Daxxify: The New Injectable That Lasts Longer than Botox - podcast episode cover

Daxxify: The New Injectable That Lasts Longer than Botox

Nov 15, 202231 minSeason 1Ep. 211
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Episode description

Move over Botox, there’s a new shot in town and this one claims to last on average 6 months (and up to 9 months for some patients)!

We sit down with board-certified dermatologist, Dr. Corey L. Hartman, Founder of Skin Wellness Dermatology in Birmingham, AL, to learn everything we can about the yet unreleased neuromodulator. He talks about:

  • Where and when you can get it (it’s a select rollout folks!)
  • How it works – and the new mechanism of action for relaxing the muscle that differs from Botox
  • Who the ideal patient is
  • What to be aware of before trying this and what can go wrong  

Transcript

This is the Art Beauty podcast where we tell the real truth about the fake shit. Hi, everybody. I'm Amber. Today, my fabulous co-host is Dr. Corey L Hartman. He is a board certified dermatologist and the founder and medical director of Getting That Right of Skin Wellness Dermatology in Birmingham, Alabama. Thank you so much for joining us today. Oh, it's my pleasure and honor to be here. Amazing. And you know what? I try to memorize those and really get them down.

But sometimes it's like, okay, let me just let me just check in. Make sure. Yeah. Okay. So today we are talking about something that I think might be, you know, I guess the technical thing is better than sliced bread, but better than Botox because it's going to rival Botox. It's called Daxxify. And we we're going to get so into that. But before we do, how are things in Birmingham, Alabama, today? Oh, it's a beautiful day in Birmingham. It's a crisp, like 70 degrees.

The sun is shining, it feels like fall. And I'm really happy about that because it can take a long time for people to show up around here. I'm like, giggling in my heart because in New York, like, a 70 is like still summer, you know? We're like, Oh, yeah, it's like a summer day here. Yay! I'm going to a baseball game this weekend, and I'm like, I'm going to be in, like, a T-shirt shirt and tank top, and I know you're probably zipped up there. Yeah. But the half zips already.

Yeah. Yeah. You know, my parents are in Florida, so I get it. It's like once you hit 60, it's winter, and it's. Exactly as we can. Well, good to hear it there. You know, I want to get right into this because I hadn't heard about Daxxify but that's because it was just FDA approved. I think it's September 8th. So I'm going to just shut up and let you tell us all about this. So what is Daxxify Yes, well, we are all very excited. They got their produce for date on September 8th.

It all went through the FDA as planned. We have been waiting and anticipating and hearing about Taxify for about four years now. Actually. And there were just a lot of issues with development and then there were the issues with COVID that delayed the FDA's approval. But we've heard from the beginning that it was going to change the market because it's going to bring a novel way to treat our lines and wrinkles that none of the other products on the market currently do. So that's great.

It's like an innovation in 40 years that we hadn't really seen. It's claim to fame, is that it? Last six months, a lot of my patients have had trouble maintaining their duration on their neurotoxin here lately. I'm not sure what that's about. Some have found different success with other products, but there is a large market out there for people who are looking for duration. They looking for something that will take them farther so they don't have to have injections quite so frequently.

The injections aren't a big deal, we all know that. But they're, you know, every little inconvenience in our busy lives that we can save us a trip, then we want to do it. So I think that that's going to really be the beautiful thing about Taxify, which everybody has shortened to taxi. That's right. First part of the generic, the name, the molecular name. So they all ended in botulinum. There's only a botulinum abo botulinum and now there's Dex Ebucks.

Alina, the taxi just sounds a lot easier to say to me. I don't. Know. All right. So we're going to call it taxi, but is it okay if I walk on the bridge? That's the name. That's the official name is Taxify, but we're calling it that. All right. So to be clear, so Daxy is now it's the first neural modulator that is not. But it has a different way of of affecting the nerve. Correct. Do you want to get into with you? But essentially what we're talking about is a new something. You can hit the mark.

Now, Botox just had I think it's the 33rd birthday of 30th. Now, Botox has been on the market for. Well, for many 20. 20, 24, 24 cosmetic. But it came out in 1989. Yes, yes. Yeah. Well studied. I use it now when I'm seeing Botox. I know that there are many variations, so I'm going to call it, but I'm going to call Botox. We'll know that there's a different. But essentially that's been the only way that you can go. And I happen to know I go every every three months. I'm in my doctor's office now.

Botox is a company made last year. I did a little research, $4.7 billion for their parent company. I mean, I was responsible for like at least four payments towards that. Okay. So I'm super, super excited about this. But I want to be clear because Doxy is very, very new that are you from what I've heard, like not a lot of doctors even have their hands on this yet, have you?

Oh, so the only people who have any experience with, you know, the people who did the clinical trials and we were not a clinical trial site, we do injectable trials. We were not a part of that site. However, they are rolling this out in a very deliberate, very smart and thoughtful way because these days, you know, we haven't had such a big rollout since the days of social media really becoming a thing.

And there have been some missteps with other companies where the education and the implementation of how to use the product wasn't exactly right and it got out that it didn't work when it really wasn't anything wrong with the product. It was just sort of snap, was it who was using it and how they were doing it. So they're being very specific about how they let this product get out. The first rollout is going to be very select doctors and for about three months that's all you're going to have.

They're mandating that you go to their headquarters in Nashville to be trained and learn all about the different intricacies of the molecule. There are four different botulinum on the market now. Botox, despite Zemin and Jibo, they all have their own individual little personalities, but at their heart they all stop the transfer of acetylcholine, which makes the nerve make the muscle fire.

So if you stop that synaptic or transfer, then the muscle won't work because there's no nerve firing it to work. And that's how we relax the muscles to smooth out the lines of expression in our faces. Botox itself has a medical indications as well. It was the first to the market. It's kind of like the Kleenex of tissue. We call it elbow, but they're different brands that are available. It's just they don't have market share. But Botox specifically was indicated first for sweating, I believe.

Now it's used for like a million different things, migraines toward a call. Is there, you know, every specialty it seems like, is finding a use. For depression and clinical depression. But I was saying it makes me feel way less depressed every time I go get my Botox. So, I mean, I. Love that study. I saw that recent study that came out that suggested that it actually affects serotonin levels. You know, we've said for a time now, we know that it stimulates collagen.

We know that it can maybe impact oil production, but it also releases endorphins. So it just makes you feel good. So it's it's a corollary that you would think that it would also treat depression. So we're excited about that. But that's it, too, just to kind of continue the discussion about the different options, all four of those options, while they have their own specific characteristics, like some are more purified, that semen doesn't have this additional protein.

This sport is a smaller molecule. It's it has a wider diffusion area. So it can give a wider area of effect. It comes on fast or maybe like two days as compared to five days. I think on the issue of duration, all of these products on paper and in the studies lasted for months. Now patients will tell you different things based upon their different experiences. And I say everybody's going to have a different reaction to different products.

You're going to figure out the one that works, the best for you. I think a lot of it has to do with the circumstances surrounding the treatment.

You know, if you like the doctor more, if you got a deal or if it was a better environment, then you may have a different experience with that product that impacts your way of viewing it, but on paper, all for months, because they all bind with a human protein and albumin protein, that's how they bind dak sapphire doxy is going to bind with a peptide and this peptide binding is thought to enhance the absorption into the skin which affects the muscle, stops that trans

fur of acetylcholine to make the nerves fire, to stop the muscle from being active for a longer period of time. That's the thought. Now that's what we know. That's what they seem to be hanging their hats on. I am going to be the first one in my area to have it. I can't wait. I have my training date. Yes, December 4th I'm headed to Italy to learn all about it and I'll have it first in the area.

So that's when I'm going to be able to really get my hands on it and learn the different characteristics. Does it feel lighter? When does it come on, you know, how much does it spread? How much are patients aware of it? I have a large number of patients in my practice who have started to lose efficacy to really all of the products, and that's a terrible place to be.

So we're really happy that we have options now, even if it doesn't last six months for them, it'll give them more than they're getting now. And I think that it's good to have another option. You know, when you say lose efficacy, like how long are we talking now? Right? I mean, it has to work for a little bit, but. Yeah, a little bit. I mean, I've seen patients who have as little as 3 to 4 weeks. Oh. Yeah, I know, I know. And is that is that so?

Is it I mean, look, when I get it done, I would say like it takes about 5 to 7 days to, you know, as you said, hit kick in work, take effect. And then, you know, it's not totally frozen for three months. You know, it starts to gradually wear off. But you're talking me. But by the end of 3 to 4 weeks, they've got no nothing. I'm talking they're back to baseline now let me tell you I know it well and it gets even worse.

There are very few number, very few people that I know of in my practice who get nothing. One of them works for me in the front. Michel, and we put it we can put 50 units of Botox in our forehead and tomorrow it's going to be moving. So she's really excited. Yeah, I tried to get my block for her, which was the botulinum toxin B, which we don't have any available brands in America, but it's only available in Europe and it's even more difficult to get it these days. So it's it's not so okay.

Of course, there's so many questions when I ask you right now. But going back to so we're talking about efficacy, you know, this is something that is very new. And I just have to ask you, you said, you know, for years you were waiting for this. I know it was a problem, but there were some bumps in the road where the FDA was like, we can't approve this yet. Yes, those were.

So I think that there were some issues with like manufacturing and maybe like at the plant, I'm not privy to all of the the information. And as you can imagine, whenever there's a new product coming to market that is perhaps going to impact existing brands, some of those brands may, you know, have issues. You know what I mean? So you're right in saying, hey, check this out. Yeah. Yeah, that or this is our idea. Not really there. You know that. Okay, so. But so. Yeah. So you're not you're not.

And I hate to cut you off, but you're not you're not connected to Taxify in any way, correct? Oh, I'm. That an employee at all. I you know, we have their billers in our office and we are a high volume practice. And that's what allowed me to be able to have first access. But no, I have I'm not even a speaker for them, not consulting nothing. Okay. And so as a professional, you're you're excited about this for your own patients? I'm super excited.

You know, there was a little pushback when we first started talking about it, because if you were touch points with patients, if you're treating you know, I mean, that can be an issue. But I feel like the people who are really going to be into this, I mean, they're going to be loyal to you. They trust what you're telling them. That's going to be the best product for them.

And if they're busy professionals and they've been on this neurotoxin journey for a while, they're not going to mind and they're going to find other reasons to come and see you. So, you know, they'll still be in. On the flip side of that, you know, we've all seen recently where sometimes things go awry with neurotoxins. So there's always going to be the possibility of something going wrong.

And then you have to deal with that effect lasting for longer than it would with some of the shorter acting products. Oh, my God. Yikes. We're going to dig into that in a second. But I will tell you, because I keep it real here with people. And you guys know, I have been the first to try a lot of different things. I'm very excited about this, but mama is not going to be the first to get injected. I'm going to wait a little bit. No, look, I waited. I waited till I was 35 to even do Botox.

And, you know, I've been in this business for for 20 years. And people, you know, in my late twenties were like trying to love it. I was like, let me just lean a little bit. You know, there's been, as you said, 20 years of clinical data for Botox as a Cosmo, stick it for cosmetic use. Mama's going to wait a little bit on this one, but it really does look like it has the potential to disrupt the market in a huge way. Now, as a doctor, you know, you're talking about fewer touch points.

Is that essentially right? What I'm hearing is they're going to come in less if you have a patient coming in once every four times a year, every three months or even three times a year, which is now going to be maybe two. How how do you feel about that? Well, I mean, the Botox visits are after you've developed your pattern and you get to know the patient, they're really quick visits anyway. It's not like we were sitting in there and talking about all these different things.

I always leave the floor open to patients, but most of the time when they're coming in for these visits, they're coming in to get this commodity and then they're on about their day. If they really have a concern, they're going to bring it up and find a way to ask you about it. I think that it might free them up, actually, to kind of focus on other things because they don't have to always be thinking so much about having to come and get their toxin so frequently.

So I'm not too concerned about that part of it. You know, I think that establishing the relationship with the patient is the most important thing. And to your point, I have a lot of patients who aren't necessarily like knocking down the door to get it, because if everything is going right with your current neurotoxin, like, why would you change it? We'll get into course in a little bit, too, because I think that that does factor in.

But there is a large population of patients who have a need for this. So we'll be able to get our with all of them. We're going to be very willing participants because nothing else is really giving them what they need. I mean, Michelle, let us know how it goes. We'll have you on next. Michelle, from your front desk and I'll be asking her next. But now, you know, it's interesting.

I know that a lot of people say, you know, that you become more acclimated or accustomed to it. Your body becomes used to it. I've heard from some doctors, you know, you maybe your metabolism, certain people metabolize it. I'd actually believe it or not. Never until talking to you heard about people who doesn't work for it all. So, so excitement must be we're going to be excited for them. Still going to wait for it. You mentioned Price.

You know, when I first heard about this, I was like you'd be well. But you know, let's be honest, just because you're going last, you're going to make this probably more expensive, right? I mean, they're going to get their money from you anyway. Less than okay, if you had something that was going to potentially disrupt the market and had a or an audience that was like wide awake and ready to try it, why would you do it cheaper? That just doesn't. Do it on sale in. America, right?

The value is in your visits and disruptions to your life. So they have not commented on price at all, which I think is smart, but I expect it to cost more. I expect it to same as more or more. Yeah. Meaning that you're going to outlay more money each time you do it. You're just going to do it your time. That's also going to cater to certain folks and not work for other people. Some people really have to, you know, figure it out for those for three or four times a year.

And then some people want to pay for the convenience of not having to go so frequently. It's just like anything else in life. Yeah. I mean, you're absolutely right. Like Botox. And again, depending on how much you need, can be, you know, an arm and a leg. So if you're adding more, it'll be really interesting to

see how that plays out. But what I'm hearing, you know, for rather what I've read, you know, online and what I'm hearing for you sort of echo the same thing which are like, don't think that because you're coming in less than we found something that you're not going to be spending as much, if not more. You're right. What you're saving in is that convenience of not having to go down to your doctor's office. Exactly. In our dermatology community, that was a lot of the initial conversation.

Will, if it's cheaper and they're coming in less, then I'm not sure if I can get on board with that. Right. But, you know, because that just doesn't make sense from a business standpoint. But I just don't think that's going to be the case right now.

Do you think, you know, as a professional and you mentioned you've done other injection trials before, do you feel like, you know, for the for the general public that there's enough safety background for those people who are going to be brave enough to to go for this? The first time I do the FDA really has stringent criteria for approval of these types of medications.

And in this instance, I really think that this prolonged period has really put them through the ringer, maybe even more so than other companies, because it is not a human alpha women protein. It probably, you know, confers less of an overall risk, I would say. But there is still that area of the unknown. Whenever you're innovating, you're going to be at that point where you know, you just have to kind of see what happens.

Yeah, but no, I have no qualms or concerns about the safety of the product. Got it. By the way, I know my father listens to this and he's probably so happy that for the first time because I'm always like, I'll try that. Sign me up that. I'm like, Daddy, don't worry, I'm going to wait. I know he's listening and I know he's happy right now. So, you know, you mentioned before, though, so DAX ify, you have their fillers. Yes. Oh, so I never heard of I've never heard of DAX inside before.

Okay. So so this is like a brand new. You know, so DAX by is, is the brand of their neurotoxin. But the company, the parent company is called Riverdance. Okay. And you've tried their fillers. Oh, we've had their fillers for a while. Yes. They have a collection of fillers called RH A and RH two, three and four. And then they just launched one. That is a lighter filler for feeling very fine lines, very superficially called density.

I don't know why they did go with RH one, that's what it's called in Canada, but for whatever reason it's called for density here in the United States. They have a beautiful new headquarters in Nashville downtown that I have had a chance to visit because it's my alma mater is in Nashville, too. So I stopped by it, my 20 year reunion. And yeah, they just have state of the art facilities with some really cool rooms where you can do live demonstrations and have it, you know, simulcast out.

It's really kind of neat. I'm laughing. I'm like, Yeah, of course they do. Because they're like, We are about to be rolling in it. Let's show the world what we're hope. They're, you know, interesting thing you mentioned before and I do like to be serious on here, you know, even with Botox, even with using neuro modulator. ZM And the other ones that we were talking about is Port in the wrong hands. Things can go wrong for Doxy. From what I understand right now it is only FDA approved for the.

Is it good? Beller Yeah, well, I have braces, so it's really hard for me to say. But the lines in the forehead, you're 11 lines. It's not approved for anywhere else. Yeah, but you know. Yeah, you know. You know, I mean, they all start off with the approval there. I think Botox just got approval for crow's feet like two or three years ago. Oh, it's the only neurotoxin that's approved for the big three areas. But we all know that we use Botox all over the face. I mean, I did it on the chin.

I do it here, here, all over here. Exactly. So I don't think that's really going to be an issue. Your point about injector is huge, though, because understanding the nuances between the different products and what their capabilities are and what the needs of the patient are, all of that factors into a successful treatment. It's not just the product. So that knowledge is really important.

And I think that's what all of us are going to be gaining when we get acclimated to how it behaves, what the dosing schedule is going to be like. Because there's also going to be a difference in dosing that we're going to have to get used to. And that's another reason I think they're being very cautious about how they roll this out. So yeah. We are. Yeah. Well, so Botox is 20 units in the LaBella and Dax's approved dosage is 40 units. Now, they you can't compare unit to unit.

And now you look at it on a kill adult and basis, they're equal. But there's going to be a difference just like this port is actually dosed two and a half times the number of Botox units. So it gets kind of a little a little different. Now, I know from what I understand by Botox, it always has to be diluted as well. Right. You can't inject pure Botox. There's a certain dilution that happens with it. Is there a dilution with. So that's to be determined.

But let's okay, so let's back up a little bit. Dilution and reconstitution are two separate things that I think sometimes get conflated. These products that we have available to us now index if I will be one of them all come in a vial as a like a dry powder that's on the bottle. We introduce bacteria, static sailing or some other liquid to release it, to allow it to be injected. So there s the reconstitution.

The dilution is really up to the individual doctor to determine and a lot of factors go into that. So I use a 2 to 1 dilution with Botox because I like the way that it spreads, but also the needles and syringes that I use that make it more comfortable for patients have such small measurement, you know, ticks that my fingers just do better with the 2 to 1 dilution. Gotcha. My partner, Dr. Luck, Katie. Lucky it. She prefers a 1 to 1.

So understanding the nuances of spread, understanding how with the push is going to feel, all of that goes into determining the dilution. And I think that there's an acceptable range of dilution that we all agree is, you know, just sort of discretionary. And then there's a level of dilution that is like, okay, now you're just trying to stretch it and. Well, and I'm going to take this moment to be a PSA. I am not a doctor, but you've heard me say it again and again. Botox, do not get the Groupon.

Get the Groupon for your workout classes. Get the Groupon for your shoes. I mean, do not do it when it comes to and injecting neurotoxins. I mean, you just don't want to do it because you look at the end of the day, maybe places offer a deal. But from what I've understood in talking to you, get what you pay for, right? Or so. And if they dilute it too much, you can have really bad, you know, like my daddy always said, you don't say here's two areas you don't save money on.

You don't try to save money on your birth control or your surgery or any cosmetic surgery. Right. Like your dad, he sounds super wise. That's what he's like. These are the two areas, honey, not to save money in because you get what you pay for, so. Okay. So when do you anticipate now that we're going to start to see roll out of of vaccine in the US here. All right. So what I understand and this is nothing permanent might be some secret and whatever it hasn't been verified before.

And I understand there's going to be a very select group of doctors that gets it in December when they train. Okay. And then the next group, which is going to be a little bit larger, will be sometime in March. Okay. And then it won't be available to the masses until the summertime of 2023. So they're being smart and they're making everybody go to their location and train because they don't want bad press. They don't want bad press. And it's so easy these days.

It doesn't end with there's just so many people out here injecting these days that it's hard to really contain that. So I think they're doing it in a very smart way. We'll be able to get so much information knowing that they're relying on very experienced master injectors. Everybody calls themselves that. But, you know, we'll see who's to in this first three months and that. What is your what is your it? I go into December 4th. Oh, wow. You are the first today. All right, Dr. Hartman?

Yeah. Oh, my God. Wait. I mean, have the phones been ringing off the hook? Listen, I have been telling all my patients who I think would be interested, you know, because they are looking for options. So it's my responsibility to share that. But yeah, we anticipate lots of demand when it. Comes, oh, my gosh, I'm going to be watching this like a hawk. You know, I have more questions before we go. But do you have are you can be posting this on Instagram like where can we watch yours?

Yeah. You can totally say, yeah, I've given a little bit of a sneak peek already, did a little media and got some information on like that. I've share with you guys today about the peptide, why it's different. Some of it is just my own commentary and what I think about pricing, but I think I'm on it with that. So yeah, I can't wait to share it with you guys.

If you all follow along, you will learn everything that you want to know so that when the time comes you can feel confident about perhaps trying it or sticking with your product, you know? I mean, hey, everybody's not going to be a candidate for this product. And, you know, that's okay. It's good to have. Options as it launched anywhere else. But actually, where's your app? What's your Instagram? Yeah, that's Dr. Cory Hartman. C.A.R.E. Hartman. Yeah. Corey Hartman. Okay. Yeah.

Has it launched anywhere else already? That's the other thing that is cool and unique about this product. So the other neurotoxins, Europe gets everything 10 to 15 years ahead of us, right? So all the others launched their first and then came here. This is the first one that's launching even ahead of Canada. Wow. Okay. Well, look, I've got to be determined to be seen. Before we let you go, though, is there anybody you know, we've talked about all that wonderful things about this.

Is there anybody who like because this is a different sort of mechanism of action who should not use this? Yeah. So I can't really think of anybody offhand. That would be contraindicated to trying this because it's a peptide peptides are generally very safe and well tolerated by everyone. I think that we're going to determine that group based upon the performance of the product once it gets into our hands. Right. So I don't there's nobody that I can say absolutely should not try it.

It might get in to practice and we realize that it's a little heavier or a little lighter or a little more restricted or whatever than we realize. And that might rule out some groups. But right now it looks like it's wide open for anyone who wants to try it. Well, I mean, I am waiting with bated breath because I feel like, again, this is the first thing that really has the potential to totally disrupt the market. And like I said, Botox alone, not all of its other versions.

I know Botox made $4.7 billion last year for its parent company. So this has incredible potential. You know, keep in mind, we keep it real here. You know, you said it earlier on. And I just want to point that out. If you are one of the first people to try this, if things go wrong, you're going to have to wait a long time. You know, if things go wrong with Botox, we've all seen it. You got to just wait it out. It's not permanent damage. But trust me, 3 to 5 months can feel like eternity.

If you've got something wrong, can't be longer. So six to nine some people. And the studies were even as long as nine months, which sounds great until it doesn't sound great. It doesn't sound great. Well, look, we love this. I'm so honored to have you on. Dr. Hartman, you were so eloquent. I can tell that you are, you know, really excited about this book, but approaching it with all of the precautions, you would want your doctor to do that. You know, people want to know more about you.

If they're in the Birmingham area and they want to come visit you, what's the best way to find you? Oh, we would love that. By our well website is SkinWellness.com We are in Birmingham, Alabama. I'm Dr. Corey Hartman. And Skin Wellness Dermatology across all platforms. Well, you know, before we lose you again, I don't know if you heard my little joke about, you know, being frozen and it feels like an eternity. I want to thank you so much Dr. Hartman.

You know, if you have questions you want me to pass on to Dr. Hartman to see? I'm always happy to do that. You can email me at hello@artbeautypocast.com You can find us on Facebook Instagram and YouTube @artbeautypodcast and is always we will see you next Tuesday and a year from now, maybe you'll be a little less frozen. Thanks for being on. Thank you. All right. All right.

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