Better Than Botox? Unlikely

It’s expensive, it involves a needle and it looks scary.

So with all these beauty products coming out on the market that claim to be “the Botox (search) alternative,” it’s tempting to believe them.

But doctors say don’t be fooled.

“Botox acts on the neuromuscular junction. You can’t deliver a neuromuscular blocking agent through intact skin,” said Dr. Z. Paul Lorenc, a plastic surgery professor at NYU School of Medicine. “These creams, they work great, moisturize skin. Vitamin E, vitamin C, retinol might help [fight wrinkles], but nothing on the order of Botox.”

But many companies are making the claim that their products are as good or even better than Botox, which is most commonly used to treat wrinkles on the forehead and between the brow, and costs about $900-$1,500 per doctor's visit, according to Lorenc.

Bliss spa (search) has just unveiled No-Motion Lotion, at $35 an ounce. It's a serum with "skin-firming peptides" that they say was specifically designed to be a Botox alternative. Beauty and skin care company Joey New York (search) has a product called Line Up, for $42 an ounce. It has collagen and sodium and is billed as “the safe alternative to Botox.” And there are countless others.

But Manhattan dermatologist Dr. Bruce Katz says these products are using deceptive marketing gimmicks in comparing themselves to Botox.

"There's StriVectin (search) — it's very popular but it doesn't have anything remotely similar to Botox and no benefits. Peptides, collagen, sodium — they don't do anything," he said.

Katz said StriVectin-SD was actually sued by Allergan Inc., the company that makes Botox, for asking the question "Better than Botox?" in its advertising, a suit StriVectin won because the slogan is in the form of a question.

"Other ads are doing similar things ... it's all a marketing scam. It may work one in 500 times, but it has to be scientifically tested and have a significant benefit," Katz added.

Beauty companies, however, stand by their products.

“It takes a few days, but you will see wrinkles relaxing. I tested it on my forehead and I really saw a difference,” Bliss spokeswoman Robin Fishelson said about the company's No-Motion Lotion. “Besides being more cost-effective [than Botox], people are a little wary of injectables,” she added.

Joey New York sales director Jennifer Saraf says its Line Up product is not going to duplicate the effects of Botox, but it is "a safe alternative."

“Nothing is going to work as well as Botox unless you get injections or plastic surgery. But it is a safe alternative and you will see a diminish in the line."

Indeed, Line Up user Betty Gregg, 58, from Buffalo, N.Y., swears by Joey's serum.

"I think it's wonderful. I put it on in the morning, and it diminishes lines on my forehead and around the mouth. I think after continual use, the lines on my face have literally diminished. I have a lot of friends who have gotten Botox injections — I think this is just as good," she said.

But beauty professional Anya Dorfman, one of Dr. Lorenc's regular patients, previously tried StriVectin ($135 for 6 ounces) and CureDerma (search) from Aloe Cream laboratories (the ad copy reads "a collagen boosting protein tested and proven to reduce skin wrinkles and decrease the signs of aging without painful injection treatments," and the cost is $80 for 6 ounces.) And she says they're fool's gold.

“There’s no comparison. They don’t work — you’re wasting your money. Maybe it makes a difference, but it’s such a subtle difference that when you’re in the mirror looking and hoping for change, you might not even notice. And the creams are expensive also.”

Dorfman said the Botox shot is not painful, and well worth the cost.

"It’s an instant and just refreshed look — not dramatic, just better and younger," she said.

Last year, 2.2 million Americans got Botox injections, including a growing number of men and many people under 25, and celebrities like Madonna, Nicole Kidman and Sharon Stone are rumored to be in their ranks.

But after the recent case in which four people in Florida apparently sought Botox treatments and came down with symptoms of botulism poisoning, a rare and potentially fatal paralytic illness that affects muscles, eyes, limbs and the respiratory tract, alternative potions may be even more tempting to the needle-wary. Botox is a derivative of the botulism toxin, but it contains only a billionth of a gram of the highly purified protein.

That said, the Florida investigation is now focused on unlicensed and unregulated products, not the FDA-approved Botox cosmetic, said Caroline Van Hove, a spokeswoman for Allergan.

Lorenc said consumers need to be wary of peddlers selling "Botox" on the cheap.

“More than one manufacturer is selling discounted botulism," he said. "Botox has been in use for 15 years, FDA approved for wrinkles for three years. Not one case of botulism. Watch out for discounts, ask for a source. This is a medication. Patients have to do their homework.”

Even when Botox is properly applied, there is a risk of side effects, like temporary bruising, headaches and eyelid drooping. Some patients are also worried about losing expression, as a common spectator sport these days is pointing out celebrities whose foreheads don't move.

Dorfman said the face-freezing only happened to her a little bit, and she was glad it did.

“I have not had a problem with that. It made my forehead a little less expressive. I lift my eyebrows up, and you shouldn’t do that," she said.

Others, however, come from the Meryl Streep/Susan Sarandon school of aging gracefully. New Jersey resident Jane Flannelly, 52, drinks water, uses moisturizer and crosses her fingers — but she won't go near a needle.

"I would never use Botox," she said. "Friends of mine have tried it; it left deeper grooves than you had before, you have to keep it up and it's expensive. I say what nature gave you, keep it."