Frowning, squinting and smiling are expressions you make thousands of times a day. Over the years, those repeated movements etch lines into the skin. Neurotoxins soften them by temporarily relaxing the muscles underneath, and they are by far the most popular anti-wrinkle treatment in the United States.
Most people call every neurotoxin Botox. But Botox is a brand, not a treatment, and it now has competitors. We offer four of them, and people ask us every week how they differ. Here is the honest answer.
The Four at a Glance
| Botox® | Dysport® | Xeomin® | Daxxify® | |
| FDA approved | 2002 | 2009 | 2011 | 2022 |
| Results start | Within a week | Two to three days | Three to four days | Within a few days |
| Typically lasts | 3 to 4 months | 3 to 4 months | 3 to 4 months | Up to 6 months |
| What sets it apart | The original, most studied | Fastest onset, spreads more | No accessory proteins | Longest lasting, peptide-based |
Botox, Dysport and Xeomin all contain the same active ingredient, botulinum toxin type A. The differences come from how each manufacturer formulates it, and that affects how much is used, how quickly it works and how far it spreads.
Botox
Botox was the first neurotoxin approved by the FDA for frown lines, in 2002, and it remains the most studied. Its active ingredient comes packaged with accompanying proteins.
Beyond wrinkles, Botox is also FDA-approved to treat chronic migraine and excessive underarm sweating, which is part of why it is the best known of the four.
Dysport
Dysport contains a smaller version of those accompanying proteins. In practice, that means it tends to spread a little more once injected.
That spread can be an advantage over a wider area such as crow’s feet, where an even, soft result is the goal. It also means placement matters more, since it can occasionally relax a neighboring muscle. In the hands of a trained injector, that is uncommon.
Dysport also tends to work fastest. Most studies back this up, and it matches what we see in our own clinic.
Xeomin
Xeomin is often called the “naked” neurotoxin, because it contains no accessory proteins at all, only the active ingredient.
That matters to people who plan to use a neurotoxin for many years. In rare cases, the body can develop antibodies to the proteins in a product over long-term use, which makes it gradually less effective. Because Xeomin has none of those proteins, some providers believe it may carry a lower risk of that happening.
Xeomin usually shows first results in three to four days, with the full effect within two weeks for most people. In our experience, it is hard to tell apart from Botox in how quickly it works.
Daxxify
Daxxify is the newest option, approved by the FDA in 2022. Instead of the human serum albumin used to stabilize other neurotoxins, it is stabilized with a peptide, so it contains no human- or animal-derived ingredients.
Its main appeal is how long it lasts. Where the other three typically hold for three to four months, Daxxify can last up to six for many people. If you find quarterly appointments hard to keep, that means fewer visits across the year.
Do They Look Different?
Usually not. Contrary to what many people expect, most of our clients notice little to no difference in how the options look once they have settled. The real differences are in speed, spread and how long results last.
That said, some people do notice a difference, and they tend to become very loyal to their brand. That is exactly why we carry all four.
How Dosing and Pricing Really Work
This is where many people get caught out.
Botox and Xeomin are dosed on the same scale. Dysport is not. Roughly three units of Dysport do the work of one unit of Botox or Xeomin. So a treatment needing 20 units of Botox would need about 60 of Dysport.
That creates a pricing trap. Some practices advertise Dysport at around $4 a unit next to Botox at $12 a unit, which makes Dysport look far cheaper. Then you arrive and learn you need three times as many units, and the cost comes out essentially the same.
We do that conversion for you before you book, so you are comparing real treatment costs, not unit prices. Daxxify is dosed on its own scale and does not convert directly, so we quote it separately. Current pricing for all four is on our neurotoxins page.
How Long Results Last
Botox, Dysport and Xeomin typically last three to four months, and some people see results for up to six. Daxxify often lasts up to six months.
People who exercise hard or have a fast metabolism may find results fade sooner. For the most consistent result, we recommend treating on a regular schedule, roughly every three months for the first three.
If you notice your results wearing off faster than they used to, with the same injector, dilution and dose, it is worth raising. Switching brands occasionally is one option some providers suggest.
Where We Treat
The most common areas are:
- Crow’s feet around the eyes
- Frown lines between the brows, often called the 11s
- Horizontal forehead lines
Neurotoxins can also relax a gummy smile, create a subtle lip flip, smooth bands in the neck, slim a square jaw by softening the masseter muscles, and lift corners of the mouth that have started to turn down.
We often recommend treating the whole upper face rather than a single area. It tends to look more natural and balanced.
Which Is Right for You?
There is no single best option, only the best fit for your goals.
- Want results fast, perhaps before an event? Dysport tends to work quickest.
- Planning to use neurotoxins for years? Xeomin is worth discussing.
- Want fewer appointments? Daxxify lasts the longest.
- Want the most established, most studied option? Botox.
Every plan starts with a consultation with one of our experienced providers. They will recommend a product, dose and schedule for your face and goals. Many clients also pair a neurotoxin with dermal fillers, which restore volume rather than relaxing movement.
Book a Consultation
Well Labs+ Medspa Charleston, 1470 Tobias Gadson Blvd, Suite 100A, West Ashley. Call (843) 405-5906 or book online.
Also Read: Ultherapy®: The Non-surgical Face
