Botox alternatives: Do they work? Derms weigh in on the best ways to fight wrinkles
Since entering the beauty scene in 2002, Botox injections have become the holy grail of modern anti-aging skin care, a must-have aesthetic treatment for those looking to reduce the appearance of fine lines and deeper wrinkles and create more youthful-looking skin overall. Botox is the most well known of a family of cosmetic neurotoxins — others include Dysport and Daxxify — that, once injected into the skin, temporarily relax the muscles of the face, smoothing forehead lines and crow's feet as they go. Adding to the treatment's popularity is the (relatively) low point of entry: An average session costs around $350, depending on your state, and results can last between three to six months. Though neurotoxins are safe and effective for most, not everyone is comfortable with the (rare and/or mild) risks associated with them and the regular upkeep and cost. Because of this, we see more and more anti-aging beauty products marketed as "Botox alternatives" — even if these claims, according to dermatologists and skin care experts, are lies."One of my biggest pet peeves is when you see a product — a serum, moisturizer, etc. — and it says 'better than Botox' or 'you won't need Botox anymore…' This is very misleading," says Kristin Gunn, celebrity aesthetician and owner of Halcyon Skincare and Beaux Medspa in Austin, TX. "There is literally nothing in the world that does the same thing [as Botox]. Nada. Zero. Botox [and other neurotoxins like Daxxify] works by literally stopping you from making the expression that is creating a wrinkle. For instance, raising your brows all day is folding the skin and creating creases — and wrinkles. When you Botox your forehead, you stop the skin from creasing. There is no product in the world that will do the same thing. There are many products that claim to, but it's physically impossible.""Yes — unfortunately — there are no true alternatives to Botox," says Dr. Katie Mann, founder of the med spa Curated Medical in Scottsdale, AZ. Mann, along with every other expert I spoke with for this story, explained that while nothing on the market will have the same effect as Botox, focussing on quality skin care with specific, clinically-proven ingredients — and, if your budget allows, in-office dermatological treatments — can help lessen the appearance of wrinkles."If you're looking for a smoother appearance with fewer fine lines without using Botox, the most effective approach is to combine treatments," says Paula Brezavscek, founder of Miami's Azala Skin Clinic. Along with religious use of high-SPF sun protection and complexion smoothers like micro-needling, Brezavscek recommends "a consistent, at-home, medical-grade skin care routine."For those who want to slow the signs of aging and maintain more youthful-looking skin without injecting neurotoxins, here's the full list of at-home therapies and treatments that Brezavscek — and other skin-care specialists — prescribe.
Update, Feb. 4, 2025: We checked all prices and availability.
You've probably seen the term "peptides" in product ingredient lists, but, if you're like me, haven't really known what it means.
"Peptides are small chains of amino acids, which are the building blocks of proteins. In skincare, peptides are used to mimic natural processes in the skin and encourage anti-aging effects like collagen production and improved elasticity," says Boston board-certified facial plastic surgeon Dr. Akshay Sanan. "Peptides stimulate collagen production. As we age, collagen production declines, leading to wrinkles, sagging, and thinner skin." Sanan explained that peptides send messages to skin cells, in effect "telling" them to produce more collagen, elastin and other structural proteins to keep your skin firm and plump.
"Peptides also strengthen the skin barrier — the outermost layer — protecting against moisture loss and environmental damage, Sanan says. "Peptides can actually have a 'botox-like' effect by relaxing facial muscles and reducing the depth of wrinkles caused by repetitive movements. Lastly, peptides like copper peptides have antioxidant properties, protecting skin from free radical damage caused by UV exposure, pollution, and stress."
And according to Brezavscek, "Peptides signal to your skin to repair itself, boosting firmness for a smoother complexion. They also promote a beautiful, radiant glow, leaving the skin looking healthier and more vibrant."
For the past decade, retinol — one of many vitamin A compounds known as retinoids — has been among the buzziest ingredients in anti-aging skin care. And for good reason — it really works. "Retinol and retinoids are highly effective at reducing the appearance of wrinkles and improving overall skin texture," says Sanan. "They work by targeting the root cause of wrinkles — collagen breakdown. Retinol/retinoids boost collagen production by stimulating fibroblasts in the skin to produce more collagen and elastin, which are essential proteins that keep skin firm and smooth. By increasing collagen, retinoids thicken the dermis, reducing the depth of fine lines and wrinkles."
In addition to increasing collagen production, Sanan says that retinoids promote faster cell turnover, helping to replace your old, damaged skin cells with new, healthier ones. "This process smooths rough skin texture and minimizes fine lines," he explains.
However, not all retinoids are created equal. "Keep in mind that formation and strength is very important when choosing a retinoid," says Mann. "If you have more fine lines and wrinkles, you will need a stronger product." And remember, as with most anti-aging products, your skin needs time to adjust to any new retinoid and you won't see results overnight. "Retinoids take time for your skin to get used to — but can be extremely effective if you can endure dry skin, redness and flaking for a few weeks," Mann says.
"Growth factors are naturally occurring proteins in the body that regulate cell growth, repair and regeneration," says Sanan. "In skin care, growth factors are applied topically to encourage skin rejuvenation and repair, making them effective in reducing the appearance of wrinkles, fine lines and other signs of aging. Growth factors also enhance skin repair and healing, promote cell turnover, reduce inflammation and improve skin thickness. All these factors are important for skin texture, tone and overall health. The end result is plumper, smoother skin with less-noticeable wrinkles." Most experts I spoke with agreed that growth factors should be used as a complement to other skin care, as they work synergistically with retinoids, peptides and hyaluronic acid.
"Red light therapy is an extremely popular at-home treatment currently, that is also very effective," says Houston plastic and reconstructive surgeon Dr. Rukmini Rednam. "It helps reduce the appearance of wrinkles by helping your cells work more efficiently in skin repair, supporting new cell growth and enhancing rejuvenated skin. Red light therapy increases blood circulation, reduces inflammation, stimulates collagen production and can improve wound healing, all in a simple and painless process."
Related: The best LED face masks of 2025
No "Botox alternative" story would be complete without the inclusion of Frownies, a product that experts are mixed on but consumers adore.
Boston facial plastic surgeon Dr. Akshay Sanan
Houston plastic and reconstructive surgeon Dr. Rukmini Rednam
Dr. Katie Mann, founder of Curated Medical med spa in Scottsdale, AZ
Paula Brezavscek, CEO and Founder of AZALA Skin Clinic in Coconut Grove, FL
Kristin Gunn, celebrity aesthetician and owner of Halcyon Skincare and Beaux Medspa in Austin, TX
If you have Amazon Prime, you'll get free shipping, of course. Not yet a member? No problem. You can sign up for your free 30-day trial here. (And by the way, those without Prime still get free shipping on orders of $35 or more.)
The reviews quoted above reflect the most recent versions at the time of publication.
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Boston Globe
12 hours ago
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Bad Botox? Six cases of botulism on the South Shore tied to possible Botox injections
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Yahoo
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Botox has traditionally been sought out by older women looking to do something about the wrinkles they already have. But that's changing. Now younger women are turning to the cosmetic treatment to avoid getting those fine lines in the first place. That's the idea behind preventative Botox, which Houston plastic surgeon Dr. Kristy Hamilton has seen explode in popularity over the past five years. 'The summer of 2020 was when I started seeing younger patients coming in and asking about starting Botox to prevent lines,' Hamilton tells Yahoo Life. 'What I tell them is that when you start to see lines linger when you're not moving your face, that's a good indicator that it's a good time to do so.' Data from the 2023 American Society of Plastic Surgeons report indicated that while patients between the ages of 40 and 54 account for the largest percentage of those getting Botox, treatments among patients from 18 to 39 years old have been increasing. 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Yahoo
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Botox has traditionally been sought out by older women looking to do something about the wrinkles they already have. But that's changing. Now younger women are turning to the cosmetic treatment to avoid getting those fine lines in the first place. That's the idea behind preventative Botox, which Houston plastic surgeon Dr. Kristy Hamilton has seen explode in popularity over the past five years. 'The summer of 2020 was when I started seeing younger patients coming in and asking about starting Botox to prevent lines,' Hamilton tells Yahoo Life. 'What I tell them is that when you start to see lines linger when you're not moving your face, that's a good indicator that it's a good time to do so.' Data from the 2023 American Society of Plastic Surgeons report indicated that while patients between the ages of 40 and 54 account for the largest percentage of those getting Botox, treatments among patients from 18 to 39 years old have been increasing. 'Many in Gen Z are starting preventative Botox, known by some as 'Baby Botox,' to stop wrinkles before they form,' the report reads. Results from a recent Yahoo News/YouGov poll align with those findings. Among 1,677 U.S. adults surveyed in late March, 15% of women ages 18 to 39 said they would likely try Botox, compared with just 10% of women age 40 and older. This, experts say, indicates that the messaging behind preventative Botox — that when it comes to wrinkles, the best defense is a good offense — is not only spreading but also successfully convincing more people to start Botox sooner rather than later. But not everybody is buying in. Christine Cambus, a 36-year-old makeup artist living in New York, is someone who hopped on the Baby Botox train before it was a bigger trend. In her mid-20s, she started noticing expression lines in her forehead that weren't going away. 'When I turned 26, I decided to start doing Botox because I was like, I want to get ahead of this problem before it gets more intense,' she tells Yahoo Life. 'Now here we are 10 years later and — not to toot my own horn — but people routinely think I'm still in my early to mid-20s.' Baby Botox, aka micro-toxing, refers to using smaller doses of the neurotoxin (which isn't always Botox brand) to temporarily paralyze muscles in the face. According to Hamilton, these dosage amounts vary. 'It's still customized on the patient because I'm assessing the intensity of their muscle movement, which is going to be different person to person just based on anatomy, age, all of that,' she says. 'What we're talking about is just less than a full [Botox] treatment … usually less than half of what is recommended by the pharmaceutical companies.' Cambus receives 30 units for the injections across her forehead. 'I get it up into my hairline,' she says. 'I get my 11's and the very outward edges of my eyebrows because I want my brows to kind of tick up a bit at the end.' She believes that the injections she's had over the years are the reason she hasn't developed lines elsewhere, like crow's-feet. Hamilton backs this up. 'It's preventing the lines that are caused by movement, so if she's getting a little bit around the corners of the eyes, that's what is preventing her crow's-feet wrinkles,' she says. But if Cambus were only injecting the 11's between her eyebrows, for example, it wouldn't have that same preventative effect on the outside of the eyes. Jess Peachy, a 26-year-old from Charlotte, N.C., on the other hand, has been interested in getting injected since first hearing about preventative Botox on Bravo shows like Vanderpump Rules. But she has decided against it after doing further research. 'I looked into it, looked at other people's TikTok videos about their experiences and everything seemed fine and seemed good and normal. Everyone was like, 'My face isn't moving, I'm not getting wrinkles,'' she tells Yahoo Life. 'But what changed my mind about getting it was when people had masseter Botox and started discussing that after a while, they got the jowls.' Peachy is referring to people having Botox injections in their masseter muscle along the jaw — not an area prone to wrinkling — and experiencing jowl-like drooping. Peachy worries that sort of effect could happen elsewhere on her face if she tried Botox. 'At the end of the day, it is weakening your muscles, so I'm afraid of putting it in my face and the long-term effects of it,' she says. 'I don't want any muscle atrophy and to end up with loose and saggy skin.' Dr. Sean McNally, a plastic surgeon in Oregon, tells Yahoo Life that there is a slight possibility of experiencing significant weakening. But he says it's rare for people to be getting so much Botox so frequently to get to that point. 'If people are very consistently, very aggressively high-dosing Botox in certain muscles, and if they do that for years, those muscles can actually look weak and anemic, kind of pink instead of red. They do weaken with time,' he says. But McNally adds: 'For most people, they are not redosing their Botox before their Botox has completely worn off. So they're going to have this break in between where the muscle is functioning and you're actually using it for a while and then redosing it. It's not a long-term concern because if somebody is dosing you appropriately, they're going to be weakening the muscles but not completely freezing them out.' McNally himself has been getting injections for 12 years, starting when he was 31. If he hadn't gone the preventative route, he says, 'I would now have permanent creases that even with Botox wouldn't go away.' The messaging of preventative botox is working when it comes to getting younger people interested and considering it. What was previously a part of beauty regimens and culture for older women is now 'just something that Gen Z talks about,' says Hamilton. But that doesn't necessarily mean that every young person is running to get it. For some, it's concerns about the long-term effects holding them back; for others, it's the price tag. For those who are eager to begin, McNally encourages patients to wait until they're 25. 'I don't think you're going to get a ton of benefit out of it until you're in your late 20s, early 30s,' he says, unless there's an otherwise significant indication (like a skin or collagen condition) that someone younger should be starting. Hamilton recommends that people of all ages be particular when selecting who is doing the injection. That's especially important for young patients who don't want to overdo it. 'It's about going to someone that matches your aesthetic or understands your aesthetic,' she says. 'So if you walk into the office and everyone is completely frozen and people don't have any movement, that's probably not the office for you.'
