Botox, Dysport, Xeomin: What’s the difference?

difference between botox dysport xeomin

Botox, Dysport, Xeomin: All neuromodulators

We get questions every day from patients looking to lift the appearance of their skin. Many would ask about Botox, its safety, and its effectiveness. Rest assured, Botox ticks both boxes and has been in our toolkit for years. But there are some new kids on the block that our patients are curious to know about. Dysport and Xeomin have been making waves over the last few years. You can even find some comparison videos on YouTube. So Botox, Dysport, and Xeomin; what’s the difference? For starters, they all fall under the umbrella of neuromodulators. It’s essential to understand this concept first before exploring any differences.

What’s a neuromodulator?

For muscles to contract and expand, the muscle depends on signals from connecting nerves. 

A neuromodulator is a tiny protein that blocks communication between nerve and muscle cells. As a result, the muscle cannot move. The contraction of the muscles of facial expression causes most wrinkles on the forehead and around the eyes. These muscles are used for both smiling and frowning. By reducing the movement of these muscles, you can remove the signs of wrinkles and aging.

Botox, Dysport, and Xeomin each contain a neuromodulator called Botulinum toxin type A. Yes, this is the same protein that causes the condition botulism, with types A and B especially dangerous to humans. However, the active ingredient is purified from the source. Therefore, these injectables are a safe, easy way to reverse the hand of time. It works by relaxing muscles through a mild weakening effect. Of course, each brand will claim they are the most effective in reducing wrinkles. Here’s what you need to know about each one. 

Botox: The Old Guard

Botox is the brand name of an injectable produced by Allergan Inc. It’s the first and most popular neuromodulator. Botox contains Botulinum toxin type A, hence its name. There are also small amounts of albumin and sodium chloride. Botox was FDA approved in 2002 for the treatment of forehead wrinkles, Crow’s feet, and other fine lines on the face. There are other FDA approved uses of Botox. These include migraines, excessive sweating, eyelid spasms, and cervical dystonia

For cosmetic purposes, your dermatologist will administer small doses in multiple places for it to take effect. Botox can last as long as 4-6 months, on average. Some dermatologists and general practitioners may use Botox for conditions that are not FDA approved. Some of these off-label uses are still in the research stages. Your medical provider will advise you of any off-label use. 

Dysport: Holding its own

People use the term Botox interchangeably for products like Dysport. This is understandable as Dysport produces the same result as Botox, but Botox was first to market. However, Dysport has been in Europe since the late 90s, becoming FDA approved in 2009. In addition to Botulinum Type A, Dysport contains other inhibitors and muscular blocking agents to improve its effectiveness. Don’t worry. These are all safe ingredients that combine to treat wrinkles. 

Where Dysport differs from Botox is the size of the dosage. The injectable comes in a single-use 300 unit or 500 unit vial. That means there will be more Dysport applied per injection site when compared to Botox. This makes it useful for larger surface areas like the forehead. Dysport is FDA approved to last up to 4 months but may last longer. Based on the patient and use, Dysport may also activate faster than Botox.

Xeomin: The New Kid On The Block

While Botox and Dysport have been holding the fort in the injectables space, Xeomin wants to crash the party. Xeomin came to the American market in 2010 and was FDA approved in 2011. So it’s one of the new kids on the skin-smoothing block. While these three brands have the same active ingredient, the difference lies in their molecular makeup.

Both the Dysport and Botox molecules contain a complexing protein. On the other hand, Xeomin is “naked” and experts consider it the purest injectable. This gives Xeomin an advantage for persons with skin sensitivities as there are fewer proteins to interact with the body. A lack of additives means that Xeomin may work faster than the others; however, this varies with each patient. 

Efficacy/ Safety:

Although Botox has the longest track record, studies have shown that Xeomin and Dysport are equally safe and effective. For instance, research has been demonstrated that Dysport has an 82% success rate after three months. For most persons, there would not be a big difference in the efficacy of each drug. However, a versed dermatologist will know which treatment works best. For example, the dermatologist may use Dysport for larger surface areas or Botox for small treatments like Crow’s feet or Marionette Lines.

What are the side effects of Botox, Dysport, and Xeomin?

Each injectable carries the same side effects as they all have the same active ingredient. Side effects include injection site pain, irritation, headache, eye dryness, blurry vision, and temporary bruising. Other side effects may pop up based on the use of the injectable. 

Whether you choose Botox, Dysport, or Xeomin, it’s essential to seek medical advice from a dermatologist before using any injectable. Make sure to follow your doctor’s instructions to prevent the chance of developing any unwanted side effects. 

Which should you choose?

All three products will give you the desired result. At their core, they are all neuromodulators that contain the Botulinum toxin. Through the careful application, each injectable will improve the signs of wrinkles on the forehead, chin, and other areas. Xeomin has fewer additives when compared to Dysport and Botox. 

Botox holds the advantage in terms of brand, similar to Apple or Coke. However, this does not discount the effectiveness of Dysport and Xeomin. The question should not be which do you choose. The question should be who you could rely on for your cosmetic needs. 

At Eternal Dermatology, we are experts in the use of injectable neuromodulators in all skin types and for all indications. Our years of experience and expert training ensure that we can help you choose the product that’s best for you.


Click here for a list of more medical conditions and cosmetic procedures performed at Eternal Dermatology.


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