Neurotoxins, particularly botulinum toxin type A, revolutionized the cosmetic and medical fields. These injectables treat various conditions ranging from facial wrinkles to debilitating muscle disorders. Botox’s approval from the FDA is for both the most asthetic and the most medical uses. Providers use Dysport, Xeomin, Jeuveau, and Daxxify in similar ways, but understand these products are different and none are FDA approved for all the various uses Botox is.
Botox (OnabotulinumtoxinA)
Botox, the most well-known botulinum toxin, was the first to receive FDA approval and has since set the standard for other neurotoxins. It has a wide range of FDA-approved indications for both aesthetic and therapeutic uses. Aesthetic Indications for Botox includes Glabellar Lines: Temporary improvement in the appearance of moderate to severe frown lines between the eyebrows in adults. Lateral Canthal Lines: Temporary improvement in moderate to severe crow’s feet around the eyes in adults. Forehead Lines: Temporary improvement in moderate to severe forehead lines in adults.
Medical uses of Botox for these Therapeutic Indications
Chronic Migraine: Prevention of headaches in adults with chronic migraines (15 or more headache days per month).
Overactive Bladder: Treatment of urinary incontinence due to overactive bladder in adults who do not respond to anticholinergic medications. Detrusor Overactivity: Treatment of urinary incontinence due to the bladder muscle’s overactivity associated with neurological conditions (e.g., spinal cord injury or multiple sclerosis).Upper and Lower Limb Spasticity: Management of increased muscle stiffness in the arms, legs, wrists, and fingers in adults and children aged 2 and older. Cervical Dystonia: Treatment of abnormal head position and neck pain in adults with cervical dystonia. Blepharospasm: Treatment of eyelid spasms or twitching in adults. Strabismus: Treatment of eye misalignment in patients aged 12 and older. Primary Axillary Hyperhidrosis: Treatment of severe underarm sweating that is not managed by topical agents.
Dysport (AbobotulinumtoxinA)
Dysport is another popular botulinum toxin type A product, known for its rapid onset and specific dosing units, which differ from Botox. Its FDA approved aesthetic Indications is for Glabellar Lines: Temporary improvement in moderate to severe frown lines between the eyebrows in adults under 65 years of age.
DYsport’s Therapeutic Indications
Cervical Dystonia: Treatment of cervical dystonia in adults to reduce neck pain and abnormal head position. Upper Limb Spasticity: Management of increased muscle stiffness in adults’ upper limbs (arms, wrists, and fingers) and in pediatric patients aged 2 years and older, excluding cerebral palsy. Lower Limb Spasticity: Treatment of increased muscle stiffness in the legs of pediatric patients aged 2 years and older.
Xeomin (IncobotulinumtoxinA) Is Approved for Glabellar lines
Xeomin “naked” formulation, meaning it contains only the active neurotoxin with the fewest surrounding proteins. This is thought to potentially reduce the risk of developing resistance. Aesthetic Indications: Glabellar Lines: Temporary improvement in moderate to severe frown lines between the eyebrows in adults, even with crow’s feet and forehead lines.
Therapeutic Uses FDA APPOVED for xeomin
Like Dysport there are a few therapeutic approvals for Xeomin. Blepharospasm: Treatment of eyelid spasms in adults who have previously received Botox. Cervical Dystonia**: Treatment of abnormal head position and neck pain in adults with cervical dystonia. Upper Limb Spasticity: Treatment of muscle stiffness in the arms, wrists, and fingers in adults.
DAXxify (DaxibotulinumtoxinA-lanm) and Jeuveau (PrabotulinumtoxinA-xvfs)
Jeuveau is a relatively new addition to the market and is sometimes referred to as “Newtox.” It is specifically marketed for aesthetic use. Daxxify is the newest botulinum toxin product on the market and has a unique peptide-enhanced formulation offering a longer duration of effect. Both are approved for Aesthetic Indication of:
Glabellar Lines: Temporary improvement in the appearance of moderate to severe frown lines between the eyebrows in adults. Neither has any medical uses approved.
Comparing Botox to Other Neurotoxins
Botox is the Neurotoxin with the most research and the most approvals from the FDA. Few head to head studies exist, however at Hada we have had two decades of use of neurotoxins and how they perform with on and off label uses. While many women request treatment for gummy smiles and better upper lip curl, most don’t quite realize these treatments have not been studied in the rigorous ways that treatment. While all these neurotoxins are derived from botulinum toxin type A, there are some important differences to consider:
Onset, Dosage, and Duration of Effects of Your Botox
First movement comes back and then, if left untreated long enough the wrinkles will start to reappear. Botox, Dysport, Xeomin, and Jeuveau** generally have similar durations of effect, lasting around 3-4 months. Dysport’s onset is 2-3 days, Botox’s 2-5 days and most neurotoxins have full effect in 2 weeks. Daxxify is unique in potentially offering a longer duration, with effects lasting up to 6 months or more for some patients. This could reduce the frequency of treatments, making it a more convenient option for some. It’s onset is rapid, but it takes up to 3 weeks for full effect.
Dosing is different for Daxxify and Dysport, where as the dosing for Botox, Xeomin and Jeuveau for approved areas is similar. Doses given can affect both the naturalness of the look as well as longevity. Having treatments less than 3 times a year will decrease effectiveness as well.
The Molecules around the Neurotoxins vary making Formulation Differences
Xeomin is notable for its “naked” formulation without any complexing proteins, which could reduce the risk of developing antibodies and resistance. Daxxify incorporates a peptide-based stabilization method, which may contribute to its longer duration.
Conclusion: Choosing the Right Neurotoxin
When it comes to choosing a neurotoxin, it is essential to consider the specific needs and preferences of each patient. **Botox** remains the most versatile with the broadest range of indications, while **Daxxify** offers a potentially longer duration of effect for those looking for fewer treatments. **Dysport** may be preferred for its fast onset, and **Xeomin** could be ideal for patients concerned about developing resistance to neurotoxins. **Jeuveau** is a good option for those seeking aesthetic improvements, particularly in the glabellar lines.
Each of these neurotoxins has its unique characteristics and benefits, allowing for personalized treatment plans tailored to individual patient goals and needs. Each can be used off label. One of the interesting uses of Botox is with microneedling to create the Korean glass look. Another interesting use is for acne resolution. Consulting with a qualified medical professional is always recommended to determine the most appropriate neurotoxin for a given condition or aesthetic preference.
New financing and bonus structure makes Botox the best choice. However, we have options and may have a different treatment plan for you. Feel free to ask if you want to know more about a specific neurotoxin,
