon
4.0 out of 5 stars 10 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
4.7 out of 5 stars 30 reviews

Botox alternative

In the US, BOTOX is manufactured by Allergan, Inc. for both therapeutic and cosmetic use.

Dysport, a therapeutic formulation of the type A toxin developed and manufactured in Ireland, is licensed for the treatment of focal dystonias and certain cosmetic uses in the US and worldwide.

Lanzhou Institute (China) manufactures a BTX-A product, producing 50U and 100U type A toxin

Neuronox, a BTX-A product, was introduced by Medy-Tox Inc. of South Korea, in 2009.

The only thing that is an alternative in the U.S legally is Dysport

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon
4.9 out of 5 stars 9 reviews

Botox alternative with better longevity

A longer lasting alternative to Botox is GFX, which is a radiofrequency procedure that lasts approximately 1 year or more. This is due to ablation of the nerves which cause muscular contraction of the glabella (corrugator, procerus, depressor supracillii). Only one treatment is required.

Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 53 reviews

Alternatives to Botox

There really are no alternatives to Botox for forehead wrinkles. However, Botox injections are done with tiny needles that are quite painless, so you do not have to fear that it will hurt.  Give it a try! you will likely LOVE it!
Dr. Quenby Erickson

Quenby Erickson, DO, FAAD, FACMS
Chicago Dermatologic Surgeon
5.0 out of 5 stars 30 reviews

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.