Neurotoxins: treatment guide
Daxxify: what it is, how long it lasts, side effects and cost
What is Daxxify?
Daxxify is a prescription injection of daxibotulinumtoxinA-lanm, a botulinum toxin type A approved by the FDA in 2022 for the temporary improvement of moderate to severe frown lines between the eyebrows in adults.[1] Like other botulinum toxins, it blocks the nerve signals that make the injected muscles contract.[1] In two phase 3 trials, frown lines stayed at none or mild for a median of about 24 weeks after one treatment.[2]
Daxxify quick facts
| What it is | Daxxify (daxibotulinumtoxinA-lanm), a prescription botulinum toxin type A injection[1] |
|---|---|
| What it treats | Temporary improvement of moderate to severe frown lines (glabellar lines) between the brows in adults. It is also approved for cervical dystonia, a neck muscle condition.[1] |
| How long it lasts | In the phase 3 trials, frown lines stayed at none or mild for a median of 24.0 and 23.9 weeks[2] |
| Label dose for frown lines | 40 units, given as five injections of 8 units each[1] |
| Treatment time | A single office visit; you go home the same day[6] |
| Downtime | Most people return to everyday activities right away after botulinum toxin treatment[5] |
| How often | No more often than every three months[1] |
| Cost | Varies by clinic and area. Depends on the amount of product, the areas treated, the provider and location.[7] |
| Insurance | Botulinum toxin treatment for signs of aging is generally not covered[4] |
How Daxxify works
Daxxify is a botulinum toxin type A. Its active ingredient is a 150 kDa botulinum toxin without accessory proteins, purified from the bacterium Clostridium botulinum type A.[1]
When it is injected into a muscle, Daxxify blocks the release of acetylcholine, the chemical messenger that tells the muscle to contract. The treated muscle relaxes, so the frown lines it creates soften. Nerve signaling recovers gradually over time, which is why the effect is temporary.[1][5]
Daxxify is made with a peptide excipient called RTP004, which the label describes as preventing the toxin from sticking to surfaces and promoting its thermal stability.[1] The label lists no human albumin among its ingredients.[1] Its cosmetic approval covers frown lines between the brows; it is also approved for cervical dystonia.[1] For a full overview of botulinum toxin treatment, see our Botox guide.
What to expect, step by step
- Before your consultation: preview it in the appIf you like, scan your face in the SkinSync AI app and look at an illustrative neurotoxin simulation, so you can show your provider what you have in mind. The simulation is not specific to Daxxify, it does not predict your result, and your provider decides what is appropriate for you.
- ConsultationShare your goals, your medical history and a current list of medicines and supplements. Tell your provider if you have had any other botulinum toxin product in the last 4 months, and which one.[1] Blood thinners and NSAIDs can increase bruising.[6]
- PreparationYour provider may apply a topical numbing agent to the skin.[6]
- InjectionsFor frown lines, the label dose is 40 units divided into five injections: two in each corrugator muscle and one in the procerus muscle between the brows.[1] The injections can cause some pain.[6]
- Right afterYou go home the same day, and most people return to everyday activities right away. Ask your provider when you can apply makeup, and take care not to press or rub it in.[5][6]
- ResultsIn the phase 3 trials, the main result was measured at week 4, when about 74% of people treated with Daxxify reached the trial's goal of none or mild frown lines with at least a 2-grade improvement, compared with 0% to 1% on placebo.[1][2]
- MaintenanceDaxxify should not be given more often than every three months.[1] Your provider will tell you how often you will receive it.[1]
Side effects and who should avoid Daxxify
Common side effects
In the two placebo-controlled trials for frown lines, the most common side effects were:[1]
- Headache (6%, compared with 2% on placebo)[1]
- Drooping eyelid (2%)[1]
- Facial weakness, including facial asymmetry (1%)[1]
- Injection site reactions such as pain, redness, swelling or bruising (6%, the same rate as placebo)[1]
The label notes that the most common side effects usually appear within one to two weeks after injection and, while generally temporary, can last several weeks or months. In a long-term study of repeat treatment, side effects did not become more frequent with retreatment.[1] Dry eye has also been reported with botulinum toxin products used for frown lines; tell your provider about eye irritation, light sensitivity or vision changes.[1]
Serious but rare: spread of toxin effect
The FDA label carries a boxed warning: the effect of Daxxify, like all botulinum toxin products, can spread from the injection area and cause symptoms such as trouble swallowing, breathing or speaking, which can be life threatening. These symptoms have been reported hours to weeks after injection. Get medical help right away if they occur.[1] If you notice muscle weakness, blurred vision or drooping eyelids, do not drive or do other dangerous activities.[1]
Who should avoid Daxxify or talk to a provider first
- Allergy to any botulinum toxin product or any ingredient in Daxxify[1]
- Infection at the planned injection site[1]
- Pregnancy or breastfeeding. It is not known whether Daxxify can harm an unborn baby or passes into breast milk.[1]
- Neuromuscular disease such as ALS, myasthenia gravis or Lambert-Eaton syndrome, drooping eyelids or weak forehead muscles[1]
- Heart problems, breathing problems, swallowing problems or bleeding problems, past side effects from a botulinum toxin, or past facial surgery[1]
- Under 18. Safety and effectiveness have not been established in children.[1]
Only get Daxxify from a licensed provider
Do not buy botulinum toxin online, and avoid injections at a non-medical spa, a party, a salon or someone's home, where serious complications have occurred.[5]
Daxxify aftercare
Follow your own provider's instructions. General advice after botulinum toxin injections includes:[5][6]
- Do not rub or massage the treated areas, especially in the first few hours.[5][6]
- Stay upright for three to four hours after treatment.[6]
- Hold off on strenuous exercise for at least two hours, and follow your own provider's instructions.[5][6]
- Makeup is fine if you apply it gently without pressing or rubbing.[5]
- Watch for warning signs such as trouble swallowing, speaking or breathing, and seek care right away.[1]
Daxxify vs Botox vs Jeuveau
Daxxify, Botox Cosmetic and Jeuveau are all botulinum toxin type A products approved by the FDA for frown lines. They differ in their approved uses, their formulation and how their doses are measured.[1][8][9] Dysport and Xeomin are also FDA approved for frown lines.[10][11]
Swipe sideways to see all three products.
| Daxxify | Botox Cosmetic | Jeuveau | |
|---|---|---|---|
| Active ingredient | daxibotulinumtoxinA-lanm | onabotulinumtoxinA | prabotulinumtoxinA-xvfs |
| Company on the FDA label | Revance Therapeutics, Inc. | Allergan, Inc. | Evolus, Inc. |
| First U.S. approval (any use) | 2022 | 1989 | 2019 |
| FDA-approved cosmetic uses | Frown lines (adults) | Frown lines, crow's feet, forehead lines, neck bands (adults) | Frown lines (adults) |
| Label dose for frown lines | 40 units | 20 units | 20 units |
| What is in the vial | A 150 kDa toxin without accessory proteins, with the RTP004 peptide; no human albumin listed | The toxin as a complex with accessory proteins, with human albumin | A 900 kDa toxin complex, with human albumin |
| Can units be compared? | No. Each label states that its units are specific to that product and cannot be compared with or converted to units of another botulinum toxin. | ||
| Source | FDA label[1] | FDA label[8] | FDA label[9] |
Daxxify's phase 3 trials found a median of about 24 weeks with frown lines at none or mild.[2] Those trials compared Daxxify with placebo, not with other brands, so they do not show how Daxxify compares head to head.[2]
Which product suits you is a decision to make with a licensed provider.
Frequently asked questions about Daxxify
How long does Daxxify last?
In two phase 3 trials, frown lines stayed at none or mild for a median of 24.0 weeks (SAKURA 1) and 23.9 weeks (SAKURA 2) after one treatment, and did not return to their starting severity for a median of 27.7 and 26.0 weeks.[2] Results vary from person to person, and the label says Daxxify should not be given more often than every three months.[1]
How quickly does Daxxify work?
The trials measured the main result at week 4, when about 74% of treated people had none or mild frown lines with at least a 2-grade improvement, compared with 0% to 1% on placebo.[1][2] Ask your provider when to expect a visible change.
How is Daxxify different from Botox?
Both are botulinum toxin type A. Daxxify contains a 150 kDa toxin without accessory proteins and a peptide excipient, while Botox Cosmetic is a toxin complex with accessory proteins and human albumin. Botox Cosmetic is approved for more cosmetic areas, and the label doses for frown lines differ (40 units of Daxxify, 20 units of Botox Cosmetic).[1][8] Units of one product cannot be converted to another.[1][8]
What is Daxxify approved for?
For cosmetic use, the temporary improvement of moderate to severe frown lines between the eyebrows in adults. It is also approved to treat cervical dystonia in adults.[1] Using it in other areas is an off-label decision for your provider.
How much does Daxxify cost?
Varies by clinic and area. The cost of botulinum toxin injections depends on how advanced the lines are, the amount of product used, the provider's expertise and the location.[7]
Who should not get Daxxify?
You should not get Daxxify if you are allergic to any botulinum toxin product or its ingredients, or if you have an infection where it would be injected. Tell your provider if you are pregnant or breastfeeding, or if you have a nerve and muscle disease, drooping eyelids, weak forehead muscles, or breathing, swallowing, heart or bleeding problems.[1]
What are the most common side effects?
In the frown line trials: headache (6%), a drooping eyelid (2%) and facial weakness or asymmetry (1%). Injection site reactions happened at the same rate as with placebo.[1]
What is the biggest risk of Daxxify?
The FDA label carries a boxed warning that the effect of any botulinum toxin product can spread beyond the injection site and cause trouble swallowing, speaking or breathing, which can be life threatening. Symptoms have been reported hours to weeks after injection. Seek medical care right away if they occur.[1]
Can I switch to Daxxify from another neurotoxin?
That is a decision for your provider. Units are not interchangeable between botulinum toxin products, so a dose of one cannot be converted to another.[1] Tell your provider about any botulinum toxin you received in the last 4 months, and exactly which product it was.[1]
Does Daxxify last as long for everyone?
A peer-reviewed analysis of the SAKURA trials found that frown lines stayed at none or mild for a median of at least 24 weeks across the age and race groups studied.[3] Individual results vary.
Can I see a Daxxify simulation in the SkinSync AI app?
The app shows an illustrative neurotoxin simulation that is not specific to any brand, including Daxxify. You can scan your face, preview treatment of areas such as frown lines, forehead and crow's feet, and then find a clinic and book a consultation. A simulation does not predict results, and a licensed provider decides what is appropriate for you.
SkinSync AI: Aesthetic Care
See a simulation before you book.
Read up here, then use the app to picture a neurotoxin treatment on your own face and take the next step with a clinic. Arrive at your consultation informed and ready to ask the right questions.
- Scan your face and see an illustrative neurotoxin simulation (not specific to Daxxify) from the front and both sides: forehead, frown lines, crow's feet, lip flip, masseter reduction and more
- Find participating clinics and providers, with availability and pricing
- Book a consultation, in person or virtual, or a treatment in the app
- Save your scans and get reminders and aftercare guidance
Simulations are illustrative and do not predict results. The app does not give medical advice; a licensed provider determines appropriate treatment.
Sources
Every medical fact on this page is linked to one of these sources. Reviewed October 30, 2026.
- FDA approved prescribing information and Medication Guide: DAXXIFY (daxibotulinumtoxinA-lanm), via DailyMed, National Library of Medicine
- Carruthers JD, et al. DaxibotulinumtoxinA for injection for the treatment of glabellar lines: results from each of two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). Plast Reconstr Surg. 2020;145(1):45-58 (PubMed)
- Solish N, et al. Efficacy and safety of daxibotulinumtoxinA for injection in the treatment of glabellar lines by age and race: subgroup analysis of the SAKURA clinical trials. Aesthet Surg J. 2023;43(2):205-214 (PubMed)
- American Academy of Dermatology: Botulinum toxin therapy, overview
- American Academy of Dermatology: Botulinum toxin therapy, FAQs
- Advances in Dermatology and Allergology (Postepy Dermatologii i Alergologii): The whole truth about botulinum toxin: a review (2019); Clinical, Cosmetic and Investigational Dermatology: Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect (2019)
- American Society of Plastic Surgeons: How much do botulinum toxin injections cost?
- FDA approved prescribing information: BOTOX Cosmetic (onabotulinumtoxinA), via DailyMed
- FDA approved prescribing information and Medication Guide: JEUVEAU (prabotulinumtoxinA-xvfs), via DailyMed, National Library of Medicine
- FDA approved prescribing information: DYSPORT (abobotulinumtoxinA), via DailyMed
- FDA approved prescribing information: XEOMIN (incobotulinumtoxinA), via DailyMed
Related guides
Daxxify, Botox, Botox Cosmetic, Jeuveau, Dysport and Xeomin are trademarks of their respective owners. SkinSync AI is not affiliated with or endorsed by these companies.