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Botox, Dysport, Jeauveau, and Xeomin: brand names for neuromodulators derived from BOtulinum TOXin

Many individuals are confused and are under the impression that there is only Botox, the brand, to take care of their facial lines. Botox has been long marketed in the medical field as it was the first FDA approved neuromodulator for therapeutic and cosmetic use. Since then, other brands have been FDA approved.

We are now in an era of Evidence Based Medicine where we base our decisions on available data based on scientific studies. Most injectors choose their product based on personal preference. At Aura Aesthetics, we choose to be evidence based. We review scientific studies but it just cannot be any study though.

Studies involving a small number of patients or if the researcher is aware of which product a patient is receiving, will be subject to biases that will render results unreliable. A randomized, controlled trial is the best single study you can look for. However, the best studies include multiple studies chosen based on strict criteria to minimize biases : a meta-analysis or a systematic review. I'll mention some in the end that you can look up on the internet.

The main difference is how these neuromodulators are produced. Only Xeomin is not associated with other proteins, thus the "Naked Protein" claim. There are reports that individuals who received the products made with other proteins develop some tolerance down the road with repeated treatments (requiring more dose). This "tolerance" could be due to delayed hypersensitivity (allergic type) reaction to the other proteins. Yet, with all these neuromodulator brands, there are individuals who DO NOT respond and are referred to as "non-responders."

In summary, all these products provide the same effect but do vary --in time of onset, peak time for effect, and duration of effect--- but these variations are due to EACH individual's response.

Here are the scientific evidence we have reviewed:

  1. JP, Ellis D, Quinn JG, Ansari MT, Rabski J, Kilty SJ. A comparative assessment of three formulations of botulinum A toxin for facial rhytides: a systematic review and meta-analyses. Systematic Reviews. 2013;2:40. doi:10.1186/2046-4053-2-40.

  2. A Comparative Assessment of Three Formulations of Botulinum Toxin Type A for Facial Rhytides: A Systematic Review with Meta-Analyses. Plastic reconstructive Surgery 2016 Apr; 137(4):1125-1140.

  3. IncobotulinumA for Aesthetic Indications: A Systematic Review of prospective Comparative Trials. Dermatologic Surgery. 2017 Jul;43(7):959-966

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