A New Rapid-Onset Neurotoxin Was Just Approved. Could It Disrupt Injectables?

Until now, every aesthetic neurotoxin on the market has been formulated with botulinum toxin type A. But a new neurotoxin could change how first-time patients approach injectable treatments.

Meet Boey (BoNT/E), a first-of-its-kind neurotoxin that offers a faster-onset, shorter-duration alternative to traditional neuromodulators, some of which can take several days to reveal their full effect. It can begin smoothing lines in as little as eight hours, with results that fade within weeks.

Made with trenibotulinumtoxinE or botulinum neurotoxin type E (presumably where it gets its name from), Boey temporarily improves moderate to severe glabellar lines, known more commonly as the vertical “11s” between the eyebrows.

Approved by Health Canada over the summer ahead of its potential rollout, though a clinical launch date has not been announced, Boey demonstrated a rapid but short-lived effect in clinical trials, with visible smoothing in as little as eight hours, peak results at approximately seven days and a return to baseline within two to three weeks of treatment.

“When they first presented it to us to do the clinical trial I said ‘Why?’ but as you do the trial you realize why. It works really rapidly, really within 24 hours you see the results,” says Dr. Sheetal Sapra of Oakville Skin in Ontario.

Longer-lasting results are usually a selling point. But for someone curious about injectables and hesitant to commit, could wearing off sooner be the appeal? That’s where the physicians we spoke with see a place for Boey.

Who might prefer results that don’t last as long?

For someone who has never tried a neuromodulator, committing to a result that may last three or four months can feel intimidating.

“This [Boey] may have a role in my practice specifically for patients who are nervous to try a longer lasting neuromodulator,” says Dr. Shannon Humphrey of Humphrey & Beleznay Cosmetic Dermatology in Vancouver. “They could always start with this and see how it feels and then upgrade to the longer-lasting formulation.”

Boey is a relatively low-commitment introduction that provides the toxin-curious with an opportunity to see whether they like the look. That first experience, though short-lived, could give patients the confidence they need to explore longer-lasting options, like Botox.

“The reason I think it’s important is for those people who are scared of toxins,” says Dr. Sapra, who admits those who’ve seen poor results from less-experienced injectors have potentially scared away prospective patients. “If it’s something that’s only going to last for a week or two and then wears off, they can try,” adding, “Rent the Runway. If you like it, buy the dress.”

Could faster results help when time is short?

A wedding, a job interview, a last-minute invitation: sometimes the occasion arrives before you’ve thought about treatment. Dr. Humphrey sees a possible role for Boey when there’s less time to plan.

“Patients [who] have left it too late and they really want their neuromodulator to kick in on the same day, this may provide an option for them, at least for a short-term solution,” explains Dr. Humphrey.

Short-lived can be useful in surgery, too. Dr. Brian Biesman, an oculofacial plastic surgeon in Nashville, explains why a toxin that wears off could suit a brow lift.

“If I’m doing a brow lift procedure, I like to use Botox-type drugs to relax the muscles that pull the eyebrows down so that after I set the brows into their new position, I avoid the downward pull of the facial muscles…because I want the brows to stay in their new position for at least a few weeks,” explains Dr. Biesman. “By that time, they’ll heal into place and you won’t need the Botox-type drugs to have that relaxing effect.”

Approved, but when can you book it?

While authorized in Canada and Europe, treatment has not yet commercially launched in either market as of publishing.

“We’re going to be learning about the science, about dosing and safety once this comes to market, but it will give us more flexibility with our patients,” says Dr. Humphrey.

But while this may not replace longer-lasting neurotoxins for patients who prioritize longevity, its combination of speed and brevity could give injectors another way to tailor treatment around a patient’s schedule, comfort level and aesthetic goals.

“Is it going to be as huge as normal neuromodulators? No. It’s really for those people who need to try something,” says Dr. Sapra.

Curious about neurotoxins in general? Speak with a professional at a Vos Collection clinic near you about what fits your schedule and your comfort level.