What’s the difference between all the neurotoxins? That’s a great question!
I’m Dr. Julie, your favorite cosmetic injector, and I’m going to give you the scoop on the differences between neurotoxins. I’ve had more than 25 years of experience injecting neurotoxins, and I’m going to tell you the truth.
So, there was a study in JAMA that looked at four different neurotoxins: Botox, Dysport, Jeuveau, and Xeomin, and compared them head-to-head. It looked at onset of action and duration of action. According to this study, Jeuveau and Dysport had the quickest onset of action at about three days, (1) but they all have equal efficacy by about 30 days. (1) They also looked at duration of action and found that Jeuveau and Xeomin had the longest duration of action at about 180 days. (1)
There’s another study that was done by the Cochrane Group that looked at 65 randomized controlled trials; it included about 14,000 patients. They looked at the safety and the efficacy of these four different neurotoxins. According to their analysis, they have equal efficacy, determined by both the patients and the physician. (2) As for the safety, they said that the biggest risk is of lid ptosis, which is [eyelid sagging]. This happened very rarely in any of the neurotoxins looked at, so they also concluded that all of the neurotoxins are equally as safe. (2)
So, which neurotoxin should you use? Well, that depends on which one you like the best! Really, they’re all about the same.
References
- Lemdani MS, Honig SE, Habarth-Morales TE, et al. Comparison of Botulinum Toxin A Formulations for Glabellar Strain Treatment in Women. JAMA Dermatology. Published online May 28, 2025. doi:https://doi.org/10.1001/jamadermatol.2025.1335
- Satriyasa BK. Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clinical, Cosmetic and Investigational Dermatology. 2019;Volume 12(12):223-228. doi:https://doi.org/10.2147/ccid.s202919
