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Botox is one of the most trusted, reliable anti-aging treatments on the market. It's also one of those rare treatments that delivers instantaneous results while also improving the look of skin over time. That being said, there are a few reasons you might not want to get Botox, such as cost, pregnancy, fear of needles, or just not being ready to commit to regular appointments.
Fortunately, there are a few Botox alternatives that can delay the signs of aging (and even improve existing fine lines and wrinkles). But it's important to note that none of these alternatives will stop the formation of new wrinkles like Botox can. With that said, there are alternatives you can try first if you're not ready for Botox. Ahead, dermatologists Dr. Joshua Zeichner, Dr. Jessica Wu, Dr. Paul Jarrod Frank and Dr. Marisa Garshick share the 10 most effective Botox alternatives you can try.
Meet the Expert
- Joshua Zeichner, MD is the director of cosmetic and clinical research at the Mt. Sinai Department of Dermatology.
- Jessica Wu, MD is a top cosmetic dermatologist based in Los Angeles, CA.
- Paul Jarrod Frank, MD, cosmetic dermatologist and founder of the Fifth Avenue Dermatology Surgery and Laser Center in Manhattan.
- Marisa Garshick, MD, is a board-certified dermatologist in New York City, and an Assistant Clinical Professor of Dermatology at Cornell.
Fractional Lasers
Laser therapy is perhaps the most effective, non-surgical option for getting more youthful-looking skin on the whole. “Fractionated resurfacing lasers like Fraxel can improve tone and texture,” explains Zeichner. “With a week of a sunburned appearance afterward, you can even out dark spots while minimizing pores and improving skin texture,” he says.
These fractional lasers, the most popular of which is the Fraxel Restore, are considered ablative, which means they damage the top layer of skin to stimulate the skin’s natural healing process. This promotes the production of collagen, which results in healthier, younger-looking skin. Fraxel Restore is clinically successful in reducing the appearance of fine lines, treating acne scars, and improving overall skin texture.
“In my office, I often use lasers such as the Affirm, which combines two wavelengths of light to stimulate new collagen production and remove the top layers of dead skin,” says Wu. “It’s a fractionated laser, so it delivers the laser light in tiny dots (the Fraxel is in the same category), and it leaves normal skin in between the dots, so there’s no blistering or scabbing. The result is that you look smoother and fresher after a few days,” she says.
Microcurrent
Microcurrent treatments involve gentle electrical stimulation to penetrate the deepest layers of the skin, catalyzing collagen and elastin production for overall toning and firming. Part of the improved muscle tone, firmness, and cellular activity means tighter pores, reduced fine lines and wrinkles, and less puffiness. Fortunately, microcurrent can deliver an immediate lifting effect, but it will require regular use (about three times a week for six months) to see a difference in fine lines or wrinkles. Microcurrent is also a great way to maintain skin's elasticity and prevent future sagging.
Radiofrequency
Radiofrequency therapy generates heat to tighten loose skin—and as such, it's a great option for a non-face-lift face-lift. These devices work by sending heat deep into the skin, which causes tissue tightening and collagen formation.
“For tightening the lower face and jawline, my favorite treatment is the ePrime,” Wu says. “It uses a row of fine needles to deliver the radiofrequency underneath the skin, to the deeper levels where the collagen sits. There is typically no crusting or scabbing, as with lasers. It takes one-and-a-half hours to do the treatment, and patients are swollen for seven to 10 days, but my patients have been thrilled with the results,” she says.
Ultherapy
Ultherapy is another popular heat treatment that works via ultrasound and is FDA-approved for both tightening and lifting. “It can be used to reduce sagging skin on the eyelids, tighten the jawline and neck, and lift the brow,” says Frank. “Ultrasound technology is used to view the skin layers that will be treated so that only the precisely targeted tissue will be treated. The innovative procedure provides heat to the targeted tissue, and thereby tightens and lifts the skin, without the need for surgical incisions.”
Though patients can opt for a mild sedative to be more comfortable in the process, no recovery is needed afterward, Frank confirms. "You can return to your normal daily activities immediately after the procedure."
Microneedling
“Microneedling is a procedure that’s popular in Asia and Europe and starting to become more popular here in the U.S.,” says Wu. Various devices puncture the skin with very fine needles, stimulating collagen production. Studies have shown that microneedling reduces wrinkles by increasing collagen production. “The effect is even better if you apply vitamin A (retinoids) and vitamin C at the same time,” Wu says.
There are various devices for microneedling, Dermapen being one of the most popular. It looks like a roller pen and yields results in a similar fashion to how lasers work—the points of the microneedle pen stamp over the skin, microscopically puncturing it, which the body responds to with an increase in collagen production meant to heal the perceived injury.
LED Therapy
LED (light-emitting diode) is a completely non-invasive type of light therapy that works by interacting with the skin’s cells to stimulate rejuvenation through increased collagen, which in turn results in a reduction of lines and wrinkles, faded scars, diminished age spots, smaller pores, and overall more even skin tone. However, unlike Botox, results from LED masks are not instantaneous. You will need to be committed to nightly use to increase the chances of a visible skin improvement, and keep in mind that the masks needed to emit LED can sometimes be more expensive than Botox itself.
Cosmetic Acupuncture
Cosmetic acupuncture is another less invasive way to tighten sagging skin and enhance overall tone. It helps to strengthen the muscles below the skin for a more taut appearance and increases blood flow to these tissues for collagen production. Like microneedling and lasers, it works because the minor trauma from the insertion of the needles signals the body to create collagen, resulting in a more elastic and youthful appearance.
Temporary Skin Tighteners
For a quick, instant fix with no needles, try a temporary skin tightener like the Peter Thomas Roth Instant Firmx Eye Treatment. Skin tightening eye creams create a dramatic, immediate tightening effect to loose or wrinkled skin, but it's important to note that the results are only temporary. These formulas typically only last for a few hours before the cosmetic tightening effect wears off.
Retinoids
Prescription-strength retinoids like tretinoin can make a dramatic improvement to the tone and texture of the skin in as little as a few months. “Nightly use of this retinoids—a vitamin A derivative—can stimulate collagen and keep the skin youthful and elastic while minimizing fine lines,” Zeichner says.
Garshick recommends incorporating a retinoid into your nightly routine, paired with a simple cleanser and face moisturizer. If you're new to the ingredient, she recommends opting for a lower dosage (like Neutrogena's Rapid Wrinkle Repair Regenerating Cream) and starting slow, using it a couple times a week and increasing usage as tolerated. When paired with SPF, she says this combo can be a, "good fix for standing fine lines and wrinkles, but not expression lines."
Daily SPF
Speaking of SPF, whether you're looking for a Botox alternative or not, you should always use sun protection regardless of your skin tone or skin type. While sunscreen won't necessarily revert damage that's already been done, it is one of the best tools we have for preventing fine lines, wrinkles, sun spots, according to Garshick. Even if you're not at the beach or laying out on a rooftop, incidental sun exposure—like driving in your car or sitting near a window at the office—accumulates quickly over time, leading to photoaging.
“UV light’s damaging effects adds up over a lifetime, and five minutes of exposure a day adds up,” says Zeichner. “An ounce of prevention is worth a pound of repair.” To prevent aging (and more importantly, skin cancer), wear a sunscreen of at least SPF 30 every single day, like Lightsaver's Tinted Activated Mineral Sunscreen SPF 33.
