Botox, Dysport, Xeomin, Jeuveau, Daxxify, and Letybo: What Is Actually Different?

The short answer: six related products, not six versions of the same thing

Botox Cosmetic, Dysport, Xeomin, Jeuveau, Daxxify, and Letybo are all botulinum toxin type A products used to temporarily soften movement-driven facial lines. That shared category can make them sound interchangeable. They are not.

Each product has its own active drug name, formulation, manufacturing process, potency assay, FDA-approved cosmetic areas, labeled dose, and clinical evidence. Even the word unit belongs to the individual product. The prescribing information for every brand warns against comparing or converting its units to those of another botulinum toxin.

This matters most when someone tries to compare prices. A lower advertised price per unit does not establish a lower treatment cost when the unit itself is not the same measurement across brands.

The useful comparison is:

• the same treatment goal and anatomical area
• the complete treatment plan, not one unit price
• the product’s current FDA-approved cosmetic uses
• your prior response, desired movement, and maintenance experience
• the provider’s assessment, technique, and follow-up plan

As of this review, current U.S. FDA labeling identifies these six cosmetic botulinum toxin type A brands. Beauty Medica confirms current availability during consultation rather than implying that every product is stocked at every visit.

What a wrinkle relaxer can—and cannot—do

Botulinum toxin type A temporarily reduces the nerve signal telling a targeted muscle to contract. When a trained medical provider places it in a specific facial muscle, the muscle pulls less strongly and the skin above it folds less.

That makes these products most useful for dynamic lines: lines appearing or deepening when you frown, squint, smile, raise your brows, or tighten your neck. A line remaining when the face is completely relaxed is partly etched into the skin. Reducing muscle pull may soften it and help keep it from deepening, but may not erase it on its own.

Wrinkle relaxers are not fillers. They do not add volume, replace lost collagen, or physically fill a crease. They address muscle activity. Filler, resurfacing, skin-quality treatment, or a combined plan may be more relevant when structure or skin—not movement—is the main issue.

All six products at a glance

Five ways these products are not the same

1. Their units are product-specific

The potency unit for each product comes from that product’s preparation and assay. FDA prescribing information explicitly says the units cannot be compared with or converted into units of another botulinum toxin product.

That remains true when two labels display the same number. A labeled 20-unit glabellar treatment with Botox Cosmetic, Xeomin, Jeuveau, or Letybo does not make those four products identical or automatically interchangeable.

It also remains true when one number is larger. The 50-unit Dysport label does not mean Dysport is “weaker” than a 20-unit product. The 40-unit Daxxify label does not mean it is “twice as strong” as one using 20 units.

2. Their FDA-approved cosmetic areas differ

Botox Cosmetic currently has the broadest cosmetic-area label of the six, extending across the major upper-face areas and platysma bands. Xeomin’s current cosmetic label covers upper facial lines. Dysport, Jeuveau, Daxxify, and Letybo currently have U.S. cosmetic labels for glabellar lines.

A licensed clinician may use an FDA-approved drug in another area when medical judgment supports it. That is off-label use. The product may be approved while the particular area is not included in that product’s cosmetic label.

3. Their formulations differ

The products use different active drug preparations and excipients. Xeomin is manufactured without accessory proteins. Daxxify uses a synthetic peptide excipient. Dysport contains lactose and may contain trace cow’s milk protein. Several products contain human albumin, while Daxxify’s listed excipients are different.

These are real distinctions, but they should not be turned into unsupported claims that one product is universally “cleaner,” safer, or more natural. The patient’s history and the complete prescribing information matter.

4. Their timing and duration evidence is not one head-to-head contest

Onset and duration claims come from different labels, trials, endpoints, patient groups, and assessment methods. They cannot be ranked as though all six were tested in one standardized study.

Botox Cosmetic labeling describes glabellar muscle relaxation beginning in approximately one to two days and lasting approximately three to four months. Xeomin labeling states a median onset of two to seven days and a typical effect of up to 12 to 16 weeks. Dysport labeling states its glabellar effect may last up to four months. Daxxify’s pivotal glabellar trials reported a median onset of three days and a median of approximately 24 weeks for none-or-mild frown-line severity by combined investigator and patient assessment.

Jeuveau and Letybo labeling directs retreatment no more frequently than every three months. That instruction is not the same thing as promising an identical three-month result for every patient.

5. The same brand can perform differently in different patients

Muscle strength, forehead height, brow position, eyelid support, natural asymmetry, treatment area, prior response, dose, dilution, injection volume, and placement all influence the result. A brand cannot compensate for a plan that does not fit the face.

Botox Cosmetic: broad cosmetic labeling and long familiarity

Botox Cosmetic is the most widely recognized name in the category. Its active drug is onabotulinumtoxinA, and its current U.S. cosmetic label covers moderate to severe glabellar lines, lateral canthal lines, forehead lines treated with glabellar lines, and platysma bands.

For glabellar lines, the labeled total is 20 Botox Cosmetic units across five sites. Labeling describes muscle relaxation beginning in approximately one to two days, increasing during the first week, and lasting approximately three to four months for glabellar lines.

Its formulation contains a botulinum toxin type A neurotoxin complex, human albumin, and sodium chloride. That formulation, label breadth, and extensive treatment history distinguish it; they do not make it the automatic choice for every person.

Botox Cosmetic may be part of the conversation when:

• the plan includes multiple areas covered by its current cosmetic label
• you have used it before and know how you respond
• you value a familiar maintenance history
• your provider’s dosing and placement plan fits your anatomy and movement goals

Dysport: a distinct unit scale and glabellar-line label

Dysport contains abobotulinumtoxinA. Its current U.S. cosmetic indication is moderate to severe glabellar lines in adults younger than 65. Its labeled total is 50 Dysport units divided among five sites.

Those 50 units cannot be converted into Botox Cosmetic, Xeomin, Jeuveau, Daxxify, or Letybo units. Dysport is not “weaker Botox,” and comparing its advertised price per unit with a Botox price per unit is not mathematically valid.

Dysport labeling states that its glabellar effect may last up to four months. Patients sometimes hear broad claims that it always acts faster or “spreads more.” Individual experience may differ, but dose, concentration, injection volume, anatomy, and technique also shape the treatment field. Those slogans should not replace a clinical plan.

Dysport contains human albumin and lactose and may contain trace amounts of cow’s milk protein. Its label lists hypersensitivity to cow’s milk protein as a contraindication. That is different from lactose intolerance and should be discussed with the treating provider if a true milk-protein allergy is part of your history.

Dysport may be part of the conversation when:

• the treatment goal is glabellar-line improvement
• you have had a good and predictable prior response
• your provider prefers its behavior for your particular frown-muscle pattern
• the total treatment quote and plan make sense without relying on unit-price comparison

Xeomin: upper-face labeling without accessory proteins

Xeomin contains incobotulinumtoxinA. Its current U.S. cosmetic label covers glabellar lines, horizontal forehead lines, and lateral canthal lines, treated individually or together according to the prescribing information.

For glabellar lines, the labeled maximum dose is 20 Xeomin units across five sites. Its label states a median onset of two to seven days and a typical duration of up to 12 to 16 weeks, with individual variation.

Xeomin is manufactured as the active 150 kDa neurotoxin without accessory proteins. Its listed inactive ingredients include human albumin and sucrose. That is the basis of the “naked toxin” nickname.

The nickname should not be overstated. Xeomin is not protein-free; the active neurotoxin is itself a protein. The absence of accessory proteins is a genuine formulation distinction, not proof that Xeomin is universally safer, cleaner, more natural, or better for every patient.

Xeomin may be part of the conversation when:

• the plan involves an upper-face area included in its current label
• you prefer or your provider recommends a formulation without accessory proteins
• you have responded well to Xeomin previously
• its expected treatment rhythm fits your goals and history

Jeuveau: a cosmetic glabellar-line option with its own evidence

Jeuveau contains prabotulinumtoxinA-xvfs. Its current U.S. label is specifically for the temporary improvement of moderate to severe glabellar lines in adults. The label is not approved for other conditions.

The labeled total is 20 Jeuveau units across five sites, and retreatment should occur no more frequently than every three months. Those units remain Jeuveau-specific even though the number 20 also appears in several other labels.

Jeuveau contains a botulinum toxin type A neurotoxin complex, human serum albumin, and sodium chloride. It deserves its own profile because it is an FDA-approved cosmetic product with product-specific trials and labeling—not merely a generic substitute for Botox Cosmetic.

Jeuveau may be part of the conversation when:

• the treatment goal is glabellar-line improvement
• you want to discuss a product developed and labeled for cosmetic frown lines
• you have a useful prior-response history with it
• your provider’s experience and total treatment plan support the choice

Daxxify: peptide-based formulation and longer median glabellar data

Daxxify contains daxibotulinumtoxinA-lanm. Its current U.S. cosmetic indication is moderate to severe glabellar lines in adults. The labeled total is 40 Daxxify units across five sites.

Daxxify uses a 35-amino-acid synthetic peptide excipient called RTP004 and does not list human albumin among its inactive ingredients. This formulation is meaningfully different from the other products; the 40-unit label is still product-specific and cannot be converted into another brand’s units.

In two pivotal Phase 3 trials, glabellar-line severity at maximum frown remained none or mild for a median of approximately 24 weeks by combined investigator and patient assessment. Median means half of measured responses were shorter and half were longer. It is not a six-month guarantee for every patient.

The pivotal program reported a median onset of three days. These findings are specific to the trial design and glabellar indication. They do not establish the same timing or duration for the forehead, crow’s feet, lower face, or neck.

Daxxify may be part of the conversation when:

• longer median glabellar-line duration is an important goal
• reducing the number of maintenance visits matters
• you understand that individual duration still varies
• your provider is experienced with its product-specific dose and behavior

Longer duration can mean fewer appointments when the plan is right. It can also make conservative assessment and precise placement especially important because botulinum toxin cannot simply be switched off after treatment.

Letybo: a sixth FDA-approved glabellar-line product

Letybo contains letibotulinumtoxinA-wlbg. Its current U.S. cosmetic label is specifically for the temporary improvement of moderate to severe glabellar lines in adults, and the label states that it is not approved for other conditions.

The labeled total is 20 Letybo units across five sites. Its potency units are not interchangeable with other botulinum toxin preparations, and labeling directs retreatment no more frequently than every three months.

Letybo contains botulinum toxin type A, human albumin, and sodium chloride. It belongs in a complete comparison because it has its own FDA-reviewed formulation, clinical program, prescribing information, and product-specific unit—not because it is automatically equivalent to another 20-unit label.

Letybo may be part of the conversation when:

• the treatment goal is glabellar-line improvement
• you want to understand all six current U.S. cosmetic products
• your prior treatment history or provider experience supports it
• current availability and the total treatment plan are confirmed during consultation

Why price per unit cannot compare these products

Suppose one advertisement gives a Botox Cosmetic price per unit and another gives a lower Dysport price per unit. The numbers look comparable because both use the word “unit.” They are not the same measurement.

The FDA-labeled glabellar totals make the problem obvious:

• Botox Cosmetic: 20 product-specific units
• Dysport: 50 product-specific units
• Xeomin: 20 product-specific units
• Jeuveau: 20 product-specific units
• Daxxify: 40 product-specific units
• Letybo: 20 product-specific units

Those numbers cannot be converted into one another, and they do not tell you what your individual treatment should contain. Dividing or multiplying them to create “Botox-equivalent units” produces a marketing shortcut, not an FDA-established conversion.

FDA-approved product does not always mean on-label treatment area

The FDA approves a product for particular uses, doses, and patient populations supported by submitted evidence. A licensed clinician may use an approved drug in another area when medical judgment supports it. That is called off-label use.

Off-label does not mean counterfeit or automatically inappropriate. It does mean the provider should be able to explain:

1. which product is being used
2. whether the proposed area is on-label or off-label for that product
3. why the choice makes sense for your anatomy and goal
4. what evidence and experience support the plan
5. what the material risks, alternatives, and follow-up expectations are

This distinction matters because the six cosmetic labels are not identical. A brand can be FDA-approved while the particular area under discussion is outside that brand’s current cosmetic indication.

What matters more than an online brand ranking

Your treatment history

If one product has consistently produced a natural result with a predictable onset and maintenance pattern, that history is more useful than a generic ranking. Bring the product name, date, areas treated, dose if known, when you first noticed the effect, and when meaningful movement returned.

Your anatomy and movement

Two people asking for “forehead Botox” may need very different plans. One may have a high forehead and strong frontalis muscle. Another may depend on forehead movement to help hold a naturally lower brow. Treating them identically can create very different outcomes.

How much movement you want

Some patients want a strong reduction in movement. Others want lines softened while keeping visible expression. Say that clearly during consultation because it influences dose and placement. A natural result does not come from a magic brand; it comes from matching treatment to the face and goal.

The area being treated

Glabellar lines, lateral canthal lines, forehead lines, lower-face muscles, and platysma bands do not behave the same way. A product fitting one part of a plan is not automatically the answer for every area.

Provider experience and follow-up

The provider must understand the selected product’s labeling, preparation, dose, anatomy, placement, expected response, adverse effects, and complication management. Follow-up policy also belongs in the comparison because a treatment relationship is more than what comes in the vial.

So, which one should you choose?

There is no honest universal winner.

• If current on-label cosmetic-area breadth matters: Botox Cosmetic has the broadest cosmetic-area label, while Xeomin covers the upper face.
• If the concern is glabellar lines: all six have a current U.S. cosmetic indication for that area, but their products and units are not interchangeable.
• If longer median glabellar duration is the priority: Daxxify has the clearest differentiated pivotal-trial data to discuss, without guaranteeing the same duration for everyone.
• If a formulation detail matters medically or personally: review the actual prescribing information, including the Dysport cow’s-milk-protein warning and the different listed excipients.
• If one product already works predictably for you: your documented history often matters more than a new promotion.
• If cost matters: compare the total quote for the same goal and area, not price per unit.

At Beauty Medica, Elena Gorbunova, PA-C, makes the product decision with you. She connects the product, total dose, placement, expected treatment rhythm, and follow-up to your anatomy, movement, treatment history, and goals. Current product availability is confirmed during consultation.

The brand is part of the plan. It is not the plan by itself.