All four of these FDA approved botulinum toxin-A products are currently available at Medical Cosmetics. Why? What’s the difference? Does it really matter which one of these I utilize for wrinkles on my face, facial shaping, migraines, excessive sweating, or TMJ issues? If you want to know the ins and outs of Botox vs Dysport vs Xeomin vs Jeuveau, the answers may surprise you. In this article, Dr. Carter shares all of the details.
What Are the Differences?
From strictly pharmaceutical, biological, and physiological aspects, it does not matter which one is used for any of these purposes. But is there ANY difference inside the vials of each one of these that separates one from the other? Yes, there is. Three of these products have biologically inert associated or aggregated proteins attached to the 150 kilodalton active botulinum toxin-A molecule. Xeomin has no inert aggregating proteins attached to the naked botulinum toxin-A molecule. Is this important? Probably not.
Where Do Botox vs Dysport vs Xeomin vs Jeuveau Come From?
They all come from different companies that are located within different countries.
Botox comes from Allergan in California, Dysport from Galderma in the UK, Xeomin from Merz Aesthetic in Germany, and Jeuveau from Evolus in South Korea.
They have all successfully gone through the required FDA hoops to be available for sale to licensed physicians and dentists in the United States. On average they all provide 3-4 month duration of effect for aesthetic and migraine prevention uses and 8-9 months of benefit to lessen the amount of sweat produced in localized regions of the body where excessive sweating is an issue.
Sometimes one company or another will be having a special that would temporarily give some advantage to the patient to try their product. So, at Medical Cosmetics we try to offer more selection to be able to offer these different discounts as they occur. Also, there are a lot of people who ask for one product by name over the others for their own reasons. If we stock it, then they can have it.
Do They All Provide the Same Effect?
When discussing Botox vs Dysport vs Xeomin vs Jeuveau is the duration of effect always the same? Absolutely not. And why not? Many reasons. Some of the pertinent ones include number and placement of units of toxin put into each location, the number of times that a person’s brain is trying to make a given expression in a certain period of time, and the exact amount of toxin that happens to be in the particular vial used at the time of the treatment. Understand that the amount of botulinum toxin-A in any vial of each of these products measures less than one billionth of a gram. This extremely small amount is less than can be seen by human eyes and is impossible to measure exactly. If the amount of toxin is a tiny bit higher than intended, the duration of effect will be slightly longer. If it is a bit less than the target amount, the duration will be a bit less. The relationship is not precisely 1:1 (e.g., double the amount of toxin will give perhaps a 20-25% longer duration, but not twice as long).
Botox vs Dysport vs Xeomin vs Jeuveau – Which Lasts Longest?
Is it possible that for a particular individual one of the products will last longer than the other products? This is the most difficult question of all. I believe the answer is yes, but I know of absolutely no logical reason for this to be so. Furthermore, I would estimate that this is true in only about 5% of all people. I suspect that variations in duration of effect for a particular person are more likely to be for any (or several) of the reasons listed in the previous paragraph.
Just to make all of this more confusing, there is probably soon going to be a botulinum toxin-A product from Revance that will last an average of 6 months for aesthetic use instead of the 3-4 months that we have all become accustomed to. Stay tuned!
William A. Carter, M.D. at Medical Cosmetics