The Four Wrinkle Relaxers

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Written by Naomi Myhre, RPN

I get asked this question a lot. What is the best neurotoxin for me? What works best? What lasts the longest?  Canada now has four FDA approved neurotoxins on the market—Dysport, Botox, Xeomin and Nuceiva. In order of approval for cosmetic use,  Botox was approved in 2002, Dysport in 2009, Xeomin in 2009 and Nuceiva just last year in 2019. 

All four neurotoxins work wonderfully to relax the muscles of our faces that crunch skin together. Every time we make facial expressions, over time, we create lines that embed themselves permanently, making us look tired and/or aged. When you are deciding whether or not wrinkle relaxers are right for you, ask yourself these questions, am I noticing lines on my face without creating an expression? Am I wandering the anti-aging aisles of drug stores or scrolling online to find magical topical creams or ointments to get rid of them?  If you answered yes, you are amongst the thousands of men and women who seek the answer in “a tube” or “bottle” in the ever expanding multibillion dollar beauty industry. The reality is that these creams and lotions, while possibly hydrating the skin, will not remove the lines you may be concerned about. A neurotoxin will relax the muscles and smooth the lines caused by the muscle contractions. A cream does not have this ability. 

Your experienced injector has the answer in the tips of his/her gloved fingers though. With a consultation to assess your level of movement, what goals you are hoping to achieve and what will fit your budget, once you receive your treatment and the product of choice starts working, you’ll feel like you just won the lottery - and all for 30 minutes of your time. Most patients spend many hours researching products, reviews and false advertisement pictures before seeking a medical injector consultation. 



All four approved neurotoxins really do the same thing, they smooth your skin and the more repeated treatments you do, the slower you will age and the smoother your skin will be. Your friends and family may notice an improved change in your appearance but may be unable to determine what you actually had done. The beauty of this treatment is that the results of this treatment are subtle to others but obviously visible to you when the product “kicks in”.  All of the approved neurotoxins are clinically proven to last three to four months regardless of which brand you chose.  An important note to remember is that all of the neurotoxins DO NOT work immediately. Expect for the products to start working as soon as 3 days and to be waiting two full weeks for full results. Following up at 2 weeks can sometimes be crucial for some individuals who have very strong muscles, as they may need more product to achieve desired results. More wrinkle relaxers may be needed at that time to adjust any unwanted bunching or movement. There are rules following your procedure and you must adhere to them for best possible outcomes. They should always be explained before your procedure. 



It is ideal to start earlier in life with treating your face preventatively with wrinkle relaxers. In fact, many men and women start in their 20’s when they start to see the lines on their forehead, between the brows or around the eyes appearing when the face is at rest. If you can stop the lines from forming with neurotoxins, they tend to never get deeper, and in fact, they will disappear if started early enough in life. 

In a nutshell, the more product that is used per area, the longer it will last, the stiffer it will be and cost will be higher. Sure you’ll see a slight difference if you use smaller dosages, but you will be coming more frequently as it won’t last as long as the recommended dosages, and you may still have movement and bunching of skin that causes lines in treated areas. It’s not wrong to come more frequently, it just may not allow you to fully take advantage of what these four products have to offer.



There are also therapeutic properties to using these products as well. Alternative uses for neurotoxins include use for migraines, bruxism (involuntary teeth grinding), excessive sweating, blepharospasms, or treating tense muscles. For instance, my three year old nephew has Cerebral Palsy and every 3 months, his neurosurgeon administers several hundreds of units of Botox into his calf muscles so his leg is able to stretch out to have leg braces on. I’ve had clients in the corporate world refuse to give public speeches because their underarms sweat so badly due to nerves of being in the spotlight. It has brought them great relief and gained confidence to use neurotoxins to treat this condition. 


Does it end at neurotoxins to help us look our very best and give us added confidence? No, it doesn’t. To truly take advantage of this popular treatment, medical grade skin care, in-office chemical peels, skin treatments, dermal fillers, and resurfacing lasers can be an added benefit to neurotoxins. 



To conclude, given that you seek an experienced and qualified injector, knowledgeable and understanding of your skin goals, no matter what neurotoxin that has been suggested or chosen for you, will you then look and feel your very best.

And remember, the earlier you start these treatments in life, the greater the long term effect and the slower the process of aging will be for you. Oh and a mosquito bite hurts way more than the wrinkle relaxer treatments do.

Naomi