The FDA has approved a new neuromodulator named Daxxify which is produced by the company Revance. Neuromodulators are those medications containing Botulinum Toxin (such as Botox, Dysport, Xeomin, and Jeuveau), which are typically used as a cosmetic procedure to reduce fine lines and wrinkles. What makes Daxxify different from the other neuromodulators is its longevity average of about 6 months (about twice as long as the other neuromodulators). The other neuromodulators last typically 3 months with some people getting 4 or 5 months.
The other aspect that separates it as unique is that it does not contain human or animal proteins (like some of the other neuromodulators) which are thought to induce a possible tolerance effect in some people over time. Specifically, it is thought that with repeated use, some people’s immune systems may attack a neuromodulator made from human or animal proteins believing it is a foreign invader. This would render Botox or Dysport for example, less effective. I have not seen many cases of this after injecting thousands of faces over the past 12 years, but there are some reported cases of this happening. The Daxxify is made from amino acid groups called peptides, which are likely what contributes to its longevity.
All neuromodulators including Daxxify work by binding to the muscle that creases the overlying skin upon contraction. Over time, these lines can become ingrained and be present even when the muscle is not contracting. The neuromodulators bind to the muscle relaxing it to the point that the lines in the overlying skin soften significantly.
Whenever a new product comes out on the market, I tend to wait to see if it meets my safety standards which may be more stringent than the standard. I would have to also use it on myself so I can explain how well it affected me and allow me to tell the patient what to expect.
During the approval process, in June 2021, the FDA identified quality control issues with a particular manufacturing facility which have apparently been corrected now that Daxxify is approved.
In terms of side effect profile, Daxxify has the same side effects as other neuromodulators namely headache, drooping eyelids, and facial asymmetry in a small percentage of patients.
What most providers are noting is that this may be a medication that may be best used after the injector has experience with the patient on the other neuromodulators and “knows” the patient’s anatomy. This is because if there are any undesirable effects, the patient won’t have to endure them for half a year. The benefits of a longer-lasting neuromodulator are fewer visits. At the time of this writing, the price point has not been established, but it should be ready for use in 2023.
