Relfydess vs Botox

For decades, aesthetic medicine has relied on botulinum toxin injections, with Botox (onabotulinumtoxinA) standing out as one of the most recognised brands. Now, Relfydess™ (relabotulinumtoxinA) has launched in the UK, sparking scientific interest into the results of Relfydess vs Botox. Patient preferences are shifting—away from frequent, formulaic treatments and toward longer-lasting, more sustainable solutions with a strong scientific backbone. Relfydess™ may have arrived at precisely the right time. Here’s how it compares to the established standard, Botox® (onabotulinumtoxinA), and other neuromodulators, including Azzalure® (abobotulinumtoxinA), Letybo® (letibotulinumtoxinA), Xeomin® (incobotulinumtoxinA), and Jeuveau® (prabotulinumtoxinA).

You can read my 12 month experience with Relfydess review here on my SubStack

Last updated June 2026 by Dr Ravi Jain

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Understanding Botulinum Toxin Type A

Both Relfydess and Botox contain botulinum toxin type A (BoNT-A), a purified protein derived from Clostridium botulinum. They work by temporarily blocking acetylcholine release at the neuromuscular junction, causing relaxation of targeted muscles. This mechanism underpins their use in both aesthetic and therapeutic applications.

Key Differences in Formulation

Feature	Botox (OnabotulinumtoxinA)	Relfydess (RelabotulinumtoxinA)
Active Ingredient	OnabotulinumtoxinA	RelabotulinumtoxinA
Complexing Proteins	Contains accessory proteins (900 kDa)	Purified toxin 150 kDa (no accessory proteins)
Diffusion	Moderate	Under clinical evaluation
Onset of Action	Typically 3–5 days	39% at Day 1, Peaks at Day 7
Duration	Typically 3–4 months	76% still not returned to baseline at 6 months

Both products require prescription by a qualified healthcare professional and should be administered by a trained clinician in accordance with UK medical regulations.

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Mechanism of Action & Clinical Performance

Onset of Action

Research shows that botulinum toxins typically start working within 3–5 days, reaching peak effects around 14 days. The approval data from the READY 1 and 2 and 3 trials suggest that Relfydess may work faster, with visible results appearing in 1–3 days.

Botox vs Relfydess Duration of Effect

While Botox is typically re-administered every 3–4 months, Relfydess has demonstrated meaningful clinical effects lasting 5–6 months (Read my 6 month review), with some patients experiencing visible results even at Day 180. In head-to-head comparisons:

• Azzlaure®lasts 4-5 months.
• Botox® and Xeomin® typically last 3–4 months.
• Letybo® last less than 3 months in some patients.
• Relfydess demonstrated 75% of patients maintaining results at 6 months in clinical trials.

This makes it an appealing choice for:

• Patients frustrated with the short-lived effects of other toxins.
• Men and high-motion patients requiring long duration.

Individual responses to botulinum toxins vary, with factors like metabolism, dosage, injection technique, and treatment area influencing how long the effects last.

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Precision & Diffusion: Implications for Treatment

A key consideration in botulinum toxin selection is how it spreads after injection.

• Botox contains complexing proteins that may influence diffusion.
• Relfydess is a purified formulation, meaning its diffusion properties may be different.

Clinical significance:

• Some clinicians prefer lower-diffusion toxins for targeted areas, such as the glabella or periorbital region, to minimise unintended effects like eyelid ptosis.
• The degree of diffusion for Relfydess is still being evaluated in large-scale studies but there is no initial reason to feel it behaves any differently to other toxins.
• The incidence of eyelid ptosis in the READY 1 trial was 0.8%, similar to Botox.

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Relfydess Immunogenicity & Resistance

A pooled analysis of over 1,847 patients from six clinical trials (including repeat-dose studies) demonstrated a remarkably low immunogenicity profile for Relfydess:

• 0% formation of neutralising antibodies, even in patients with prior exposure to other botulinum toxins.
• 1.1% developed treatment-emergent anti-drug antibodies (ADA), none of which were clinically relevant.
• No cases of secondary non-response were observed.

By comparison:

• IncobotulinumtoxinA (Xeomin®) is also free of complexing proteins but still contains human albumin.
• AbobotulinumtoxinA (Azzalure®) and OnabotulinumtoxinA (Botox®) contain both complexing proteins and human albumin.
• PrabotulinumtoxinA (Jeuveau®) has demonstrated non-inferiority to Botox but has shown slightly higher ADA rates in some studies.

Key takeaway:
The risk of developing resistance is low for all products when used appropriately by trained medical professionals.

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Botox and Relfydess Safety & Side Effects

All botulinum toxin treatments, including Botox and Relfydess, have a well-documented safety profile when administered correctly. Potential side effects include:
Common: Temporary bruising, swelling, mild headache
Rare: Eyelid drooping, asymmetry, injection site pain
Very Rare: Systemic effects if improperly administered

Both products should only be prescribed and administered by qualified medical professionals in a CQC-registered medical setting to ensure patient safety.

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Regulatory Compliance & Medical Guidance

Under MHRA regulations, botulinum toxins are prescription-only medicines (POMs), so medical professionals must prescribe them after a face-to-face consultation. The law prohibits direct advertising of these treatments for aesthetic purposes.

Key Considerations for Patients:

• Only qualified medical professionals can prescribe and administer Relfydess or Botox.
• You must have a medical assessment before receiving treatment.
• Clinics must follow UK medical regulations and operate in CQC-registered settings to ensure safety.
• Practitioners must provide clear, evidence-based guidance on expected results, risks, and aftercare.

Relfydess Training for Medical Professionals

If you’re a medical professional intrigued by the science and seeking to offer your patients longer-lasting results, our Relfydess training workshops provide everything you need to make a confident transition from traditional toxins like Botox. Hosted at the award-winning Riverbanks Wellness Clinic near Luton Airport, these small-group sessions (4–5 delegates max) offer hands-on teaching, take-home materials, product for use on the day, and the option to treat models. Designed and led by Dr Ravi Jain, a global trainer and early adopter of Relfydess, these sessions are ideal for clinicians wanting to stay ahead of the curve.

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Conclusion: A New Option in Botulinum Toxin Therapy

Both Relfydess and Botox represent clinically validated botulinum toxin treatments, each with unique properties:
✔️ Botox has an established safety profile, well-documented efficacy, and broad clinical applications.
✔️ Relfydess is a newer formulation with potential advantages in onset speed, longevity, and immunogenicity.

What this means for patients:

• Both treatments remain effective options for muscle relaxation therapies.
• The choice between them should be made in consultation with a medical professional.

Riverbanks Clinic is among the first UK clinics to assess the clinical performance of Relfydess. If you would like to find out more, contact Riverbanks Clinic or call 01582 762877.

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Scientific References

1. Jankovic J, Carruthers J, Naumann M, Ogilvie P, Boodhoo T, Attar M, Gupta S, Singh R, Soliman J, Yushmanova I, Brin MF, Shen J. Neutralizing Antibody Formation with OnabotulinumtoxinA (BOTOX^®) Treatment from Global Registration Studies across Multiple Indications: A Meta-Analysis. Toxins (Basel). 2023 May 17;15(5):342.
2. Lee, K.W.A.; Chan, L.K.W.; Lee, A.W.K.; Lee, C.H.; Wan, J.; Yi, K.-H. Immunogenicity of Botulinum Toxin Type A in Different Clinical and Cosmetic Treatment, a Literature Review. Life 2024, 14, 1217.
3. Shridharani SM, Moradi A, Donofrio L, et al. (2024). Efficacy and Safety of RelabotulinumtoxinA, a New Ready-to-Use Liquid Formulation Botulinum Toxin: Results From the READY-1 Double-Blind, Randomized, Placebo-Controlled Phase 3 Trial in Glabellar Lines. Aesthetic Surgery Journal.

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Final Note: This blog post is for educational purposes only and complies with MHRA advertising guidelines for prescription-only medicines. For personalised advice, always consult a qualified healthcare provider.

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