You’ve probably heard of BOTOX. You may have also come across Dysport, Xeomin, or Jeuveau — and wondered whether there’s a real difference, or just a branding one. They all use botulinum toxin (BTX) to temporarily relax muscles and smooth out wrinkles. But the differences in formulation affect how quickly you see results, how long they last, and which one might work best for your skin. Those differences are worth understanding before you book.
What Is BOTOX?
BOTOX is the original. Developed by Allergan, it uses a formulation of botulinum toxin called onabotulinumtoxinA. When injected into targeted muscle tissue, it blocks the nerve signals that tell that muscle to contract. If you’ve been noticing forehead lines or crow’s feet deepening because those muscles stay tense, BOTOX relaxes them — and the lines soften as a result.
BOTOX has the longest track record of any neurotoxin on the market. It was the first to receive FDA approval for cosmetic use in 2002, and that history means there’s more clinical data behind it than any of the alternatives.
What Is Dysport?
Dysport uses a different BTX formulation — abobotulinumtoxinA — but the principle is the same: block nerve signals, relax the muscle, smooth the wrinkle. Sessions take about 10 minutes, just like BOTOX.
Where Dysport stands apart is speed. It tends to spread across a slightly wider area after injection, which makes it a strong choice for larger treatment zones like the forehead. It also has the fastest onset of any neurotoxin. You may start seeing results within hours rather than days.
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What Is Xeomin?
Xeomin, produced by Merz Pharmaceuticals, uses incobotulinumtoxinA. What makes it different from BOTOX and Dysport is what it doesn’t contain: no additives. BOTOX and Dysport include compounds like lactose that help the toxin spread through muscle tissue. Xeomin is pure BTX — nothing else.
That distinction matters if you’ve been getting neurotoxin injections for a while and feel like they’re not working as well. The additives in BOTOX and Dysport can trigger your immune system to produce antibodies that gradually neutralize the treatment. Xeomin’s clean formulation makes that less likely. It also doesn’t need refrigeration, since there are no additives to spoil.
What Is Jeuveau?
Jeuveau (prabotulinumtoxinA) is the newest FDA-approved neurotoxin, cleared in 2019. It’s sometimes called “Newtox” because it was designed from the ground up specifically for cosmetic use — unlike BOTOX, Dysport, and Xeomin, which all started with medical applications before expanding into aesthetics.
In practice, Jeuveau performs similarly to BOTOX in terms of onset and duration. It’s a solid option if you like the idea of a neurotoxin that was purpose-built for aesthetics, and it gives your injector more flexibility when tailoring your treatment.
How Fast Does Each Neurotoxin Work?
Dysport is the fastest. According to the International Association for Physicians in Aesthetic Medicine (IAPAM), Dysport’s average onset is about three hours. BOTOX typically takes 24 to 72 hours. Xeomin tends to be the slowest, with full onset around 3 to 5 days. Jeuveau falls in the same range as BOTOX — most people notice results within 2 to 3 days.
If speed matters to you — say you have an event coming up — Dysport’s faster onset can be a real advantage.
Are All Four FDA-Approved?
All four neurotoxins are FDA-approved. BOTOX received approval for cosmetic use in 2002. Dysport followed in 2009. Xeomin was approved in 2010. Jeuveau, the newest, was approved in 2019 specifically for the treatment of moderate to severe glabellar lines (the vertical lines between your eyebrows). Since their initial approvals, all four have been cleared for additional cosmetic and medical uses.
How Are They Stored?
Xeomin is the only neurotoxin that can be stored at room temperature. BOTOX, Dysport, and Jeuveau all require refrigeration because they contain proteins and additives that break down in warm conditions. This is more of a behind-the-scenes distinction. It won’t change your experience in the treatment room, but it’s one reason some providers favor Xeomin for its simplicity.
Can You Develop a Resistance?
While rare, some people develop a natural resistance to neurotoxin injections over time. Your immune system identifies the ingredients in the injection as foreign and produces antibodies that neutralize their effect. When that happens, treatments gradually become less effective.
Resistance is more common with BOTOX and Dysport because their formulations include additives that can trigger an immune response. Xeomin’s pure BTX formulation — with no additives — carries a lower risk. If you’ve been getting BOTOX or Dysport for years and feel like your results aren’t lasting as long, resistance could be the reason. Switching to Xeomin or Jeuveau is worth discussing with your provider.
The overall odds are still low. Roughly 1 in 100 people who receive BTX injections develop resistance, regardless of formulation.
How Many Units Do You Need?
Not all neurotoxins are dosed the same way. A typical BOTOX treatment for one area uses about 20 units. Xeomin and Jeuveau use roughly the same — about 20 units per area. Dysport requires about 40 units for a comparable result.
That sounds like more, but Dysport’s per-unit cost is lower, so the total for a session ends up in a similar range. The math just works differently. Your injector can walk you through the specifics for the areas you’re treating.
How Long Do Results Last?
This is one of the most common questions, and the answer depends on which neurotoxin you’re using and how your body metabolizes it.
BOTOX: 3 to 4 months is typical. Some people see results lasting up to 5 months with consistent treatments over time.
Dysport: 3 to 4 months, similar to BOTOX. Some studies suggest Dysport may last slightly longer in certain patients, but the difference is modest.
Xeomin: 3 to 4 months. Comparable to BOTOX and Dysport in most clinical studies.
Jeuveau: About 3 months on average, though individual results vary.
With all four, you’ll notice movement gradually returning as the neurotoxin wears off. Maintenance appointments every 3 to 4 months keep results consistent.
Which One Is Right for You?
There’s no single “best” neurotoxin. The right choice depends on what matters most to you.
BOTOX is the safe bet if you want the most established option. It has the longest track record, the most published research, and injectors have the deepest experience working with it.
Dysport is worth considering if speed matters or you’re treating a larger area like the forehead. It kicks in faster than the others and spreads more naturally across broad zones.
Xeomin makes sense if you’ve noticed your current neurotoxin isn’t working as well as it used to. Its additive-free formulation carries the lowest resistance risk of any option on the market.
Jeuveau is the newest of the four — purpose-built for cosmetic use rather than adapted from medical applications. It performs similarly to BOTOX and gives your injector more flexibility when customizing your treatment.
At Radiance Medspa, we offer BOTOX, Dysport, and Xeomin. When you come in for a consultation, you sit down with the injector who’ll actually perform your treatment — not a salesperson. No pressure. Just a conversation about what makes sense for you.
What to Expect: Week by Week
If you haven’t had neurotoxin injections before, this is what the timeline actually looks like:
Days 1–3: The treatment itself takes about 10 minutes. You can go right back to your day — no downtime. Depending on which neurotoxin you received, you may start to notice early softening in the treated area, especially with Dysport.
Week 1–2: This is when results really settle in. Lines smooth out, and you’ll see the full effect of the treatment. It’s subtle — you’ll look like yourself, just more rested.
Month 2–3: Results hold steady. This is peak performance for most neurotoxins. Toward the end of this window, you may notice very slight movement returning. That’s normal — it means the neurotoxin is gradually wearing off, and it’s a good time to schedule your next appointment.
What Does a Session Feel Like?
During a session, your provider injects small amounts of the BTX formulation directly into the muscles where the lines or wrinkles you want to address are forming. If you’re treating crow’s feet, for example, the injections go into the muscles around your eyes.
The needles are small and thin — a quick pinch is the usual description. No sedation needed. The whole thing takes about 10 minutes.
You may be asked to flex the targeted muscles during injection. This helps place the BTX precisely where it needs to go. Once injected, the muscle gradually relaxes over the following hours or days, depending on the neurotoxin used.
The Bottom Line
BOTOX, Dysport, Xeomin, and Jeuveau all use botulinum toxin to relax muscles and smooth wrinkles. The differences come down to formulation, onset speed, additive content, and how your body responds over time. None of them is objectively “better.” The right one depends on your goals and your history with neurotoxins.
If you’re curious which option fits you best, book a complimentary consultation at Radiance Medspa in Vinings. We’ll walk you through the options and help you decide — no pressure, no obligation. You can also explore our full neurotoxin and injectable services to see what we offer.
If you’re not sure whether injectables are the right starting point, a skincare consultation is a good way to get a complete picture of your options. We’ll go at your pace.
Ready to get started?
Book a complimentary consultation – we’ll walk through your options.
Frequently Asked Questions
Which lasts longer, BOTOX or Dysport?
They’re very similar — both typically last 3 to 4 months. Some people find one lasts slightly longer than the other based on their individual metabolism, but the difference is usually a matter of weeks, not months.
Is Xeomin better if you have sensitive skin?
Xeomin doesn’t contain the additives found in BOTOX and Dysport, which makes it a good option if you’ve had reactions to those formulations. “Better for sensitive skin” is a slight oversimplification — the sensitivity that matters here is your immune system’s response to the injection’s ingredients, not your skin type.
Can you switch between BOTOX and Dysport?
Yes. Switching is common and straightforward. Some people switch because they want to try faster onset (Dysport) or a cleaner formulation (Xeomin), or because they’ve noticed diminishing results with their current neurotoxin.
Which neurotoxin looks the most natural?
All four produce natural-looking results when administered by an experienced injector. The “frozen” look people worry about comes from technique and dosing, not the product itself. An experienced injector preserves your natural expressions while smoothing the lines you want to address.
How many units will I need?
It depends on the area being treated and which neurotoxin you’re using. A general guideline: about 20 units of BOTOX, Xeomin, or Jeuveau per area, or about 40 units of Dysport (which is dosed differently but costs less per unit). Your injector will give you an exact recommendation during your consultation.
What’s the difference between neurotoxins and dermal fillers?
Neurotoxins (BOTOX, Dysport, Xeomin, Jeuveau) relax muscles to smooth dynamic wrinkles — the lines that form when you make expressions. Dermal fillers add volume to areas that have lost fullness, like cheeks, lips, or under-eye hollows. They solve different problems and are often used together.