BOTOX®, DYSPORT™ or Xeomin®? Which is the best?
Article by John W. Bass, MD
Phoenix Plastic Surgeon
Now that there is a new botulinum preparation called Xeomin® to reduce the signs of aging, there are many questions about which one is best - BOTOX®, DYSPORT™ or Xeomin®?
BOTOX® (onabotulinumtoxinA, Allergan) was first approved by the Food and Drug Administration (FDA) in 1989. Botox remained the sole product of its type until 2009 when DYSPORT™ (abobotulinumtoxinA, Medicis) was approved. Xeomin® (incobotulinumtoxinA, Merz) was approved by the FDA in July 2010 for treatment of adults with cervical dystonia or blepharospasm. Xeomin® is the newest FDA-approved product for the treatment of wrinkles.
BOTOX® is the standard used for softening crow’s feet, frown lines and forehead wrinkles. Injected by a qualified practitioner who is experienced in the art of the procedure, it’s a great product. It is very safe with very rare side effects and complications when injected by an experienced health care professional. BOTOX® lasts 4-6 months.
DYSPORT™ was the first major competitor to BOTOX®. While the makers claim that it starts working sooner and lasts longer claims, actual results show very similar responses. DYSPORT™ also lasts 4-6 months.
Xeomin® is the newest FDA-approved product now available for the treatment of wrinkles. The main advantage of this product is that it doesn’t need to be refrigerated before use, a convenience to physicians but not really significant to consumers. Like the others, Xeomin® also lasts 4-6 months.
Scientifically, several studies give us some useful information:
1. One study of BOTOX® and Xeomin® spread out through the tissues to the same extent. This means that patients’ response to the placement of an injection is very similar.
2. A comparison study performed by independent raters of BOTOX® and Xeomin® for wrinkles in the glabella (frown lines) found these two products to work virtually the same.
3. Xeomin® worked just as well as DYSPORT™ in a comparison test in the crow's feet area. (The usual 3:1 conversion ratio was used.)
4. The potency (LD50) of BOTOX® and Xeomin® is very similar, so the dosing is the same. This means that no conversion ratios are needed.
The great news is that all three products work similarly for the treatment of dynamic facial wrinkles. None is clearly better than the other in any way.