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Botox, Dysport, Xeomin?

Ask Charlotte: Botox, Dysport, Or Xeomin? Which Is Best, Or Are They All The Same?


April 30, 2018

Coke vs. Pepsi? McDonalds vs. Burger King? Botox vs. Dysport? Dinner-table conversations no longer revolve around which soda brand or fast food chain is better. These days, the hot topic is injectables and fillers. To delve even deeper, this reader reached out to find out if there are any differences among the most popular wrinkle freezers.


I want to get rid of a few frown lines and crow’s feet, and am wondering if there’s a big difference between Botox vs. Dysport that I should know about. Is there a real reason to ask for Botox by brand name, or are they all interchangeable?


To clear up this issue, several leading cosmetic doctors in our expert directory (aka The Book) have shared their experiences with Botox, Dysport, and Xeomin, explaining the basics of how they work and how they choose which to use.

Botox (manufactured by Allergan), Dysport (manufactured by Medicis), and Xeomin (manufactured by Merz) are all injectable neuromodulators, meaning they temporarily alter the nerve impulses of targeted muscles, therefore reducing or eliminating contraction-induced wrinkles.

FDA Clearance

Botox was first on the scene, hitting the U.S. market in 2002. Dysport was approved by the FDA in 2009 for treating forehead wrinkles and frown lines. Xeomin was the last to hit the market, having only been FDA-approved for fine lines and wrinkles within the last seven years.


Each brand has a slightly different recipe of the same substance, bacterium Clostridium Botulinum, or Botulinum Toxin A, but they all work the same way: they block the nerve impulses of the injected muscles to temporarily paralyze muscle movements that cause wrinkles.

Xeomin is sometimes considered a “naked” neuromodulator, since it contains no additives. It also does not require refrigeration prior to administering it to a patient, making it easier for transportation and storage. While this is relevant for the practitioner, it makes little difference to you, except that it may lower costs and make your anti-aging pursuits slightly less expensive.


The most common targets of these injectables are horizontal lines across the forehead and perpendicular frown lines between the brows (also called “The Elevens”). But many doctors also rely on Botox, Dysport, and Xeomin for crow’s feet, nasal squint lines, lines around the neck, eyebrow lifting, and even profuse underarm sweating and migraines.

The Verdict

“They are all very similar,” Dr. Debra Wattenberg tells us. She specializes in cosmetic dermatology at her NYC boutique clinic, and is Associate Clinical Professor of Dermatology at Mount Sinai Hospital. “In certain situations, one may get a slightly different reaction versus the other,” Dr. Wattenberg continues.

One small difference is the time until a patient sees results. The effects of Dysport may kick in more quickly than the effects of Botox. Some research shows that it takes Botox three to five days to work, while Dysport takes effect within one to two days. Dysport may also last longer than Botox injections. Some studies have shown that Dysport results last for six months to one year, while Botox lasts for about three to six months.

“I personally think Dysport has a little bit more diffusion, which is better for correcting a lot of little crow’s feet because it has a more even distribution,” Dr. Wattenberg says. “But if I need to make a small correction of a rogue wrinkle, I usually use Botox. In general, I use all three of them all interchangeably.”

Charlotte Knows

It’s of the utmost importance to find a qualified cosmetic doctor who knows how to create natural-looking results using Botox, Dysport, or Xeomin. Botox-gone-bad cases are more often the result of the doctor who’s injecting it than the injection itself. Once you’ve found your doctor, he or she will know what’s best to use for your particular concerns. Take a look at our directory to find a qualified cosmetic doctor in your neighborhood.


Read This Next

Here’s everything you need to know about fillers and how to determine which one’s right for you.
Plus, can botox and microcurrent work together?

Find Beauty And Wellness Experts

Read client reviews, book appointments, and get advice from the experts in Charlotte’s Book. Only the best cosmetic doctors, skincare gurus, nutritionists, and fitness and wellness professionals make it into our book.

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