Botox, Dysport, or Xeomin — What's the Difference?

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Coke vs. Pepsi? McDonalds vs. Burger King? Botox vs Dysport? 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 The Book have shared their experiences with Botox, Dysport and Xeomin, explaining the basics of how they work and how they choose which one 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; it hit the U.S. market in 2002. Dysport was approved by the Food and Drug Administration (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 5 years.

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Formulation: 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. The most common targets are horizontal lines across the forehead and perpendicular frown lines between the brows (also called “The Elevens”), but many 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.

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.

Usage: “They are all very similar. In certain situations, one may get a slightly different reaction versus the other. 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. 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,” says Dr. Debra Wattenberg, who specializes in cosmetic dermatology in her New York City boutique clinic. She is also an associate clinical professor of dermatology at Mount Sinai Hospital.

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Results: Another small difference is the time until a patient sees results. The effects of Dysport may kick in quicker 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 as some studies have shown that Dysport results last for six months to one year, while Botox lasts for about three to six months.

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, then he or she will know what’s best to use for your particular concerns. Consult The Book to find a qualified cosmetic doctor in your neighborhood.

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