(Standing Appointment)

I Tried A Botox Alternative To Smooth My Forehead Wrinkles — And It Worked

No needles? No problem.

Standing Appointment is our review series that investigates the best new and notable cosmetic treatments in the aesthetics space and determines whether or not they are worth trying for yourself. This week, one writer tries Skin Laundry’s The Fixer treatment for fine lines and wrinkles.

As someone with a lifelong aversion to needles, I envy those who can so casually pop into a dermatologist’s office for lunchtime Botox like it’s no big deal. I’m what’s known as vasovagal syncope, meaning I experience sudden drops in blood pressure and heart rate caused by the sight of blood or needles. Blood draws, IVs, and shots are always a will she/won’t she of whether or not I’m going to pass out on a kind nurse just trying to do their job. My squeamishness is so bad I don’t even need to see the blood or needles — when I lived in New York, I once passed out on the C train platform after reading a particularly graphic New York Magazine medical feature. Nothing like getting stepped over by rush hour traffic while coming to the horrific realization that your hair has touched the subway floor.

Needless to say, I’ve made it through my entire adult life without ever having neuromodulators or fillers injected into my face — not because I’m against them, but because I sincerely doubt I’ll be able to get through it without fainting on the floor with a syringe still stuck in my forehead. Instead, I’ve relied on lasers and other devices like high-intensity ultrasound and red light therapy to help keep my skin looking refreshed. But as my 40th birthday approached this past July, I noticed the fine lines on my forehead and between my brow were looking more and more pronounced despite all my diligent zapping, facials, and SPF use. So, consider my interest piqued when I saw Skin Laundry, the international chain that made laser facials a thing, was offering a topical Botox alternative to smooth fine lines completely needle-free. Called The Fixer, it’s an add-on serum treatment that promises to temporarily soften fine lines and tighten the skin.

What Is The Fixer?

A peptide-based topical treatment, The Fixer blends high percentages of acetyl hexapeptide-8 and acetyl hexapeptide-30 with hibiscus esculentus (better known as okra) and camellia sinensis leaf extract (aka green tea). Hexapeptide-8 is commonly referred to in topical products as argireline and is well known for its Botox-like effect in smoothing expression lines. However, it's not generally thought to deliver equal results to injectables. Argireline also has been shown to have some skin-firming benefits as well as supporting healthy collagen. “Over time, we lose collagen, we lose elastin and that makes our skin look a little bit more wrinkly, less tight, less firm,” says Dr. Roberta Del Campo, M.D., a Miami-based dermatologist and Medical Director of Skin Laundry. “The more of these peptides you have that are entering the skin, they're going to increase that firmness. It's going to soften those fine lines and wrinkles and actually make the skin more taut. Which is what we go for when we use Botox.”

My skin before Skin Laundry’s The Fixer treatment. Courtesy of Megan McIntyre

How Does The Fixer Work?

The trick is getting those peptides to enter the skin, which is where Skin Laundry’s Thermo Fractional treatment comes in. A non-laser resurfacing treatment, it works by creating tiny micro-channels in the surface of the skin by combining heat and motion to deliver a short burst of thermal energy via a titanium tip to the top layer of skin. This stimulates cellular regeneration and allows any topical treatments that follow to penetrate more deeply.

To get the most noticeable results, the brand recommends combining its Power Signature Laser treatment with a Thermo Fractional treatment prior to your Fixer application. According to Dr. Del Campo, this so-called Power Duo facial helps to improve all-over skin quality, which in turn will enhance the overall benefits of The Fixer treatment. The Power Signature treatment uses an Nd:YAG laser to deliver controlled heat and laser energy into the skin to stimulate collagen production as it helps improve skin texture and tone.

Peptides are obviously not a new skin care ingredient, however according to Del Campo the high percentages of the hexapeptides, combined with the unique delivery system are what make The Fixer such an effective topical treatment. “These are medical-grade formulations,” she explains. “Conservatively, I would say it’s at least 100 times more concentrated than what you typically buy over-the-counter at the pharmacy or a Sephora. It’s basically putting pure peptides directly on the skin with no additives or ingredients to water it down.”

Skin Laundry’s treatment room. Courtesy of Megan McIntyre

What Happens During A Fixer Treatment?

For my Fixer treatment, I headed to the newly opened Skin Laundry clinic in the West Highlands neighborhood of Denver, Colorado in June of 2023. Skin Laundry has locations in the U.S. in Arizona, California, Colorado, Connecticut, Massachusetts, New York, and Texas. For international customers, there are clinics in Hong Kong, the U.K., Dubai, and Kuwait.

While I was initially scheduled to have the full treatment at my first appointment, because it had been several years since my last laser appointment (thanks COVID), it was decided that we would do a test session with a light setting of the Power Signature laser and spot treatments of the Thermo Fractional before undergoing a full strength session to make sure that my skin could handle the treatment without a negative reaction. While the lasers are gentle and safe for all skin types and tones, there is always the chance of a negative reaction and the length of time since my last laser treatment meant my technician wanted to err on the side of caution.

The first session was a success, with zero irritation or negative reactions, so I made an appointment to come back in early August for the full strength treatments — called a Power Duo facial — with the Fixer add-on. When I walked into the clinic, I was given a headband and a cleansing wipe to clean my face, then shown to my treatment room. There, my technician Michaela walked me through the process and asked me which areas I wanted to target for fine line smoothing. I pointed out my forehead and brow area, was handed a pair of protective goggles for my eyes, and was instructed to to lay back while she got to work.

My skin mid-treatment. Courtesy of Megan McIntyre

First up was the full strength Power Signature laser, which felt like a warm sensation on my skin. There was no pain and we were done in one pass. The protective goggles were removed and we moved on to the Thermo Fractional device, which Michaela warned me might feel “a little spicy.” As someone who has undergone radiofrequency microneedling (which weirdly didn’t trigger my vasovagal response) and the torture of Ultherapy before, I was confident in my pain tolerance, however what I forgot in those experiences is that a healthy dose of numbing cream and oral pain medication is involved. The Thermo Fractional treatment is quite literally “punching” tiny holes into your skin and must be placed segment by segment on the skin. My forehead, for example, took about six “punches” and by placement number four my eyes began watering. When we got to my cheeks I let out a little whimper of pain, and by the time we got to my upper lip, which Michaela saved for last because it is apparently the most painful, I was digging my nails into the stress ball so ferociously I was afraid I was going to pop it and send blue goo shooting all over my freshly punctured face. Thankfully the process is quick and I have the pain tolerance of a very cranky toddler, so most people will probably have a less dramatic experience than mine.

After the Thermo Fractional treatment was finished, Michaela reached for a syringe that was (thankfully) needle-free. Inside was The Fixer treatment, which she spread across my still somewhat “spicy” feeling skin, targeting it on my brow 11’s and forehead, as well as my smile lines, crow’s feet, and a few lingering acne scars. As she explained, the collagen boosting properties of the peptides and smoothing effect would help soften the lines and smooth the texture for those as well. The serum solution felt extremely cooling and soothing on my temperamental skin.

The needle-free syringe used to administer The Fixer treatment. Courtesy of Megan McIntyre

What Does Aftercare Look Like?

I was told that in order to get the most effective results, I needed to allow The Fixer to work its way into the microchannels that had just been made and not clog them or flush out the product. That meant no washing my face for 24 hours, no sunscreen or makeup for two days, and to stay away from any product with vitamin C as there is the risk of it creating a DIY chemical peel effect due to ascorbic acid’s slightly acidic pH. I was told to stay away from any exfoliating or harsh ingredients for the week following my treatment and to expect my skin to look red and feel rough and bumpy for a few days following my treatment. To help minimize that effect, I was advised to use a hyaluronic acid serum every hour, for up to six hours directly following my treatment, followed by a rich moisturizer that evening to keep my skin as hydrated and supple as possible. Michaela told me I could expect to see the peak benefits within three to five days following that initial treatment. I popped on a bucket hat to protect my skin from the harsh Colorado sun and headed home.

My skin two days post-treatment.Courtesy of Megan McIntyre

My Results

That evening, my skin looked red and felt tender to the touch, but I dutifully slathered on my Medik8 Hydr8 B5 Intense Hyaluronic Acid Serum, six layers over six hours, followed by my ultra-nourishing Dermalogica Super Rich Repair Moisturizer. I felt like a skin care truant for not washing my face that night but I headed to bed with a thick layer of moisturizer on and tried not to feel too guilty about committing a skin sin. The next morning, my skin felt rough to the touch and I could see tiny dots where the Thermo Fractional treatment had been applied. The following day those dots intensified into tiny brown scabs and patches to go along with the redness, something Michaela had warned me about and cautioned me against picking or rubbing off. These so-called micro-dots were part of the collagen building process as the skin was damaged (in a controlled way) and healed itself, resulting in accelerated collagen production.

By day four, the majority of the micro-dots had faded and the redness had completely abated. By day six, the micro-dots were completely gone and I noticed my wrinkles were softened and my skin texture looked brighter and my tone was slightly improved. I looked refreshed and glowy with the added bonus of a boost in overall firmness of my face.

My skin one month post-treatment. Courtesy of Megan McIntyre

My Final Thoughts

The Fixer itself costs $100, however it’s only offered as an add-on service to the Thermo Fractional treatment. In order to achieve the best results, Skin Laundry recommends pairing The Fixer with the Power Duo facial, which rings in at $800, putting the total for this treatment at $900. It’s definitely not a money-saving option and the results typically only last about a month — I started to see my fine lines creep back to after that one-month mark. Considering Botox tends to have a lifespan of about three to four months and costs within the same price range, depending on how much you inject and where you place it, you might be (rightly) wondering why someone would opt for The Fixer over Botox.

“What I love about this treatment is that it’s going everywhere in your skin [because] you’re applying it topically versus Botox where you’re injecting just to a focal area,” says Dr. Del Campo. “So you’re getting an overall global enhancement of your skin, fine lines, and wrinkles over the full area that we are treating.” For someone like myself, who can’t do injections, a treatment like The Fixer allows me to experience a Botox-like effect without the needles and potential fainting that could ensue. Dr. Del Campo notes it’s also a great option for those considering Botox who want to see what a wrinkle-softening effect could look like on their skin before they opt for an injectable treatment.

Plus, Dr. Del Campo notes that if you are consistent with your Fixer treatments, you will see cumulative benefits. “The peptides are basically signaling the skin to start this process of repair and to build a little [more] collagen and elastin,” she says. “Every time you do it, it’s going to increase that signal to build more.” She notes that just like any topical you put on your skin, when you stop using it, the benefits will gradually disappear, however as you redo it, the signal will stay active and continue to keep skin healthy, firm, and smooth.

That said, it’s important to be realistic about what type of results you can expect. Did I have a total erasure of fine lines and wrinkles and the baby smooth complexion of a 22-year-old? No — it’s a beauty treatment, not a magic spell. There is no topical treatment that is going to take 20 years off my skin. But, I knew going into the treatment that I was going to experience a Botox-like effect, not Botox itself. There’s a big difference between those two things and Michaela did a wonderful job of making sure I was well-informed about what my results would be. That said, looking in the mirror a week later (and at my before and after photos), there was a very clear improvement in the depth of those lines and in the overall tone, texture, and firmness of my skin after my treatment. I’ll happily continue to get my Fixer fix on a monthly basis if it gives me that smooth, glowy visage without any of the needles, fainting, or drama of injectables.