BOTOX Cosmetic, Dysport and Daxxify are all botulinum toxin type A. All three temporarily relax the muscle they are placed in, and all three are FDA-approved for frown lines between the brows. They are still separate medicines, made by different manufacturers, with their own doses, approvals and ingredients. Here is what actually differs, and what the evidence can and cannot tell you.
What each one is approved for
BOTOX Cosmetic (onabotulinumtoxinA) has the widest cosmetic labeling of the three: frown lines, forehead lines, crow’s feet and, since 2024, vertical neck bands. Dysport (abobotulinumtoxinA) is approved for frown lines in adults under 65. Daxxify (daxibotulinumtoxinA-lanm) was approved in 2022 for frown lines in adults.
Using any of them outside those approvals, such as Dysport on the forehead, or any product in the jaw muscles, is off-label. That is legal and common, and we will tell you when it applies.
Why units do not convert
The labeled dose for frown lines is 20 units of BOTOX Cosmetic, 50 units of Dysport and 40 units of Daxxify. That does not make Dysport the strongest. Each manufacturer measures potency with its own test, and each label states that its units cannot be compared with or converted into the units of other botulinum toxin products. A unit of one is simply not a unit of another. This matters most when comparing prices, which is why our page on Botox cost suggests comparing the price of treating an area rather than the price per unit.
Onset and duration: what the evidence shows
This is where marketing claims and evidence part ways, so we will stick to what has been measured.
Duration. The BOTOX Cosmetic label gives about three to four months for frown lines, and Dysport’s trials showed results lasting up to about four months. In Daxxify’s two trials, the median time until frown lines were no longer rated “none” or “mild” was about 24 weeks. Those Daxxify trials compared it with a placebo, not with Botox, so a direct “six months versus four” comparison has not come from its approval studies.
Onset. You may hear that Dysport works faster. The head-to-head evidence does not clearly show it. In one randomized, double-blind study, women treated with Botox and with Dysport first showed an effect at almost the same time, about five days. Comparisons between brands also depend on which dose ratio a study used, which is part of why results differ. In practice, all three usually start working within a few days.
What is in the vial
Botox and Dysport are both stabilized with human albumin, a protein derived from human blood. Their labels describe the risk of transmitting a viral disease through albumin as remote, and note that no such case has ever been identified for licensed albumin. Dysport also contains lactose and may contain trace amounts of cow’s milk protein, so it must not be used in anyone allergic to cow’s milk protein. Daxxify uses a small peptide to stabilize the toxin and contains no human albumin.
Side effects
They share the same basic side effects: injection-site redness or bruising, headache, and occasionally a drooping eyelid or brow. In the labeled frown-line trials, eyelid drooping occurred in about 3 in 100 people with BOTOX Cosmetic and about 2 in 100 with Daxxify. One point specific to Daxxify: because it can last longer, an unwanted effect may also take longer to wear off. All three carry the same FDA boxed warning about rare spread of the effect beyond the injection site.
How we choose
For frown lines, all three are reasonable, and the choice comes down to what you value. For forehead lines and crow’s feet, BOTOX Cosmetic is the product with FDA approval. A cow’s milk protein allergy rules out Dysport. If fewer appointments a year matters most to you, Daxxify is worth discussing. And if you have had good results with one product, there is usually no reason to switch. We will explain the reasoning behind whatever we recommend. More detail is on our Dysport and Daxxify pages.
Frequently Asked Questions
Frequently Asked Questions
Frequently Asked Questions
Frequently Asked Questions
Which is better, Botox or Dysport?+
Neither is simply better. They work the same basic way, and head-to-head studies are mixed. BOTOX Cosmetic has FDA approval for more areas of the face, while Dysport’s cosmetic approval is for frown lines.
Why does Dysport use more units than Botox?+
Because each brand measures its units with its own test. The numbers cannot be converted, so a higher unit count does not mean a stronger dose.
Is Daxxify worth it for longer results?+
For some people. In its trials, the median time before frown lines returned beyond “mild” was about 24 weeks, but not everyone gets that longer effect. We can talk through whether it suits your goals.
Can I switch between brands?+
Yes. Tell us which product you had and when, and we will plan the timing and dose for the new one. Doses are not converted unit for unit.
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