Neuromodulators, also known as neurotoxins, are substances used in cosmetic treatments to relax muscles temporarily and reduce the appearance of wrinkles and fine lines. They work by blocking the release of a neurotransmitter called acetylcholine at the neuromuscular junction, which is the point where nerves and muscles communicate.
The most well-known neuromodulator brand is BOTOX, but there are other brands available as well. Each brand contains a slightly different formulation and ingredients.
The Major Neuromodulator Brands
- BOTOX (OnabotulinumtoxinA): BOTOX is one of the most recognized and widely used neuromodulators. It is produced by Allergan and has been approved by the FDA for various cosmetic and medical applications, including the treatment of wrinkles, migraines, and excessive sweating.
- Dysport (AbobotulinumtoxinA): Dysport is another neuromodulator used to treat wrinkles and fine lines. It is produced by Ipsen and is similar in function to BOTOX. Some individuals and practitioners prefer Dysport due to its potentially faster onset of action.
- Jeuveau (PrabotulinumtoxinA): Jeuveau, also known as “Newtox,” is a relatively new neuromodulator produced by Evolus. It is primarily used for cosmetic purposes, particularly in the treatment of glabellar lines (frown lines between the eyebrows).
- DAXXIFY® (daxibotulinumtoxinA-Ianm): This peptide-powered formulation may last up to twice as long as conventional frown line treatments for some patients.
- Xeomin (IncobotulinumtoxinA): Xeomin is a neuromodulator produced by Merz Pharmaceuticals. Like the other injectables listed here, it is used to reduce the appearance of wrinkles. Xeomin is known for being a “naked” neurotoxin, meaning it does not contain complexing proteins like some other neurotoxins.
What They Do
These neuromodulators work by temporarily blocking nerve signals to muscles, which results in muscle relaxation and a reduction in the appearance of wrinkles caused by muscle contractions. Each brand may have slight differences in formulation, dosing, onset of action, and duration of effect, so the choice of which neuromodulator to use can depend on patient preferences, practitioner experience, and specific treatment goals.
One of the most well-known cosmetic uses of neuromodulators is the reduction of facial wrinkles and fine lines. Neuromodulators are injected into specific facial muscles to temporarily paralyze them, which smooths out the overlying skin. This is particularly effective for wrinkles and lines caused by repetitive muscle contractions, such as frown lines (glabellar lines), forehead lines, and crow’s feet. Neuromodulators can also raise the eyebrows slightly and create a more refreshed and youthful appearance.
It’s important to note that the effects of neuromodulators are temporary, typically lasting several months, after which the muscle activity gradually returns. As a result, repeated treatments are often necessary to maintain the desired results. The specific application and dosage of neuromodulators depend on the condition being treated and should be administered by a qualified healthcare provider, such as a board-certified plastic surgeon. Your provider can determine which neuromodulator is most suitable for your individual needs and to ensure safe and effective treatment. These treatments should only be administered by trained and licensed professionals.
Beyond Cosmetics
Temporary muscle relaxation has various medical applications outside of aesthetics, including:
- Hyperhidrosis (Excessive Sweating): Neuromodulators are effective in treating hyperhidrosis, a condition characterized by excessive sweating. When injected into the sweat glands in the armpits, hands, or feet, they can temporarily block the signals that trigger sweat production.
- Migraine Management: Neuromodulators can be used to prevent chronic migraines in some individuals. By targeting specific muscle groups, such as those around the forehead and neck, these injections can reduce the frequency and severity of migraine attacks.
- Muscle Spasticity: Neuromodulators are used to treat muscle spasticity, which can result from conditions such as cerebral palsy, stroke, or spinal cord injury. By relaxing overly contracted muscles, these injections can improve mobility and reduce pain and discomfort.
- Eye Conditions: Certain eye conditions, such as strabismus (crossed eyes) and blepharospasm (involuntary eyelid spasms), can be treated with neuromodulators. These injections help relax the muscles responsible for these conditions, improving eye alignment and comfort.
- Neurological Disorders: Neuromodulators are also used in the management of neurological disorders like dystonia, a condition characterized by involuntary muscle contractions and spasms. In these cases, the injections can provide relief from muscle-related symptoms.
How to Know What’s Best for You
Some people may have a preferred brand of neuromodulator, in most cases because they have had treatment with that brand before and liked the results. But the reality is, the different formulations of each brand offer only subtle differences in most cases. By far what is more important is to have an experienced injector with a deep understanding of the anatomy and medicine behind the treatment they are performing.
If you are considering a treatment, take the time to discuss recommendations with a few providers, and understand what they are recommending and why.
Dr. Eric Mariotti, a board-certified plastic surgeon, is known throughout the East Bay for his genuine compassion and the remarkable results he creates. Women and men come to his plastic surgery practice in Concord because he is highly trained and experienced, and has a caring personality. His patients think of him as a down-to-earth guy who happens to be a talented plastic surgeon.
