Hate injections? Is there a “Botox cream” alternative, and will it work?

Can you use an injection filler in a cream based product? I hate injections. What is in Botox, composition? – Sandra

Dear Sandra,

I think we’d all love a way to get the benefits of these neurorelaxers (my own term for Botox/Dysport/Xeomin etc), without the needles. I dislike the term neurotoxin (medical term), because it implies something is being “poisoned.” Which it isn’t. Of the hundreds of uses that have medical benefit, they all involve temporary relaxation of a muscle group. It’s interesting that you ask this, because many people dislike needles. I’m not sure I know anyone who loves them. 🙂 Many people want to get Botox, but are afraid of the injections. Hence the rise in products claiming to be Botox cream alternatives. There is a “Botox” cream in development, but not yet FDA approved. I am hesitant to buy-in to the idea of a Botox cream alternative to injections, though.

A topical Botox cream is unlikely to be a substitute for most injections for Botox/Dysport. Here’s why:

  • These compounds are very large molecules, and difficult to get into the skin in a cream. You can’t just mix a little liquid neurorelaxer with a little cream and have it get where it needs to go.
  • These (neurorelaxers) all relax the muscles they are injected into. They bind to the attachment of the nerve to the muscle. And then temporarily block the nerve from activating the muscle. Makes sense I hope.
  • The injections need to be exactly in the right place, or problems occur. For example, if Botox/Dysport is injected in the wrong place on the forehead, you can’t open your eyelid temporarily. If it’s injected improperly into the lower face, you would look as if you’d had a stroke. So imagine a cream for this. How would it be as precise?
  • If this product worked it’s way into homes through the internet, it scares me to think children could get a hold of it.

The problem with bootleg and fake products online:

The problem with bootleg products on the web is getting worse and worse. There are tons of products claiming to be or do something that there’s no science to support. These are impure, fake and sometimes lethal pharmaceutical products, created in sketchy factories, and packaged to look just like the real thing. Scary! You are all smart women/men and I think you see the issues.

On a personal note, my husband was out of town recently and ran out of his SkinCeuticals Physical Fusion water resistant sunscreen, which is great for swimming. We were temporarily out in our products on this site, so he ordered it from Amazon. When he got it, the packaging was perfect, and the product was completely different. It was fake! When we looked at the packaging really closely, we could tell some subtle differences. Someone had gone to a lot of trouble to mimic the real SkinCeuticals packaging. So, buyer beware! Please buy from reputable sources. On our skin care product shop, we buy products direct from the brand to ensure validity.

Skin Care Recommendations for those Averse to Botox Injections

There is nothing like Botox or Dysport to relax a deep line of expression, like a frown line. But if you are looking for good skin care products and have mild lines to treat, here are some recommendations on my article here. For those over 40 with more severe wrinkles to treat, your best bets are: Botox, fillers, Sculptra, and lasers.

Hope this helps, Dr. I

8 Beauty Products That Are Just As Good As Botox

The wisdom that comes with each passing year is great—but we prefer to achieve it without the accompanying wrinkles. And while we’re known for trying out-there approaches to getting rid of fine lines, even we can hit our limit. Botox may be a simple fix for some, but for others, a needle anywhere near the face is just flat-out stressful. To cut back on your chances of a full-blown beauty-induced panic attack, we’ve rounded up eight Botox alternatives that’ll smooth your lines from the comfort of your own home.


What Lines?

This clinical-strength ferulic acid and retinol peel retextures skin, supports collagen production, reduces the look of wrinkles and restores the feeling of firmness.

Not only does this eye gel tighten and smooth fine lines, it also reduces the appearance of bags and dark circles. Win-win.

Use the SPF day cream to prevent and reverse damage caused by the sun. Then, let the night cream fight wrinkles caused by gravity and aging.

This drugstore favorite promises results like firmer skin and fewer wrinkles in just one night.

Packed with sea mayweed, which the brand calls a natural alternative to Botox, this serum claims to relax facial muscles and prevent fine lines and wrinkles before they happen.

The glycolic acid in this moisturizer reduces the appearance of fine lines and wrinkles, while also making skin look smoother.

Get dermatologist results at home with this powerful duo, and bid those wrinkles adieu.

Ingredients in this cream fend off signs of aging—hyaluronic acid hydrates and vitamin E fights free radicals for glowing, youthful skin.

Botox in a bottle reviews

Ageless, smooth, wrinkle-free skin is the holy grail of many, and with good reason as many of us try to reduce or eliminate signs of aging. Some now call it the 90 second wrinkle eraser. Many have resorted to regular trips to the doctors office for botox injections but these days there are viable products you can use right at home. “Botox in a bottle” has become a favorite way to describing these but we should say, right up front, that you won’t actually find any Botox in any of these bottles. We provide a Botox in a bottle review below but for a bit more about Botox, we also provide a detailed and thorough review of 36 Plastic Surgery procedures, of which one is Botox, here in our “Is Plastic Surgery Worth It” article.

What is Botox and why isn’t it in a bottle?

Botox is the short name for a drug that is made using, in part, Clostridium botulinum. Sounds ominous, and it is. This is the same toxin that causes a type of food-poisoning that is often life threatening call botulism. So what’s it doing in needles and why are doctors injecting it into people’s faces? Well, a side effect of it, when used in very small doses, is that it does a great job of freezing the skin temporarily. It has been deemed safe when used in this fashion and has become the standard of choice for quick-hit wrinkle removal as well as making lips look fuller.

But why isn’t it in any of these bottles? Because, as you would expect it is a controlled substance and not easily obtained nor is it easy to get approval from all of the government agencies that inspect these things. It’s far easier to use other, easier to obtain and get approval for substances that come very close to mimicking the results of actual Botox. So when you hear the term “Botox in a bottle”, the ordinary approach is a Botox injection but in these cases it isn’t really Botox but a cream or spray or something along those lines that will give you results much like a Botox injection would, but without requiring a trip to a doctor’s office and for far less money.

How much does Botox cost and how long does Botox last?

Botox injections, on average, can run between $250 and $500. This is dependent on the depth of the wrinkles to be removed as the cost is typically “per unit”…so deeper wrinkles will require more units than shallow wrinkles. Where you are also affects this…you’ll pay more for a Botox inject in New York than you will in Raleigh, for example. You can do a bit more research on costs on our Cost Estimator page.

The other corresponding issue here is how long does it last. This depends largely on how your body assimilates the Botox and how perfect you want the skin to look. Some customers have Botox injections quarterly…some every six months. This is something you’d want to talk to your doctor about.

What goes into these Botox in a bottle alternatives?

Creams, lotions, sprays, etc. There are quite a few on the market these days that do an amazing job. The downside to these is that they don’t last as long as a Botox injection…you’ll be using it daily or so. But you’re putting lotion on your face already anyway, this would be just an extra step when you are getting ready to step out.

Reading the ingredients of these offerings is a dizzying exploration into various combinations of herbs, fruits, teas, and other more scientific applications. As a quick example, here’s a partial ingredient list for one of them:

  • Organic Aloe leaf juice
  • Organic Shea butter
  • Organic Jojoba seed oil
  • Organic Grape seed oil
  • Hyaluronic Acid (we’ll talk about this a bit later)
  • Caffeine
  • Xanthan Gum
  • Sorbic Acid
  • …and about 20 others.

I think you get the picture though, it’s a combination of healthy “things” all rolled into one to help you get rid of the crow feet wrinkles. We could argue, maybe convincingly, that the key ingredient is Hyaluronic Acid. It’s not unlike going on a diet and eating all of the suggested foods they sell you on the diet plan but also applying the “drink 8 glasses of water a day” advice. The water is the key…the hinge-pin upon which just about any weight loss plan will work. Hyaluronic Acid is about the same…it’s the hinge to making this work.

Hyaluronic Acid (HA)

Hyaluronic Acid is naturally occurring in your body but it’s one of those “more is better” things. Acting as a magnet for moisture and with the ability to regulate that moisture within the cells without drowning them, HA is instructive in ensuring cells receive and hold the water they need to thrive and to live. This results in plumper, smoother, more full cells. Sound familiar?

The science side of this is interesting – I’ve not tested this out but allegedly a single gram of HA can hold up to six liters of water. Not a great visual for your face…who wants six liters of water on their face…but the underlying implications are clear. This is strong stuff and it attracts and holds a lot of water – if water is the essence of life, then this kind of hydration is a kind of face lift in and of itself.

Of course, water is the magic of life and if your cells have the water they need to thrive, everything works (and lasts!!) longer. Your skin will be more beautiful and for longer when you include HA into your daily regimen.

If you take a minute to look at the creams you are already using, there’s a good chance you’ll find HA listed among the ingredients. If not, it’s not a terrible idea to look for this the next time you purchase.

Where can I buy Botox in a bottle?

Undoubtedly, from your plastic surgeon. Most see the advantages of this approach and carry a good supply of highly recommend products. But, you can also purchase a vast variety of Botox in a bottle Amazon style, as you might expect. When looking on Amazon, Botox in a bottle products are found to be quite popular, well received and have a healthy number of reviews which are always a good source of additional information about any product you are considering.

What are some viable alternatives to $500 Botox injections every other month?

The below items are excellent products in every way and they are backed by excellent companies. You can find more information by researching phrases such as “90 second wrinkle reducer”, “botox in a bottle” or perhaps “liquid Botox in a bottle’…whatever it’s called, it pretty much falls into the category of skin treatment (lotions, creams, etc) that has added properties to tone up the skin, smooth out wrinkles, or provide a plumper look.

Taking a look at the Amazon listing for these items, you’ll find an extensive review list and, importantly, a lot of back-and-forth questions and answers between shoppers and the manufacturers. These are not products that have been thrown up on Amazon with the hope that somebody will buy – these are products that are actively supported by the manufacturers as evidenced by the amount of interaction.

Let’s take each one of these in turn:

TruSkin Naturals Vitamin C-Plus Super Serum

Anti Aging Anti-Wrinkle Facial Serum with Niacinamide, Retinol, Hyaluronic Acid, and Salicylic Acid, 1 oz by TruSkin Naturals

I’ve added this one in the top spot simply because I love not only the reviews on Amazon but also the answers provided by the manufacturer to folks asking questions on Amazon. This has a very strong customer rating with over 1,700 reviews AND with 170 questions that have been answered. Great feedback and interaction from the folks at TruSkin.

You’ll notice the ingredients include Hyaluronic Acid – no surprise there given what we discussed above. You’ll also see Salicylic Acid listed which is another oft used ingredient in many plastic surgery recovery products and other skin care products as a oil-soluble exfoliant. And with all TruSkin products, this is ‘cruelty-free’…it is not tested animals and contains none of the nasty stuff you find in a lot of over the counter offerings these days such as artificial fragrances, corn, soy or GMOs.

You can find TruSkin Naturals Vitamin C-Plus Super Serum on Amazon here.

Eve Hansen Hyalaronic Acid Serum (2 oz)

Ultimate Hydrating Serum, Face Moisturizer, Wrinkle Filler and Natural Plumper | The Natural, Cruelty Free, Vegan Anti Aging Serum by Eve Hansen

Again we see Hyaluronic Acid right in the name of the product – with good reason. Also notice the description of “wrinkle filler” and “natural plumper”….both explained earlier when we discussed the benefits HA brings to the table.

As with the others, this one is chosen to be featured because of it’s excellent reviews and the amount of interaction with the vendor. The fact it is also an Amazon Choice winner is icing on the cake.

You can find Eve Hansen Hyalaronic Acid Serum on Amazon here.

Jeunesse Global – Instantly Ageless Facelift in a box

1 Box of 25 Vials by Jeunesse Global

No Hyaluronic Acid here so a bit different than others. This one is positioned as helping with the under eye bags but also in firming up loose skin. We’ve all see the late night commercials with the unfortunate folks that have eye bags as big as actual saddle bags and the miracle cream that makes them disappear while filming. Well, that’s not what this is. Just want to clear up any confusion on that point. But, what this is is a mixture of ingredients that form a cream that is quite good at doing exactly what the product says it will do. Namely, tighten up loose skin and diminish the appearance of fine lines and wrinkles. This Botox in a bottle instantly ageless facelift is quite popular and has received more reviews than the others.

With over 2,000 customer reviews and a strong rating, coupled with a large amount of Q&A, you can see that this is a product that will be here awhile. They are not trying to cash in but rather are dedicated to providing and supporting a solid product.

You can fine Jeunesse Global Instantly Ageless Facelift in a box on Amazon here.

Yeouth – Hyaluronic Acid Serum for Face

100% Pure Clinical Strength Anti Aging Formula! Holds 1,000 Times Its Own Weight in Water, Plumps and Hydrates Skin, Reduces Wrinkle -All Natural Moisturizer by Yeouth

We are back with another offering that uses Hyaluronic Acid. At this point, it should come as no surprise. Notice the mention of holding 1,000 times it’s weight in water – this goes to what we discussed before. A gram of HA can hold six liters of water. Seems excessive but that’s the strength of the offering the HA brings to the table. ‘

With over 1,000 customer reviews and a strong a very strong customer rating, coupled with a large amount of Q&A, Yeouth has fielded a product here that can and should be in your daily repertoire of face care products.

You can find Yeoth Hyalaronic Acid Serum for Face on Amazon here.

Botox Injections

If you haven’t had them yet, it is natural to wonder about what a Botox Injection looks like…how it happens. Two videos below show this live, one man and one lady getting injections. It’s pretty clear that process isn’t painful as the guy never flinches (or wakes up?) and the lady smiles after.

It is important to note that there has been scares in the past with counterfeit versions of Botox finding it’s way into Doctor’s offices, but this is a few years in the past and with the rise in popularity, the processes are much more regulated these days. By the same token, the FDA has recently approved a rival approach to treat forehead frown lines.

I hope you have gotten some good information out of the above. The landscape of the offerings of Botox in a bottle type of products is large and getting larger. It’s important to fully understand them to make the most informed decision and what we provided here is intended to help you with just that.

As always, if you have any questions or comments about any of this, please don’t hesitate to reach out.

New Long-Lasting Alternative to Botox is On the Way

A new product currently known as “RT002” is being developed by Revance Therapeutics as a long-lasting alternative to Botox.

Also known as Daxibotulinumtoxin A, this product is injected into the target muscles just like Botox, but is shown to last up to 6 months instead of the 3 to 4 months that Botox lasts. This means patients will have to come in less often for their treatments, and it will be easier for them to maintain their results.

This also means that you can time your treatments along with your filler touch-ups and get everything done in one visit twice per year.

RT002 is currently in Phase 3 clinical trials. Once the studies are complete, the product will enter Phase 4 where it has the potential to be approved by the FDA for public use.

In a study with more than 2,500 patients, Revance Therapeutics expects to show that their product is just as safe as Botox, but can last twice as long. They plan to enter into Phase 4 by early 2019, which would mean the public release date will be some time in 2020.

RT002 is currently being studied for cosmetic use but could be used to treat any of the same conditions that Botox is currently used to treat. Botox Cosmetic is FDA approved to treat the glabella (lines between the brows), crow’s feet, and forehead lines. Botox is also FDA approved to treat many medical conditions, including hyperhidrosis (excess sweating). Treatment of hyperhidrosis currently lasts about 6 to 12 months with Botox. Hopefully, RT002 will double that as well, leading to a 12 to 24-month benefit for the treatment of excess sweating.

Many times products like this are purchased by more established cosmetic companies, like Allergan, the maker of Botox. That is what happened with Kybella!

We will have to wait and see if Allergan or one of its competitors will purchase RT002 or if it will stay with its own company, Revance Therapeutics. Either way, we will keep a close eye on this product, also known as Daxibotulinumtoxin A, as it becomes available to the public.

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New BOTOX Alternative, Jeuveau™, Coming Soon!

Proven Results From Jeuveau by Evolus

An exciting possible benefit is that Jeuveau could last longer than other wrinkle relaxers. During head-to-head clinical studies, many subjects receiving Jeuveau reported a slightly longer duration of effect.

The First New Neurotoxin in a Decade

It has been ten years since the last neurotoxin came on the market. BOTOX Cosmetic was approved in the early 2000s after decades of medical use for patients with blepharospasms. Jeaveau’s proprietary and manufacturing process is completely unique. Patients will have more options for the improved appearance of frown lines.

Which Injectable Wrinkle Relaxer Is Best For Me?

Just like with any other injectable treatment, our recommendations and guidance will largely depend on what will give you the best results for your unique needs and goals. We determine these during your personalized consultation. During this consultation, we evaluate and discuss your specific aging concerns, go over your medical and health history, and examine your skin. This helps us decide which treatment(s) are right for you. If Jeuveau is part of that personalized treatment plan, then we will proceed with injections to help you look younger and more refreshed. Otherwise, we will make other recommendations from our collection of injectable anti-aging treatments.

When Will Jeuveau Be Available at Skin by Lovely?

Jeuveau was FDA-approved in early February 2019. We expect to offer this new treatment to patients sometime in May. Please contact us for information about our current treatment offerings and whether or not Jeuveau is available at your preferred Skin by Lovely location. We will be the first office in Oregon carry Jeuveau in both Portland and Lake Oswego. Our Santa Monica, California practice will also carry Jeuveau.

Do you have more questions? Fill out the form below to contact us with any questions about this treatment or call us to get more information about Jeuveau and other wrinkle relaxers like Botox, Dysport, and Xeomin. We look forward to assisting you.

I Tried the *Other* Botox and This Is What Happened

The iconic Botox is not the only show in wrinkle-smoothing town. Most people don’t realize it, but there are two other almost identical injectables you can request from your dermatologist’s office called Xeomin and Dysport. The three are competitors in a class of drug called a neuromodulator. “Botox was the original one and has become the generic term, like Kleenex or Coke,” explains New York plastic surgeon David Shafer when I visited his office (he’s a favorite of Coveteur staffers for their own treatments). “But Botox, Xeomin, and Dysport all work by very similar mechanisms: You inject it; it blocks the signal going between the nerve going to the muscle so the muscle can’t make the wrinkles.” All three brands take about three to five days to kick in and are said to last for about three to five months.

“Molecularly, at the core, they’re all the same,” says Shafer. “Think about an M&M. They all have the chocolate in the middle, but they’re all different colors with a different shell. Botox and Dysport both have a thick shell around the molecules, and that’s what protects it as it goes into the body. Xeomin differs because it doesn’t have the shell; it’s the raw kind of protein that you inject.” (Xeomin is also the one Christie Brinkley gets.)

This is why I’m in the surgeon’s 25th-floor office looking out over midtown Manhattan. What I’ve heard over the years—and Xeomin has been in the U.S. since 2010—is some people really like that Xeomin seems like a more “clean” formula. And, having tried and liked Botox about three times, I figured I could explore something new. “One advantage is that there are fewer molecules for your body to have a reaction to,” says Shafer. “It’s very rare to have a reaction, whether it’s any of the three brands, but if it’s someone who tends to have a lot of allergic reactions or sensitivities, Xeomin might be a good one to start with because there are less proteins around it.”

While I don’t have any sensitivities to Botox, there are a few other reasons I wanted to try out Xeomin. I wanted to see if it might kick in a little faster and possibly look a little different. “There’s no study proving that one works faster than the other, there’s some anecdotal experience one might work a little faster and some people think the Xeomin looks a little softer,” says Shafer. “But it’s different for different people. Everyone has different concentrations of different enzymes in their body, and it’s all interacting differently.” And with that, the tiny needle pricks went into my forehead, around my eyes, and a little in the muscles underneath the sides of my mouth (this is technically an off-label use, but it helps lift the corners of your lips up just a teeny, tiny bit). I can report it hurts just as much in the moment as Botox does—I’d compare it to teeny fleeting bee stings.

The big question is, of course, are non-Botox alternatives cheaper? The answer is: not really. The price varies mostly by how much your injector charges. You might find there is a difference in “frequent flyer” type programs and promotions offered by the different brands, but the truth is it will all cost in the $500 – $1,000 range (that’s a very rough estimate) depending on how much is used. One thing to keep in mind: The cost of the drug is per unit, which makes the drug like Dysport appear cheaper, however, you will require more units of Dysport than Botox or Xeomin, so by the time you hit the cash register, you’re looking at pretty much the same bill.

Finally, another difference (though this is more relevant to the doctor themselves) is that while Botox and Dysport need to be refrigerated, Xeomin does not. This makes it a little easier for a doctor to travel with Xeomin in their bag and less likely for the product to go bad if there were, say, a power outage.

So did I feel or see a difference? I do think my Xeomin kicked in about two days faster than Botox. Usually, I know my Botox is all kicked in by about the week mark, maybe five to seven days. In this case, I got injected on a Friday afternoon, and during my Monday afternoon meetings I could feel some of the muscles starting to tingle and freeze, which is that telltale sign. Whether it will last longer is TBD, but I metabolize Botox pretty fast—usually three months. As for how I feel about getting neuromodulators in general, let me point you to the brilliant essay by Frances Dodds about the inherently anti-feminist “aging gracefully” sham we should all be privy to before we make decisions about what we do with our beautiful faces. I like how I look with Botox, Xeomin, or absolutely nothing at all.

Want more stories like this?

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The Secret to Better Botox Might Be about the Nurse
Meet New York’s Queen of Injectables

Botox cream for wrinkles

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