What is the difference between Botox, Xeomin, and Dysport, and does it matter which one I get?
When it comes to neuromodulators, or injectable medicines that soften wrinkles, there are several different brands. Kind of like Pepsi vs Coke. Probably the most well known is Botox® Cosmetic (onaBTXA), but there are 3 other major players - Xeomin® (IncoBTXA), Dysport® (aboBTXA), and, the newest, Jeuveau® (praBTXA-xvs). They all share the same core neurotoxin which is botulinumtoxinA (BTXA), and therefore behave very similarly. There are however some subtle differences between them.
Botox®
Botox® Cosmetic by Allergan is the only neuromodulator that is FDA approved to treat all three aesthetic areas of the face - the glabella (“11 lines”), crow’s feet, and forehead lines. The other 3 brands currently only have FDA approval for the glabellar area, but are widely, and safely used in all the other facial areas as well.
Xeomin®
Xeomin® is a purified version of botulinum toxin. This means that it does not contain any accessory proteins or additives. Theoretically this makes it a good option if you have allergies or sensitivies, or if you have had Botox® in the past and it no longer works as well on you. Some patients or injectors find that Xeomin® wears off more quickly than other neuromodulators. However there are studies that show that Xeomin actually has comparable if not longer longevity than botox (1). The subtle differences in longevity noted by patients may actually be attributed to improper mixing technique prior to injection. With Xeomin®, some of the product may reside in the cap, and therefore it needs to be flipped upside down and mixed well in order to ensure its potency.
Dysport®
Dysport® like botox has protective proteins that cluster around the active part of the molecule. Dysport® is known to diffuse or spread a bit more than Botox® or Xeomin®. This may be a good thing for some as you get more even, wide spread of the product, but for others it can be a bit harsh or too frozen. This also may make it easier for the product to spread to areas that you don’t want it to - increasing the chances of causing an eyelid droop or affecting the smile. Dysport® may kick in slightly quicker than the other neuromodulators, giving you results at 2-3 days compared to 4-7 days days for Botox® or Xeomin®. Some patients also find that Dysport® lasts longer than the other neurotoxins, although the studies can only attest to the 3-4 months that is typical of neurotoxins.
Jeuveau®
Jeuveau® is the newest kid on the block, hence giving it the name “NewTox”. Jeuveau® has a quick onset, similar to Dysport®, and is potentially less likely to spread to unwanted areas. Longevity is similar to the other neurotoxins and overall seems very comparable to the older toxins.
Bottom Line:
At the end of the day, all of the neurotoxins give very comparable results, with subtle differences that are mostly anecdotal and based on each patient’s unique experience. Some brands work better, last longer, look more natural on some patients than others - so it can take some experimenting if you want to find one that is best for you. However more often than not, the results from different neurotoxins are indistinguishable from each other. Injectors may have personal preferences or are more comfortable with one brand over another. You may also see price differences between the brands - with Xeomin®, Dysport®, and Jeuveau® being slightly less expensive than Botox®. In our office, we believe that great results are more dependent on the injector and technique, rather than the brand of neurotoxin. For that reason, we offer Botox®, Xeomin®, and Dysport® without any difference in pricing.
Curious to learn more about botox and how it will work for you? Book a free consultation with us!
Shome D, Kapoor R, Khare S. Two different types of botulinum toxins: Is there a difference in efficacy and longevity? J Cosmet Dermatol. 2019 Dec;18(6):1635-1641. https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.12949