Part One: Introduction

In 2019, more than 5 million wrinkle relaxer injections were performed, making it the single most performed cosmetic procedure of the year.^[1]This number includes injections from a variety of neuromodulator brands like Botox, Dysport, Xeomin and Jeuveau. Despite a worldwide pandemic that shut down countless industries, wrinkle relaxers held firm in the United States during 2020, amassing more than 4.4 million individual injections.

To illustrate the immense popularity of this category of treatments, consider that the second most performed cosmetic procedure was injectable fillers, which reached 3.4 million in 2020 and 3.8 million in 2019.^[1] The top three plastic surgeries were nose jobs, eyelid surgeries and facelifts, which were performed about 352,000, 325,000 and 234,000 times, respectively.^[1]

It is hard to overstate the impact of wrinkle relaxers such as Botox on the aesthetic medicine industry and pop culture. The idea of having one of these procedures performed has become widely accepted, and the once-notorious reputation wrinkle relaxers had for freezing faces is steadily falling out of the public’s opinion as more effective and conservative techniques are adopted.

For anyone who cares even a little about their appearance, wrinkle relaxers are a ubiquitous, versatile treatment that can erase fine lines, wrinkles and folds throughout the face. As the aesthetic preferences of the general population have continually shifted through generations, wrinkle relaxers have only become increasingly more commonplace.

A Brief History of Wrinkle Relaxers

There are few products on the market with a name as recognizable as Botox, but unless you were a food scientist in the late 19th

glabellar lines patient

century or a weapons manufacturer during World War II, you had probably not heard of the substance used in the injections until the late 1900s.

This is because wrinkle relaxers are made from the same toxin found in botulism, a disease that rampaged between 1895 and 1925 and continues to affect people today.^{[2, 3]} During World War II, the same toxin was investigated as a potential biochemical weapon.^[4] The average person had no reason to know anything about the substance … until modern scientists learned how to safely use it to reverse signs of aging.

As early as 1977, this toxin was being used in clinical settings to treat conditions like strabismus^5], but it was not until 1989 that Allergan received FDA approval for Botox’s clinical use.^[6]

Around the same time, a plastic surgeon from Sacramento named Richard Clark discovered its cosmetic use in patients with forehead asymmetry caused by nerve paralysis.^[7] Thirteen years later, Botox Cosmetic, the formula still used for anti-aging injections, was FDA approved to treat moderate to severe glabellar lines.^[8]

xeomin

Why Do We Need Wrinkle Relaxers?

There are two major causes of fine lines and wrinkles throughout the face: volume loss and muscle movement. As we go through our everyday routines, we are regularly put in situations where we rely on our faces to communicate our feelings to those around us. If you are listening to a story from a friend or colleague, your face is constantly moving to let them know you are engaged.

When you hear a shocking plot twist, your eyes move upward, causing the skin on your forehead to fold into itself. If you are listening to something you disagree with, you push your eyebrows together, wrinkling the skin between your eyebrows. These expressions are happening every time you have an interaction with someone — they can even occur when you are by yourself watching your favorite show, reading a book or laughing at something you saw online.

Eventually, all that movement takes a toll on your skin. It creates permanent creases on your skin the same way you would expect clothing to wrinkle if you don’t immediately hang it up. Wrinkle relaxers aim to correct these concerns by preventing the muscle from contracting entirely through a non-destructive approach.

How Do Wrinkle Relaxers Work?

We know that wrinkle relaxers are derived from a toxin. The full name of that toxin, however, is botulinum toxin type A. When small amounts of this substance are injected into specific parts of facial muscles, they can block the communication between the muscle and the rest of the nervous system.

If the brain cannot communicate with the muscle, then there is no way for expressions or other facial movements to fold the skin. This has two effects that improve the appearance of your skin. The first effect is instant — broken communication means no lines in the skin during day-to-day activities as long as the toxin remains active.

The second is a long-term benefit. While the face has time away from its regular expressions, the skin that used to go through frequent folding now has a chance to reset. In other words, the longer you use wrinkle relaxers, the more your signs of aging are actually reversed.

This is why the vast majority of medical professionals in the field will always recommend regular treatment appointments — to ensure that no progress is lost and that the optimal results are maintained.

Why Are Wrinkle Relaxers So Popular?

The counts are in the millions. So what makes them the most dominant cosmetic treatment on the market? Three things, in particular: there is no hassle, they are relatively inexpensive and, arguably the most important, they work.

They Are Convenient

Injectables are easy, minimally invasive procedures that can typically be performed within a lunch break. Wrinkle relaxers specifically are exceedingly convenient because they provide instant results that avoid looking overly worked. You can get back to work, continue taking care of your family or jump back into that adventurous lifestyle without missing a beat.

They Are Affordable

Wrinkles are tough to treat, especially when they are moderate to severe. There are few options on the market, and most of those include surgery and anesthesia, which can cost patients thousands. Wrinkle relaxers require a much lighter financial and time investment.

They Are Effective

Their popularity isn’t a fluke; muscle relaxers consistently remain at the top of cosmetic procedure lists because patients continue to return for treatments. They are more consistent than injectable fillers and more impactful than topical procedures, and they provide drastic improvements that patients come to trust.

Part Two: Botox vs. Other Wrinkle Relaxers

Botox is the most popular wrinkle relaxer on the market, but it isn’t the only option. Three others are also popular among consumers: Dysport, Xeomin and Jeuveau. So what is the difference between these four options, and which one should you consider?

Botox

Officially, the product used for wrinkles and folds is called Botox Cosmetic, but this is commonly abbreviated to just Botox by medical professionals and patients alike. It is a versatile option with a well-documented track record of success. As the oldest botulinum toxin type A product, providers are likely to have the most experience with this injectable, making high-quality results easier to attain.^[10]

Dysport

Dysport is strikingly similar to Botox in its composition, with only one significant difference: while Botox is approved to treat both glabellar lines, crow’s feet and forehead lines, Dysport is only approved for glabellar lines. This makes it more niche than Botox, and therefore less common. In some cases, Dysport will be used when patients are not having effective reactions to Botox but would like to continue to have neuromodulator treatments.^[11]

Xeomin

Xeomin strips away any additives that Botox or Dysport have in their formulas, instead opting for a pure botulinum toxin type A injection. The practical benefit is that no additional proteins are added, which means the human body is less likely to become resistant to its effects. This is good news for people who are hoping to have wrinkle relaxer treatment for long periods.^[12]

Jeuveau

When Jeuvaeu launched as a new neuromodulator in 2019, it used the tag “newtox” to signal that it was looking to compete with Botox as the most effective wrinkle relaxer on the market. While Botox has both cosmetic and medical applications, Jeuveau is only approved by the FDA for cosmetic use.^[13]

Part Three: What Can Wrinkle Relaxers Treat?

Wrinkle relaxers can be used to treat a variety of concerns. Most of these are related to facial wrinkles, but there are some other uses that products like Botox can provide. Here is a list of all the potential conditions they can address:

what can wrinkle relaxers treat

Forehead Wrinkles

These are the lines that develop between your hairline and eyebrows. Often referred to as glabellar lines, they are a common area of concern since any eyebrow movement will disrupt the skin on the forehead and cause creasing. You might not even notice their development in many cases since they often are only visible when you are talking or reacting.

Treatments: Botox, Xeomin, Jeuveau

Crow’s Feet

These lines develop on the outside of your eyes. When we smile, the skin beneath our eyes collides with the skin in our cheeks, causing tissue folding. Eventually, those folds will stick and be present even when we aren’t expressing emotion. Crow’s feet are one of the most prevalent signs of aging since the eyes are a common focal point.

Treatments: Botox, Xeomin, Jeuveau

Lip Lines

These tiny lines above and below your lips are often referred to as smoker’s or lipstick lines since they become much more noticeable when lips are pursed together. By stopping targeted muscles in the area, the squeezing movement can be controlled, preventing the development of worse wrinkles and giving the lips time to smooth themselves out.

Treatments: Botox

Frown Lines

These are the vertical lines that develop between your eyebrows and above the nose. Nearly every expression we make has some effect on this particular area, making it a common place for people to experience tissue laxity. Small doses of wrinkle relaxers can go a long way in reducing their impact on your face.