There’s a new kind of loyalty test happening in the treatment room. For years, patients may have been devoted to a single wrinkle relaxer, returning every few months for a consistent, reliable result. But now, with six FDA-approved neurotoxins on the market, including Botox Cosmetic, Dysport, Jeuveau, Xeomin, Daxxify and the newest addition, Letybo, there’s more options to choose from. So, when does it make sense to switch and when should you stay the course with your toxin?
Featured Experts
- Tina Alster, MD is a board-certified dermatologist in Washington, D.C.
- Joel Schlessinger, MD is a board-certified dermatologist in Omaha, NE
- Daniel Schlessinger, MD is a board-certified dermatologist in Omaha, NE
There are many reasons someone might consider switching injectable brands. Maybe there’s a new option you want to test-drive, or maybe your favorite isn’t lasting quite as long as it used to. Washington, DC dermatologist Tina Alster, MD says curiosity often begins with celebrity culture. “Many patients’ requests are spurred on by celebrities or influencers demonstrating a new neurotoxin,” she explains. “They see someone talking about a different brand and want to try it themselves.”
Why Some People Switch
Omaha, NE dermatologist Joel Schlessinger, MD says it’s not uncommon for patients to notice subtle changes in how long their results last or how their skin responds. “Patients usually start thinking about switching when they notice that their usual treatment isn’t lasting as long or working quite as well as it used to,” he says. “Sometimes this happens naturally as muscles strengthen or metabolism changes over time. Other times, it’s simply about personal preference, some patients want a gentler effect, while others prefer something that kicks in faster or is more potent.”
While new formulations have expanded the field, the decision to change is rarely about the product alone. “There are more options becoming available and there are more indications, such as neurotoxin for the platysma muscle in the neck, so patients may want to explore what might best match their goals,” he explains.
When It’s Time to Reevaluate
If your results start wearing off sooner than expected, it may be time to revisit your approach “The first clue is typically a shorter duration of effect—for example, when results start wearing off after two months instead of three or four,” says Omaha, NE dermatologist Daniel Schlessinger, MD. Before concluding that neurotoxin has ‘stopped working,’ we rule out factors like amount of product used, type of product used, or anatomical changes.”
True resistance, when the body produces antibodies that lessen a neurotoxin’s effect, is rare, but it can happen. In those cases, Dr. Schlessinger says switching can help “retrain” the body’s response. “It’s not an overnight fix,” he explains, “but it can restore responsiveness over time.”
Dr. Alster adds that stress and lifestyle can also play a role. “It may be the case that the patient is using their muscles more due to stress or accessory muscles are contracting and causing more movement in the treatment areas,” she says.
Is Switching Toxins Safe?
Alternating between FDA-approved relaxers is generally safe, provided your injector understands the nuances of each formula. “There’s no harm in alternating or combining different neurotoxin brands as long as the injector is educated about their preparation, dosing and administration,” says Dr. Alster.
While all six share the same mechanism of action, Dr. Joel Schlessinger notes that their subtle differences affect how they spread and how long they last. “These products all work through essentially the same mechanism but differ slightly in their structure, which affects how they spread and how long their effects last. Because their dosing isn’t exactly interchangeable, we adjust technique and unit count accordingly.”
Finding the Perfect Match
Just like choosing a fragrance or a foundation, the right wrinkle relaxer is deeply personal. “My decision on the best neurotoxin to employ in a particular patient is based on several factors,” says Dr. Alster. “Someone preparing for an event might want a faster-acting option, while another person may prioritize longevity.”
Ultimately, the best results aren’t about brand loyalty, they’re about balance. “Choosing the right product is highly individualized,” adds Dr. Joel Schlessinger. “Each has its own personality, and a skilled injector will tailor the choice to your face, not the other way around.”
