Dysport vs Botox vs Daxxify: What's the Difference?

How Do Neurotoxins Work?

Botox, Dysport, Daxxify, Xeomin and Jeuveau all contain botulinum toxin type A, a purified protein that temporarily relaxes targeted facial muscles by blocking the release of acetylcholine at the neuromuscular junction. When the muscles responsible for dynamic wrinkles (frown lines, forehead lines and crow's feet) are relaxed, the skin above them smooths out and the lines soften.

The differences between the products come down to their specific formulations: the proteins that surround or stabilize the active toxin, the molecular weight of what is in the vial, and how each product is manufactured. Those formulation differences are why the products have separate dosing units, and they are the reason the comparison questions below do not have one-size-fits-all answers.

What Is Botox? (OnabotulinumtoxinA)

Botox, manufactured by Allergan (now AbbVie), was the first botulinum toxin approved for cosmetic use in the United States, in 2002. It remains the most widely recognized and most extensively studied neurotoxin in aesthetics.

Key Characteristics

• Onset: 3 to 5 days, with full effect at 10 to 14 days
• Duration: 3 to 4 months on average
• Spread: More localized, with less diffusion from the injection site
• Molecular weight: 900 kDa (complexed form)
• FDA cosmetic approvals: Glabellar lines, forehead lines and crow's feet, plus numerous medical indications

Where It Fits

Botox's precise, localized action suits areas where control matters most, such as around the eyes and the brow, where even slight over-diffusion can cause eyelid heaviness. Its long track record also gives it the most extensive safety data of any neurotoxin. Pricing at Arbour Longevity is $13 per unit; see our Botox page for details.

What Is Dysport? (AbobotulinumtoxinA)

Dysport, manufactured by Galderma, received FDA approval for cosmetic use in 2009. Its formulation carries less associated protein than Botox, which is one of the reasons its handling in the tissue differs.

Key Characteristics

• Onset: 1 to 3 days
• Duration: 3 to 4 months for most patients
• Spread: Greater diffusion from the injection site
• Molecular weight: 500-900 kDa (less associated protein)
• Dosing: Uses its own unit system, which is not interchangeable with any other product

According to PubMed, a review by Nestor, Ablon and Pickett in the Aesthetic Surgery Journal (2017) examined the parameters that drive onset and duration across neurotoxin products. The authors noted that onset of activity has been recorded within 12 hours with abobotulinumtoxinA in some cases, and that duration of effect is influenced by muscle mass, patient age, sex and injection technique (DOI: 10.1093/asj/sjw282).

Where It Fits

Dysport's broader diffusion pattern is useful across larger treatment areas such as the forehead, where an even result across a wide field is the goal. The greater spread can mean fewer injection points across a broad area, but it also asks more of the injector, who has to place the product where that diffusion works for you rather than against you.

What Is Daxxify? (DaxibotulinumtoxinA)

Daxxify, manufactured by Revance Therapeutics, received FDA approval for glabellar lines in 2022. What distinguishes it is its formulation: according to PubMed, Gallagher et al. in Toxins (2023) describe Daxxify as a botulinum toxin type A product containing daxibotulinumtoxinA together with a stabilizing excipient peptide designated RTP004 (DOI: 10.3390/toxins15010060). Fabi et al. in Dermatologic Surgery (2021) likewise describe it as botulinum toxin type A formulated with a novel peptide excipient (DOI: 10.1097/DSS.0000000000002531). That peptide, rather than an albumin-based stabilizer, is the formulation change that sets Daxxify apart from the older products.

Key Characteristics

• Peak effect: Weeks 2 to 4 in the pivotal trials
• Duration: Median 24 weeks in the SAKURA Phase 3 program (see below)
• Molecular weight: 150 kDa core neurotoxin, without complexing proteins
• Trial dose for glabellar lines: 40 units, which is a Daxxify unit and not comparable to a Botox or Dysport unit

Who Makes Daxxify?

Daxxify is made by Revance Therapeutics. The SAKURA Phase 3 clinical program that supported its approval was conducted across multiple US centers and is published in Plastic and Reconstructive Surgery, the Journal of the American Academy of Dermatology and Dermatologic Surgery; those papers are cited throughout this article and listed in full at the end.

Dysport vs Botox: How the Two Compare

This is the most common comparison patients ask about, so it is worth answering carefully. Both products are botulinum toxin type A. The mechanism is identical. What differs is the formulation, the diffusion behavior, and the unit system each product is dosed in.

What Is the Difference Between Dysport and Botox?

Botox is onabotulinumtoxinA, approved for cosmetic use in 2002. Dysport is abobotulinumtoxinA, approved in 2009. Botox carries more associated protein and a higher complexed molecular weight; Dysport carries less. In practice, Dysport tends to spread further from the point of injection and Botox tends to stay more localized. Neither behavior is inherently better. Broader spread is an advantage across a wide forehead and a liability near the brow; tighter localization is the reverse.

Each product also has its own potency assay, which means a Dysport unit and a Botox unit are simply different measurements. That single fact explains most of the confusion in this comparison, including why per-unit prices cannot be compared across products.

Does Dysport Last Longer Than Botox?

The evidence does not support the idea that one inherently outlasts the other at an equivalent dose. According to PubMed, a preclinical comparison by Kutschenko et al. in Neuroscience Letters (2016) found that when onabotulinumtoxinA and abobotulinumtoxinA were dosed so as to produce an identical severity of effect, the duration of that effect was also the same. The authors concluded that duration tracks the potency of the dose delivered rather than the brand on the vial (DOI: 10.1016/j.neulet.2016.06.001). That study was conducted in mice, so it describes the pharmacology rather than a cosmetic outcome.

On the human side, the Nestor review cited above identifies muscle mass, age, sex and injection technique as the factors that move duration (DOI: 10.1093/asj/sjw282). In other words, how long your result lasts has more to do with you and your treatment plan than with which of these two products was used.

Onset is a different question from duration, and there the products do differ. Dysport is generally the faster of the two to show an effect, and as noted above, onset within 12 hours has been recorded with abobotulinumtoxinA in some cases.

Is Dysport Better Than Botox?

Neither product is established as superior. According to PubMed, a review by Scaglione in Toxins (2016) comparing onabotulinumtoxinA, abobotulinumtoxinA and incobotulinumtoxinA states directly that the efficacies are similar when the products are properly dosed (DOI: 10.3390/toxins8030065). A Cochrane systematic review by Camargo et al. (2021), covering 65 randomized controlled trials and nearly 15,000 participants, found that all the major neurotoxins are effective compared with placebo, while emphasizing that direct head-to-head comparisons must account for the non-equivalent dosing systems (DOI: 10.1002/14651858.CD011301.pub2).

So the honest answer is that the choice is not about which product is better in the abstract. It depends on the area being treated, how much diffusion you want there, how quickly you want to see a change, and how you have responded to either product in the past.

How Many Units of Dysport vs Botox?

There is no conversion ratio printed on either product's FDA-approved labeling, and the two unit systems are defined by different potency assays, so they cannot be swapped one for one.

The published ratios that do exist come from therapeutic rather than cosmetic use, and they should be read that way. According to PubMed, a systematic review by Dashtipour et al. in Movement Disorders Clinical Practice (2015) examined randomized trials in movement disorders and concluded that an onabotulinumtoxinA-to-abobotulinumtoxinA conversion ratio between 1:2.5 and 1:3.0 provided comparable safety and efficacy, while a 1:4 ratio produced an excessive rate of intolerable side effects (DOI: 10.1002/mdc3.12235). The Scaglione review reached a similar conclusion for spasticity, cervical dystonia and blepharospasm, adding that a ratio higher than 3:1 risks overdosing abobotulinumtoxinA (DOI: 10.3390/toxins8030065).

The important caveat comes from a review by De Boulle, Fagien, Sommer and Glogau in Clinical Interventions in Aging (2010), which notes that the FDA required distinct nonproprietary names for these products precisely to signal that the formulations are not interchangeable, and that dosing recommendations cannot be based on any single conversion ratio (DOI: 10.2147/cia.s9338). Your dose is set by your injector for your anatomy and your goals. It is not arithmetic you should be doing at home.

Daxxify vs Botox: How the Two Compare

Where Dysport and Botox differ mainly in spread and unit system, the Daxxify comparison is largely about duration. The SAKURA Phase 3 program is the body of evidence to look at.

How Long Does Daxxify Last?

According to PubMed, Carruthers et al. reported the two pivotal placebo-controlled trials in Plastic and Reconstructive Surgery (2020). Across 609 participants, composite investigator and participant ratings showed glabellar line severity of none or mild maintained for a median of 24.0 weeks in SAKURA 1 and 23.9 weeks in SAKURA 2, and severity did not return to baseline levels for a median of 27.7 and 26.0 weeks respectively (DOI: 10.1097/PRS.0000000000006327). The pooled analysis of the same two trials, published by Bertucci et al. in the Journal of the American Academy of Dermatology (2020), reported a median of 24.0 weeks (DOI: 10.1016/j.jaad.2019.06.1313).

The larger repeat-treatment study, SAKURA 3, was reported by Fabi et al. in Dermatologic Surgery (2021) across 2,691 subjects. The median duration for return to moderate or severe severity was again 24 weeks, and at week 24, 32% or more of subjects still had a rating of none or mild (DOI: 10.1097/DSS.0000000000002531).

Two things are worth reading carefully in those numbers. A median of roughly 24 weeks is about six months, which is why Daxxify is discussed as a twice-a-year option. But a median is a midpoint, which means half of trial participants had a shorter result than that. Your own duration is an individual matter, and it is not something anyone can promise you in advance.

How Long Does Daxxify Take to Work?

In SAKURA 3, peak response was seen between weeks 2 and 4, with response rates above 96% on the investigator severity scale after each of three treatments and peak rates of 92% or more on the patient-rated scale (DOI: 10.1097/DSS.0000000000002531). As with any neurotoxin, you will usually notice something before the peak, and the fair way to judge your result is at the two-week mark rather than on day three.

Is Daxxify Better Than Botox?

The pivotal SAKURA 1 and SAKURA 2 trials were placebo-controlled rather than Botox-controlled, so they do not answer this as a direct head-to-head. What Bertucci et al. do report is that earlier Phase 2 data showed Daxxify offering a more prolonged duration of response than onabotulinumtoxinA (DOI: 10.1016/j.jaad.2019.06.1313).

Duration, then, is the axis on which Daxxify distinguishes itself, and it is the reason to consider it. If what you want is fewer appointments per year, that is a real difference. If what you want is a shorter commitment while you decide whether you like the look, a shorter-acting product is arguably the better fit for you. Neither is the better product in general.

Is Daxxify Safe?

The SAKURA 3 safety report by Green et al. in Dermatologic Surgery (2021) evaluated 2,691 subjects receiving up to three treatments. Treatment-related adverse events occurred in 17.8% of subjects and were generally mild and self-resolving. Eyelid ptosis occurred in 0.9% of treatments, and no serious adverse events were treatment-related (DOI: 10.1097/DSS.0000000000002463).

On the question of antibody formation, Gallagher et al. in Toxins (2023) pooled immunogenicity data across the SAKURA trials. Of 2,737 evaluable subjects, treatment-related binding antibodies to daxibotulinumtoxinA were detected in 21 (0.8%), and no subject developed neutralizing antibodies. Every subject who did form binding antibodies still achieved none or mild severity at week 4 (DOI: 10.3390/toxins15010060). As with any injectable, whether a product is appropriate for you is a conversation to have with your injector, including your medical history and any prior reaction to a neurotoxin.

Daxxify vs Dysport: How the Two Compare

There is no published head-to-head trial of Daxxify against Dysport, so this comparison has to be built from what each product's own evidence shows rather than from a direct contest.

The clearest contrast is timing. Dysport is the faster of the two to take effect, with onset recorded within 12 hours in some cases (DOI: 10.1093/asj/sjw282). Daxxify reaches peak response between weeks 2 and 4 but carries a median duration of around 24 weeks in the SAKURA trials (DOI: 10.1097/DSS.0000000000002531), where Dysport is typically retreated on a 3-to-4-month rhythm. Broadly: Dysport shows up sooner, Daxxify stays longer.

The second contrast is diffusion. Dysport spreads more from the injection site, which suits wide fields like the forehead. The third is formulation: Dysport contains the toxin with its associated complexing proteins, while Daxxify contains the 150 kDa core neurotoxin with a stabilizing peptide excipient (DOI: 10.3390/toxins15010060).

Their units are not comparable, and no published conversion ratio exists between them. Anyone quoting you one is guessing.

Daxxify vs Xeomin: How the Two Compare

This is the most interesting comparison of the set, because Daxxify and Xeomin arrive at a similar place by different routes. Both deliver the 150 kDa core neurotoxin without the complexing proteins found in Botox and Dysport.

According to PubMed, Frevert in Toxicon (2009) describes Xeomin as containing only the 150 kDa neurotoxin without complexing proteins, noting that those proteins have no therapeutic function (DOI: 10.1016/j.toxicon.2009.03.010). Dressler, reviewing five years of clinical experience in the European Journal of Neurology (2012), reports that Xeomin's reduced molecular size does not translate into a difference in diffusion, that its potency labeling is identical to that of Botox, and that the absence of complexing proteins allows an extended shelf life and simplified temperature handling (DOI: 10.1111/j.1468-1331.2011.03559.x). That last point is worth underlining, because it is a common misconception: a smaller molecule in the vial does not mean the product travels further in the tissue.

On dosing, Jost, Blümel and Grafe in Drugs (2007) report a 1:1 dose ratio between Xeomin and Botox in the clinical development program, with no differences between the two in onset of action, duration or waning of effect (DOI: 10.2165/00003495-200767050-00003). The Scaglione review reports the same 1:1 clinical conversion ratio with a comparable adverse event profile (DOI: 10.3390/toxins8030065). Xeomin is the one product in this group whose dosing does map cleanly onto Botox.

So the practical difference: Xeomin behaves broadly like Botox on dosing and duration, with a formulation stripped of complexing proteins. Daxxify also uses the core neurotoxin, but pairs it with the RTP004 peptide excipient and carries the substantially longer median duration reported in the SAKURA trials. If duration is what you are after, that is the distinction that matters.

Botox vs Dysport vs Daxxify: Full Comparison Table

Units in the row above are each product's own units and are not comparable across columns.

How Much Does Daxxify Cost?

Neurotoxin pricing works one of two ways: per unit, or per treatment area. Botox at Arbour Longevity is $13 per unit, which you can see on our Botox page. We quote current pricing for Daxxify, Dysport, Xeomin and Jeuveau at your consultation rather than publishing figures that go stale, and we will give you the number before anything is drawn up.

The more useful point is how to compare. Because each product uses its own unit system, a per-unit price in one product tells you nothing about a per-unit price in another. A 40-unit Daxxify glabellar dose and a 20-unit Botox glabellar dose are not two versus one of the same thing; they are two different measurements. The only comparison that means anything is the total cost of a treatment that achieves your result, and then the cost across a year.

Is Daxxify More Expensive Than Botox?

Per treatment, Daxxify is generally priced above Botox. Across a year the arithmetic changes, because the SAKURA trials report a median duration of around 24 weeks for Daxxify against the 3-to-4-month interval typical of Botox, which for many patients means two appointments a year instead of three or four. Whether that lands cheaper, dearer or level for you depends on your dose and your retreatment interval, and it is a calculation worth doing out loud at your consultation rather than guessing at.

Your first visit at Arbour Longevity is $35, and that fee is applied toward your treatment plan.

Why the Units Are Not Interchangeable

This is the single most misunderstood point in the whole comparison, so it is worth stating plainly: one unit of Botox is not one unit of Dysport, and neither is one unit of Daxxify. Each product's units are defined by its own potency assay. They are different scales, in the way that a mile and a kilometer are different scales, except that the conversion factor between neurotoxins is not fixed and not printed on the label.

As the De Boulle review notes, the FDA mandated distinct nonproprietary names for these products specifically to make that non-interchangeability visible, and cautioned that dosing recommendations cannot rest on any single conversion ratio (DOI: 10.2147/cia.s9338). The Cochrane review makes the same point from the evidence side: comparisons across products are only meaningful once the non-equivalent dosing systems are accounted for (DOI: 10.1002/14651858.CD011301.pub2).

The practical consequence for you as a patient is simple. Comparing clinics on cost per unit alone will mislead you unless you are comparing the same product, and a quoted unit count only means something alongside the product name.

All Five Neuromodulators, Under One Roof in Ann Arbor

Most practices stock one or two neurotoxins and fit every patient to what is in the fridge. Arbour Longevity stocks all five FDA-approved neuromodulators: Botox, Daxxify, Dysport, Xeomin and Jeuveau.

That matters for a specific reason. Everything above describes real differences between these products, in diffusion, in onset, in duration and in formulation. Those differences are only useful to you if your provider can actually act on them. A clinic that carries Botox alone can tell you Daxxify lasts longer and then treat you with Botox anyway. Carrying all five means the comparison in this article turns into an actual choice, including using different products in different areas of the same face, or changing product between visits if your first result was not quite what you wanted.

Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging/Functional Medicine BC is a triple board certified nurse practitioner and performs every injection herself. You can read more about neurotoxin treatment on our Botox page, and about how injectables fit alongside our other work on the Skin Longevity + Botox and dermal fillers pages.

How to Choose: Questions to Ask Your Provider

The right neurotoxin for you depends on your goals, your anatomy and your preferences. Worth asking:

1. How often am I willing to come in? If fewer visits is the priority, Daxxify's longer median duration is the relevant evidence.
2. How quickly do I need to see a change? Dysport is the faster of these products to show an effect.
3. Which area is being treated? Diffusion that helps across a forehead can work against you near the brow.
4. Do I have a formulation preference? Daxxify and Xeomin both use the core neurotoxin without complexing proteins; Daxxify uses a peptide excipient in place of an albumin-based stabilizer.
5. How did I respond last time? Your own history with a product is better evidence for your face than any general comparison.
6. What will this cost across a year, not just today? Ask for the annual number, in the product you are actually being treated with.

Frequently Asked Questions

Can I switch between neurotoxins?

Yes. Many patients try different products to find their best fit. Switching between Botox, Dysport, Daxxify, Xeomin and Jeuveau can be done when you are due for retreatment, and some patients prefer different products for different treatment areas.

Do neurotoxins prevent wrinkles from forming?

Regular neurotoxin treatment reduces the repeated muscle contractions that cause dynamic wrinkles to become etched into the skin over time. Starting before deep lines form is a common preventive strategy in aesthetic medicine, often referred to as preventive Botox or baby Botox.

What happens if I stop getting neurotoxin treatments?

Your muscles gradually return to their normal function and lines reappear over time. You will not look worse than you did before treatment.

Are neurotoxin treatments painful?

Most patients describe the sensation as a brief pinch. The needles are very fine and treatment takes about 10 to 15 minutes. Topical numbing cream or ice can be applied beforehand if you are sensitive.

How do I know I am getting authentic product?

Arbour Longevity purchases all neurotoxins directly from the manufacturers through authorized distributors. We never use counterfeit, diluted or gray-market products.

Book Your Neurotoxin Consultation in Ann Arbor

Choosing between Botox, Dysport, Daxxify, Xeomin and Jeuveau is a decision worth making with someone who stocks all five and has no reason to steer you toward one. Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging/Functional Medicine BC, will assess your facial anatomy, talk through your goals and recommend a product and plan on the evidence.

Arbour Longevity is at 2217 Packard St #15, in the Eastover Professional Center, Ann Arbor, MI 48104. Call (734) 436-3357. We are open Thursday through Monday, 10am to 7pm. Your first visit is $35, applied toward your treatment plan.

Book your consultation today.

References

1. Nestor M, Ablon G, Pickett A. Key parameters for the use of abobotulinumtoxinA in aesthetics: onset and duration. Aesthet Surg J. 2017;37(suppl_1):S20-S31. DOI: 10.1093/asj/sjw282
2. Dashtipour K, Chen JJ, Espay AJ, Mari Z, Ondo W. OnabotulinumtoxinA and abobotulinumtoxinA dose conversion: a systematic literature review. Mov Disord Clin Pract. 2015;3(2):109-115. DOI: 10.1002/mdc3.12235
3. Scaglione F. Conversion ratio between Botox, Dysport, and Xeomin in clinical practice. Toxins (Basel). 2016;8(3):65. DOI: 10.3390/toxins8030065
4. De Boulle K, Fagien S, Sommer B, Glogau R. Treating glabellar lines with botulinum toxin type A-hemagglutinin complex: a review of the science, the clinical data, and patient satisfaction. Clin Interv Aging. 2010;5:101-118. DOI: 10.2147/cia.s9338
5. Kutschenko A, Manig A, Reinert MC, Mönnich A, Liebetanz D. In-vivo comparison of the neurotoxic potencies of incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA. Neurosci Lett. 2016;627:216-221. DOI: 10.1016/j.neulet.2016.06.001
6. Carruthers JD, Fagien S, Joseph JH, et al. DaxibotulinumtoxinA for injection for the treatment of glabellar lines: results from each of two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). Plast Reconstr Surg. 2020;145(1):45-58. DOI: 10.1097/PRS.0000000000006327
7. Bertucci V, Solish N, Kaufman-Janette J, et al. DaxibotulinumtoxinA for injection has a prolonged duration of response in the treatment of glabellar lines: pooled data from two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). J Am Acad Dermatol. 2020;82(4):838-845. DOI: 10.1016/j.jaad.2019.06.1313
8. Fabi SG, Cohen JL, Green LJ, et al. DaxibotulinumtoxinA for injection for the treatment of glabellar lines: efficacy results from SAKURA 3, a large, open-label, phase 3 safety study. Dermatol Surg. 2021;47(1):48-54. DOI: 10.1097/DSS.0000000000002531
9. Green JB, Mariwalla K, Coleman K, et al. A large, open-label, phase 3 safety study of daxibotulinumtoxinA for injection in glabellar lines: a focus on safety from the SAKURA 3 study. Dermatol Surg. 2021;47(1):42-46. DOI: 10.1097/DSS.0000000000002463
10. Gallagher CJ, Bowsher RR, Clancy A, et al. Clinical immunogenicity of daxibotulinumtoxinA for injection in glabellar lines: pooled data from the SAKURA phase 3 trials. Toxins (Basel). 2023;15(1):60. DOI: 10.3390/toxins15010060
11. Frevert J. Xeomin is free from complexing proteins. Toxicon. 2009;54(5):697-701. DOI: 10.1016/j.toxicon.2009.03.010
12. Dressler D. Five-year experience with incobotulinumtoxinA (Xeomin): the first botulinum toxin drug free of complexing proteins. Eur J Neurol. 2012;19(3):385-389. DOI: 10.1111/j.1468-1331.2011.03559.x
13. Jost WH, Blümel J, Grafe S. Botulinum neurotoxin type A free of complexing proteins (XEOMIN) in focal dystonia. Drugs. 2007;67(5):669-683. DOI: 10.2165/00003495-200767050-00003
14. Camargo CP, Xia J, Costa CS, et al. Botulinum toxin type A for facial wrinkles. Cochrane Database Syst Rev. 2021;7(7):CD011301. DOI: 10.1002/14651858.CD011301.pub2