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Botox vs. Dysport vs. Xeomin

posted in Cosmetic Dermatology

Despite any changes in the economy, the popularity of noninvasive cosmetic treatments continues to rise each and every year. With the increase in demand, supply of these products has also increased. We now have hundreds of fillers, lasers, and other technologies at our fingertips to treat a vast array of issues. But when so many products exist, it can become difficult for the consumer to sort through them all and decide which is the best (and the best for them). Case in point: muscle paralytics.

For years, we’ve had the one and only Botox (onabotulinumtoxin) by Allergan. It’s introduction was met with fear and skepticism which quickly faded into unparalleled popularity and adoration. Never before has an injectable product changed the marketplace as much as Botox. People became instantly hooked on it, loving it’s incredible ability to both reduce and prevent wrinkles. But now, more products are entering the marketplace, and patients are consistently asking for information as to what this means for them.

The newest products to hit offices are Dysport (abobotulinumtoxin) by Medicis and Xeomin (incobotulinumtoxin) by Merz. Both work in a similar fashion as Botox, by temporarily preventing contraction of a muscle at the level of the nerve. Preventing movements that over time form lines in the skin helps to smooth the face, giving it a more youthful appearance.


So….what’s the difference between these three?

In essence, not much.

Botox is obviously the most well-studied of the three, having over 2,300 studies written on it. Dysport is up next with 700 studies, and Xeomin comes in last at 50. All are approved by the FDA.

Patients often ask about cost differences, and it’s a good question to ask. However, they are difficult to compare because equal amounts of each product don’t equate to the same effects. 2.5 – 3 units of Dysport are the equivalent of 1 of Botox. You may find that one product is cheaper than the other, but it may end up being equivalent if you need more of that product.


In terms of results, Botox typically takes 7-10 days to demonstrate full results, whereas Dysport can appear within 2-3 days. Anecdotally, some patients report differences in how long the product lasts, but there is no clinical consensus.

Microscopically, the products do differ in their migratory tendencies, as they are reconstituted with differing amounts of sodium chloride. Some say that this change is most prominent in Xeomin, which can migrate more and become less precise, making it less fit for small target areas like the eyes. More or less, however, all products have similar efficacy in experienced hands.

So….how do you choose? Well, if you’re happy with your current product, don’t change it! There’s no need. If you’re noticing that a product isn’t lasting as long as it used to for you, you could experiment with switching to a new brand. Ultimately, it’s up to what your doctor is used to working with, and what you prefer.

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