It’s been 14 years since a new botulinum toxin was launched in the UK after Merz Aesthetics joined the likes of Allergan and Galderma with the introduction of Bocouture. Not much has changed since then, yet botulinum toxin injections have kept their hold at the top of the most popular non-surgical facial aesthetics treatments.
Fast forward to 2022, and the market has seen an influx of new toxins, marking a new and exciting aesthetics era.
So what are the new toxins, and how are they different?
Aesthetic manufacturer Croma Pharma introduced its new botulinum toxin across Europe under the brand name Letybo.
The letibotulinumtoxin A product has been indicated for the temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows in adults < 75 years old seen at maximum frown (glabellar lines) when the severity of the facial lines has an important psychological impact.
The neurotoxin claims to provide aesthetic professionals and their patients with “impressive efficacy” and “confirmed tolerability”. [1,2]
Billed as “the first ready-to-use BoNT-A neuromodulator”, Alluzience® completed its European decentralised procedure resulting in a positive decision for the first ready-to-use neuromodulator, a wrinkle relaxing injection, in Europe in June 2021.
The liquid form of botulinum toxin type A is intended for use in adult patients as a treatment to temporarily improve the appearance of moderate to severe glabellar lines (vertical lines between the eyebrows) when the severity of these lines has an important psychological impact on the patient.
All currently approved BoNT-A products (or formulations) in Europe come in powder form and require reconstitution with sodium chloride before use.  The ready-to-use liquid formulation of Alluzience® avoids any calculations. It allows for more precision, meaning it has the potential to improve safety and dosing accuracy compared with powder form BoNT-A preparations, it’s claimed. 
The European Marketing Authorisation Application of Alluzience® is based on pooled data from two pivotal trials, which demonstrated that >50% of patients reported an effect within two to three days, including 23% of patients within one day.5 An effect was demonstrated for up to six months after Injection with Alluzience®.  The responder rate at day 29 was significantly higher for patients treated with Alluzience® compared to placebo (primary endpoint) (p<0.0001). 
One of the most talked-about and highly anticipated new toxins comes from Evolus and has been nicknamed “Newtox” in the US.
In February 2019, Evolus received FDA approval for Jeuveau™ prabotulinumtoxinA-xvfs for injection. Described as “the first aesthetic-only neurotoxin approved in the US”.
Nuceiva (botulinum toxin type A) is approved for the temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at maximum frown (glabellar lines) when the severity of the facial lines has an important psychological impact in adults below 65 years of age.
The product has since been launched in the UK under the brand name Nuceiva™.
The safety and efficacy of Nuceiva® was evaluated through the company’s TRANSPARENCY program, the largest head-to-head pivotal study versus BOTOX® to date. 
Whatever toxin or toxins you choose to use in practice, making sure your training is up to scratch is essential, particularly in an evolving and changing market. Here at Interface Aesthetics, we offer both a variety of courses covering the use of toxins.
Our one-day, CPD-accredited course in Botox ® and Dermal Fillers provides training in the key treatments that you will be expected to perform as an independent practitioner. Our innovative approach to competency-based training focuses on hands-on practical injecting on live models in a supportive and friendly environment.
The Foundation Course is the first step for any healthcare professional looking to move into the medical aesthetics industry.
Our one-day advanced course in Botox® & Dermal Fillers builds on the main techniques taught in the Foundation Course.
The course is hands-on, with theory covering advanced anatomy, safety considerations and common pitfalls to avoid in carrying out advanced aesthetic treatments, including advanced toxin indications such as:
We also have a series of Masterclasses to help practitioners refine and develop their skills as their confidence and experience grows. https://interfaceaesthetics.co.uk/course/masterclass-botox-dermal-fillers-training-courses
Botulinum toxin is one of the bread-and-butter treatments aesthetics clinics offer. Making sure your training is up to date and of the highest standard is key in offering safe and effective treatments to patients.
1. Letybo® SmPC https://www.medicines.org.uk/emc/product/13707/smpc#gref
4. Alluzience Summary of Product Characteristics. https://www.medicines.org.uk/emc/product/13798/smpc#gref