04-02-2025
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
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