A new trend emerging is ‘Notox’ – where people are investing in longer-term, less instant but more consistent solutions over Botox. But what alternatives to Botox are there, and could topical skincare really claim to be ‘Botox in a bottle’?

In this article, we’ll explain what Botox actually does – not just the concerns it targets (fine lines and wrinkles). This will give you a better sense of the ways Botox can diminish signs of ageing, how other treatments may achieve similar results – and why Botox isn’t always the “best” option, despite how popular it is.

What Is Botox?

Botox is a brand that has become synonymous with the neurotoxin called botulinum toxin type A. It is a neural modulator, which means that it changes the way the neurons in our brain communicate with one another – reducing how much a muscle moves. (1)

Botox is injected into the muscle just below the skin’s surface using a small needle. It is often injected into specific facial muscles that move frequently, such as the forehead muscles or the glabella complex (the vertical frown lines, also known as ‘elevens,’ between your eyebrows). This injection weakens the muscle, reducing movement in the treated area, which results in a smoother appearance of the skin. As a result, it prevents you from making the facial expressions that cause the wrinkles and makes the wrinkles less visible (or, in some cases, completely disappear) when your face is at rest.

Botox is temporary, so the effect will fade over time and regular appointments are needed to maintain the results. One treatment usually can last between 3-6 months on average, but this will depend on the individual. (2)

Botox injections can also treat medical conditions like muscle spasms, excessive sweating, lazy eye and may also help prevent headaches and migraines in some cases. (3)

How Our Skin Ages

Changes happen to our skin as we get older, this is because of the reduction in the amount of collagen in our skin. We often notice it as “hollowing” around areas like our temples, in front of our ears, our cheekbones and around our eyes.

Collagen is found in our skin, bones, joints and connective tissues. It provides the structural support our skin needs to give it a firm appearance. As we age, our bodies naturally produce less collagen, which leads to the development of fine lines and wrinkles. (4)

There are two types of wrinkles: Dynamic wrinkles and static wrinkles. We’ll explain them to help you discover what Botox is targeting in your skin, so you can find the right “Botox alternative” to achieve similar results.

Dynamic Wrinkles

Dynamic wrinkles show up when you activate (move) your facial muscles. So when you raise your eyebrows, horizontal forehead lines appear because the muscle is contracted.

Or when you scowl or frown, you might see frown lines known as ‘elevens’ appear between your eyebrows.

In short, if the facial wrinkles disappear when your face relaxes, they’re known as dynamic wrinkles. (5)

Static Wrinkles

These wrinkles are visible on the skin, even when the face is totally at rest. If you’re young, you may not have these types of wrinkles yet.

However, as we age, these wrinkles gradually become permanent and more noticeable. Static wrinkles aren’t “bad” for our skin at all, but they are a common concern that can affect how a person feels about their looks. If they aren’t a concern for you, there’s no need to take any action, as wrinkles are not harmful (6)

Botox Alternatives For Instant Results

Similarly to Botox, these injectable treatments have instant results.

Dermal Fillers

Fillers are injectable skin treatments to achieve a smoother, more youthful look to the skin.

However, rather than paralysing muscles like Botox, fillers “fill” out areas – either to give sagging skin a more lifted look, or to add more volume to areas that have hollowed from ageing. An experienced dermatologist can inject filler deep underneath certain muscles of the skin, at certain angles, to lift the contours of the face and give it a fresher appearance.

Dermal fillers have a thick, gel-like structure and are often made using a high molecular weight of hyaluronic acid as their main ingredient. (7)

Biostimulatory Fillers

These types of fillers have two purposes – to add volume to the skin and stimulate collagen production. It does this by waking up cells called fibroblasts, which are responsible for producing collagen, hyaluronic acid and elastin – causing them to start making collagen and help give your skin more “padding.”

Biostimulant fillers also provide hydration to the deeper, dermal layers of skin, which can help slow down the ageing process. (8)

Warning: Fillers temporarily alter the contours of the face, so an incorrect application could change your appearance– making you look less like yourself or even older. It is very important to visit a trained and experienced professional at their clinic if you decide to undergo any injectable treatments.

Long-term Botox Alternatives

Laser & IPL (Intense Pulsed Light) Treatments

A laser emits a single wavelength of light, specifically designed to target a particular skin concern. For skin ageing, laser treatments stimulate collagen production, improving skin texture and reducing fine lines and wrinkles over time, leading to a more youthful appearance. (9)

On the other hand, IPL treatments use multiple light wavelengths to address several skin issues simultaneously. While not as precise or powerful as lasers, IPL can provide a range of benefits in a single session. (10)

Both laser and IPL treatments target similar skin concerns, but unlike Botox, they are not instant fixes. Achieving noticeable results typically requires at least 6 months of regular sessions.

Chemical Peels

Chemical peels are a popular treatment for smoothing fine lines and wrinkles, and improving hyperpigmentation and scarring.

An exfoliating solution will be applied to the skin, encouraging the top layers to peel off and revealing fresher and smoother skin beneath. Chemical peels come in different strengths to address various skin concerns:

Superficial Peels: These are mild. Alpha-hydroxy acids (AHAs) like glycolic acid are used to exfoliate the outermost layer of the skin.

Medium Peels: Trichloroacetic acid (TCA) peels penetrate deeper into the skin to target more pronounced wrinkles, sun damage and pigmentation.

Deep Peels: Performed with strong acids like phenol, deep peels penetrate the deepest layers of the skin for dramatic results, but they need a lot of downtime and have a higher risk of side effects.

Be aware that your skin will need some time – often several days – to heal properly afterwards. Make sure you follow the proper aftercare, including strict sun protection with a broad-spectrum sunscreen, to maintain the results. (11)

Facial Creams For Anti-Ageing (Retinoids)

While topical treatments (applied to the skin) with proven active ingredients like retinoids can deliver visible improvements in skin texture and elasticity – none can claim to be ‘Botox in a bottle’.

Retinoids won’t erase wrinkles or make facial lines disappear like cosmetic procedures, but they are beneficial for improving your long-term skin health. Retinoids can also delay loss of skin elasticity and other signs of ageing. The earlier you use them consistently, the longer your skin will maintain a youthful appearance.

Tretinoin

Derived from Vitamin A, this prescription retinoid is a gold standard ingredient for long-term anti-ageing results. Not only does tretinoin boost collagen production, it also increases cell turnover (exfoliation), which reduces visible fine lines, wrinkles and improves skin tone over time.

Adapalene

Originally developed to treat acne, adapalene is also a retinoid that helps with anti-ageing and inflammation. It can promote skin cell renewal (exfoliation) and collagen production.

Retinol

A milder, over-the-counter derivative of Vitamin A, retinol is easily available in shops or pharmacies for anyone who is new to retinoids. While the effects are similar to prescription retinoids, retinol will take longer to see results.

It is recommended to pair these products with ceramide-rich moisturisers, broad-spectrum sunscreen, and ingredients like hyaluronic acid or niacinamide to optimise long-term skin health. (12)

How To Make Informed Decisions About Botox

There are several things you may want to think about Botox before getting it.

First, the effects are temporary. They last about 3 months on average before it wears off.

Second, it’s expensive, and you may need to have the same treatment at least 3-4 times a year.

Third, if you’re looking to improve the health of your skin, Botox isn’t the answer.

Unlike retinoids, collagen supplements or other science-backed skincare, Botox can’t address the quality of your skin. Botox does not exfoliate, fade pigmentation or stimulate collagen production. Botox also does not moisturise the skin or correct any long-term skin concerns like melasma, acne or dark spots.

Essentially, botox is not going to change the inherent structure of your skin. For example, if you use Botox for forehead lines, the area will look the same as it did before you had injections when your treatment wears off.

Finally, regular Botox users may develop antibodies to it. These antibodies stop Botox from working effectively, so you may need more units to get the same effect – or the Botox may not last as long as it used to.

However, Botox could be a great option if wrinkles are a concern and you’re seeking an effective quick fix. It instantly smooths the skin and limits movement in areas where wrinkles are most prominent, which makes them less obvious.

But if you’re looking for long-term anti-ageing benefits – our dermatologists always recommend a retinoid formula that is personalised to your skin as the best first step, with or without Botox.
Find out what formulas are suitable for your skin by visiting our website.

References

1. Johnson AJ, Chen DS. Office‐based facial plastics procedures: Neuromodulators. World Journal of Otorhinolaryngology – Head and Neck Surgery [Internet]. 2023 Jul 27 [cited 2023 Dec 6];9(3):220–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541165/
2. Satriyasa BK. Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clinical, Cosmetic and Investigational Dermatology [Internet]. 2019 Apr;Volume 12(12):223–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489637/
3. Awan KH. The therapeutic usage of botulinum toxin (Botox) in non-cosmetic head and neck conditions – An evidence based review. Saudi Pharmaceutical Journal. 2017 Jan;25(1):18–24.
4. Chaudhary, M., Khan, A., & Gupta, M. (2019). Skin Ageing: Pathophysiology and Current Market Treatment Approaches. Current Alzheimer Research, 16(1). https://doi.org/10.2174/1567205016666190809161115
5. Thi T, Yi EJ, Jin X, Zheng Q, Park SJ, Yi GS, et al. Sustainable Dynamic Wrinkle Efficacy: Non-Invasive Peptides as the Future of Botox Alternatives. Cosmetics [Internet]. 2024 Jul 11;11(4):118–8. Available from: https://www.mdpi.com/2079-9284/11/4/118
6. Peng JH, Hsien-Li Peter Peng. Cheek wrinkles revisited: Etiological classifications and nonsurgical treatment options. Journal of cosmetic dermatology. 2023 Mar 30;22(6):1733–8.
7. Guo J, Fang W, Wang F. Injectable fillers: current status, physicochemical properties, function mechanism, and perspectives. RSC Advances [Internet]. 2023 Jan 1;13(34):23841–58. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413051/
8. Guida S, Galadari H, Giordano Vespasiani, Pellacani G. Skin biostimulation and hyaluronic acid: Current knowledge and new evidence. Journal of Cosmetic Dermatology. 2023 Dec 22;23(2):701–3.
9. Heidari Beigvand H, Razzaghi M, Rostami-Nejad M, Rezaei-Tavirani M, Safari S, Rezaei-Tavirani M, et al. Assessment of Laser Effects on Skin Rejuvenation. Journal of Lasers in Medical Sciences [Internet]. 2020;11(2):212–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118506/
10. Goldberg DJ. Current Trends in Intense Pulsed Light. The Journal of Clinical and Aesthetic Dermatology [Internet]. 2012 Jun;5(6):45. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3390232/
11. Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang B. Evidence and Considerations in the Application of Chemical Peels in Skin Disorders and Aesthetic Resurfacing. The Journal of clinical and aesthetic dermatology [Internet]. 2010 Jul;3(7):32. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2921757/
12. Zasada M, Budzisz E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Advances in Dermatology and Allergology [Internet]. 2019 Aug;36(4):392–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/