BOTOX® Alternatives

The following are some alternatives to BOTOX®:

1) Filling agents or injectables such as fat, Collagen, Fibril, and Gore-Tex

2) Resurfacing procedures with acids and lasers

3) Lifting operations of the forehead, temporal, neck and midface regions.

The primary alternatives to BOTOX® are creams chemical peels and surgery.

There are a few people who become resistant to BOTOX® (botulinum A). For them there is Myobloc (botulinum B) but it lasts only half as long as BOTOX®, and a much higher dose is needed. Another injectible is silicone, first used to increase breast size in the 40s and 50s. There have been problems with silicone which required subsequent surgery.

A new product awaiting FDA approval is Artecol (also called Artefill) which is an injected material made up of 75% bovine collagen and 25% plexiglas microbeads. It is injected with a needle that deposits the Artecoll while pulling out the skin, thus leaving a small cylindrical mass. Each microbead is coated in bovine collagen to keep them from clumping together. Now the company who makes Gore-Tex claims that its Subcutaneous Augmentation Material (S.A.M.) will reduce or eliminate wrinkles.

A surgeon makes a small incision in the face just under the skin, lifts up the tissue to create a small cavity for the implant which is inserted and secured in place.

Two new injectables waiting on FDA approval are composed of hyaluronic acid, a naturally occurring component of connective tissue, One is a synthetically manufactured product called Restylane for fine lines and Perlane for deeper skin folds. The other hyaluronic acid-based product is Hylaform, which is extracted from rooster combs. Another soft tissue filler waiting approval is called Radiance, which consists of calcium particles made into a paste and injected under the skin.

Physicians can administer skin surface peels using chemicals like trichloracetic acid (TCA), dermabrasion, strong phenol peels, and laser peels. These can be expensive, take a long time to heal, and have complications like scarring or uneven skin colour. Laser resurfacing is a very common treatment used for wrinkles. The use of the laser to treat wrinkles can also be called wrinkle laser, laser peel, laser surgery, and laser vaporization.

There are numerous anti-aging and anti-wrinkle creams on the market, created by the cosmetic industry, which claim to relax the fine lines and wrinkles when applied topically on the surface of the skin. These products might improve the face temporarily by offering hydration, vitamin-enrichment or other nutrients, but are treating only the outermost layer, the epidermis.

Retinoic acid (vitamin A) is a non-injection treatment for the skin and is used in medical treatments and also can be purchased at the cosmetic counter in lotions and creams. The market trend for BOTOX® injection rates are up 31%, while alternatives such as chemical peels are down 31%, and collagen injections, once very popular, have dropped by 46%. The consumer can pay $5000 for a facelift to remove lines and wrinkles now, or as an alternative can undertake twelve BOTOX® injections over time.

There are a number of new creams on the market, based on the chemical Acetyl

Hexapeptide-3, a non-toxic agent that reduces the amount of nerve stimulations to the muscles which in turn may reduce lines and wrinkles. One such product is marketed under the name of Avotox. Another is OHT Peptide-3, and another is StriVectin-SD.