Which is better- Botox, Xeomin, or Dysport?

Neurotoxins available in the US: Botox, Xeomin, and Dysport

Botox® Cosmetic entered the market in 2002, when it was FDA-approved for the treatment of glabellar frown lines (between the eyebrows).  It was the only player in the game until 2010, when Dysport® was FDA-approved for the same indication, with Xeomin following closely on its heels.

What is the difference between the three?

All three neurotoxins are derivatives of botulinum toxin. The biggest differences are in the concentration of neurotoxin in each medication, and any additional proteins that are part of the preparation. The actual potency of neurotoxin preparations is standardized into units. This means it’s possible to figure out how many units of Xeomin someone would need based on how many units of Botox they normally get.

Another difference: cost.

Botox is the most expensive of the three options on the market. It’s also been around the longest, and studied the most extensively.

Xeomin price is usually a little less than Botox. And you can compare the price per unit directly, because the units are interchangeable. So if I normally need 20 units of Botox, 20 units of Xeomin is likely to give me the same result.

Dysport seems the cheapest on a price/unit comparison. But you actually need three times as much Dysport (in terms of units, not injection volume) to get the same results. So keep that in mind when you compare costs.

What I’ve seen using all three neurotoxins.

I regularly use Xeomin and Botox in my office, and I’ve tried Dysport as well. Here’s what I’ve noticed.

• Xeomin seems to kick in a little quicker than Botox- maybe five days instead of seven days. According to the sales rep, Dysport is supposed to take effect even faster. And this is consistent with what I’ve seen. Though take it with a grain of salt- my use of Dysport is fairly limited so far.
• Dysport reportedly lasts up to four months. I haven’t seen this in my patients, but again, my use of Dysport is limited. Botox and Xeomin both last about three months. They seem to wear off faster around the eyes.
• Some people develop resistance to Botox. Likely they have formed antibodies to some of the proteins in the preparation. If this happens, switching to Xeomin or Dysport may work.

The differences aren’t huge.

As you can see, the differences between Botox, Xeomin, and Dysport aren’t huge. They’re all effective products in the right hands. If you want to get the best results possible with neurotoxins, I have three recommendations for you:

1. See a plastic surgeon or facial plastic surgeon. They’ve got more training in how the facial muscles move and interact than your average family practitioner or dentist. The actual injection technique is simple. It’s where and how much you inject that matters. Seeing a nurse injector who is overseen by a plastic surgeon is also good- he or she has the plastic surgeon there to bounce ideas off of.
2. Go every three months. The more consistent you are with your treatments, the better your results will be. Your skin remodels over time, and wrinkles actually become more shallow. But this doesn’t happen if you let your Botox wear off for months at a time between treatments.
3. Don’t office hop. It may be tempting to go to whoever is offering the lowest price. But going to the same office every time allows you to get consistent results. And to tweak your results if they aren’t quite perfect.

I hope you found this article explaining the differences between Botox, Xeomin, and Dysport helpful. If you want an estimate of the cost, download my FREE price guide here.