BOTOX, Dysport, Xeomin and Jeuveau injections have become increasingly popular in recent years. Consisting of a neuromodulator, they are able to relax muscles by temporarily blocking neurological signals. As a result, all four types of injections are effective at reducing the appearance of wrinkles and fine lines. With that said, there are subtle nuances between BOTOX, Dysport, Xeomin and Jeuveau. Before scheduling an appointment for any of these injections, you should familiarize yourself with their unique characteristics.
What Is BOTOX?
Developed and marketed by Allergan, BOTOX is an injection consisting of a specific formulation of botulinum toxin (BTX) known as onabotulinumtoxinA. It's injected directly into muscle tissue for the purpose of blocking neurological signals to the respective tissue. Our muscles rely on neurological signals to contract. When you flex a muscle, your brain is telling that muscle to contract. If a muscle remains in a contracted state, however, it may cause discomfort as well as the formation of wrinkles or fine lines. BOTOX injections are designed to relax contracted muscle tissue such as this by blocking neurological signals.
What Is Dysport?
Like BOTOX, Dysport is an injection containing BTX that's designed to block neurological signals to the targeted muscle tissue. With that said, Dysport uses a different formulation of BTX than BOTOX. While BOTOX uses onabotulinumtoxinA, Dysport uses abobotulinumtoxinA. It still consists of the same basic neuromodulator that temporarily blocks neurological signals to the muscle or muscles in which it's injected. Furthermore, the Dysport injections are administered in the same way as BOTOX injections, with each session lasting about 10 minutes. But Dysport uses a different formulation of BTX than its BOTOX counterpart, resulting in a few subtle differences.
What Is Xeomin?
As you may have guessed, Xeomin is an injection featuring yet another formulation of BTX. Produced by the German pharmaceutical company Merz Pharma GmbH & Co., it uses incobotulinumtoxinA. Xeomin is often used for the same purposes as both BOTOX and Dysport, including but not limited to the reduction of wrinkles and fine lines. Once injected into muscle tissue, Xeomin's incobotulinumtoxinA temporarily blocks neurological signals to the respective tissue, thereby forcing the muscle or muscles to relax.
What Is Jeuveau?
Also known as NEWTOX, Jeuveau is an injection that uses botulinum toxin type A. It works like other BTX injections by temporarily blocking neurological signals to muscles. While relatively new -- first approved by the FDA in 2019 -- Jeuveau has become a popular alternative to BOTOX because of its low cost. The true cost of an injection varies depending on many factors, but Jeuveau injections typically cost less than BOTOX injections. Evolus, the company that makes Jeuveau, was able to achieve a lower price by focusing specifically on cosmetic applications for its product. While BOTOX is approved for both cosmetic and medical applications, Jeuveau is only approved for cosmetic applications, including the treatment of wrinkles and frown lines.
In terms of onset, Xeomin is the fastest. According to the International Association for Physicians in Aesthetic Medicine (IAPAM), the average onset of Dysport is just three hours. To put that number into perspective, BOTOX has an average onset of 72 hours, whereas Xeomin has an average onset of 96 hours. All four types of injections use BTX to force muscles to relax, but the formulation used in Dysport has the fastest onset at just three hours.
You can rest assured knowing that all four types of injections have been approved by the U.S. Food and Drug Administration (FDA). BOTOX was first approved by the FDA in 2002 to treat moderate to severe facial wrinkles. Dysport, on the other hand, received the FDA's green light for glabellar, as well as cervical dystonia, in 2009. Just one year later, in 2010, the FDA approved Xeomin for the treatment of blepharospasm and cervical dystonia. Since then, the FDA has approved all four injections for many other cosmetic purposes.
It's also worth mentioning that Xeomin is the only type of injection that can be stored at room temperature. BOTOX and Dysport both require refrigeration because they contain additives. In addition to BTX, BOTOX and Dysport contain compounds such as lactose, which is used to help spread BTX throughout the muscle tissue in which it's injected. When stored at room temperature, commonly used additives like lactose may spoil. As a result, BOTOX and Dysport must be stored in a cool, refrigerated environment. Xeomin doesn't contain any additives, however. In fact, it only contains incobotulinumtoxinA. And without any additives present, Xeomin can be safely stored at room temperature.
While rate, some people may develop a natural resistance to BOTOX, Dysport, Xeomin or Jeuveau. Over time, for example, these injections may become less effective due to the creation of antibodies. A person's immune system may identify the ingredients used in these injections as being a foreign invader, so it responds by producing antibodies that neutralize their effect. While resistance can occur with any of these four types of injections, it's most common with BOTOX and Dysport injections.
BOTOX and Dysport injections contain additives that can "irritate" the immune system and, thus, trigger the creation of antibodies. Xeomin, on the other hand, consists solely of BTX, so it's less likely to cause resistance than its BOTOX and Dysport counterparts. The presence of additives in BOTOX and Dysport increases the risk of resistance. With that said, resistance to BTX is still rare with all three types of injections. Statistics show as few as one in 100 people who receive a BTX injection will develop a resistance to it. Nonetheless, rates of resistance are typically lower with Xeomin and Jeuveau.
Not all of these injections require the same amount of BTX (and filler ingredients for BOTOX and Dysport). According to the IAPAM, Dysport injections typically consist of 40 units per session. In comparison, Xeomin and BOTOX injections typically require just 20 units per session. Based on these figures, it takes about twice the amount of Dysport to achieve the same or similar results as BOTOX and Xeomin. But don't let that fool you into thinking Dysport is more expensive BOTOX and Xeomin. The per-unit cost of Dysport is actually less, on average, than that of BOTOX and Xeomin. Surprisingly, Jeuveau requires the most units of all four injections. Each single-dose Jeuveau vial contains 100 units of botulinum toxin type A.
If you're planning to get BOTOX, Dysport, Xeomin or Jeuveau injections, you might be wondering what to expect. During a session, you'll receive injections of the respective BTX formulation in your muscle tissue. If you're suffering fro crow's feet, for example, the injections will be into the skin around your eyes. Because they all contain BTX, all three formulations will force the muscle tissue around your eyes to relax, which should reduce or eliminate the appearance of crow's feet.
Neither BOTOX, Dysport, Xeomin nor Jeuveau require sedation. BTX injections are a minimally invasive procedure that's performed using a small, thin needle. As a result, sedation isn't required. During a typical session, you may be asked to contract the muscles to improve the effectiveness of the injections. When you contract a muscle, the injection can be made directly into the tissue for maximum effectiveness. Once the BTX has been injected into a muscle, the muscle will begin to relax. BOTOX, Dysport, Xeomin and Jeuveau all contain BTX that, when injected into muscle tissue, temporarily blocks neurological signals.
It's important to note that you won't immediately see the full effects of BTX injections. Depending on the type of injection, it may take several weeks. The onset of the injections, however, are usually visible within three to 72 hours. Dysport has the fastest onset, whereas Xeomin has the slowest onset.
The Bottom Line
BOTOX, Dysport, Xeomin and Jeuveau are all injections involving BTX. The difference between them lies in their specific formulation of BTX. BOTOX uses onabotulinumtoxinA; Dysport uses abobotulinumtoxinA; Xeomin uses incobotulinumtoxinA; and Jeuveau uses botulinum toxin type A. All four of these formulations are still BTX, meaning they all block neurological signals. As previously explained, however, BOTOX, Dysport, Xeomin and Jeuveau have a few subtle nuances.
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