Botox vs Dysport vs Xeomin — What’s the Real Difference?

Medically reviewed by Dr. Dan Xu, M.D., CCFP — CPSO Licensed Physician, official Allergan/Juvéderm trainer in North America, and Founder & Medical Director of ID Cosmetic Clinic, Markham. Last updated June 2026.

“My friend got Botox, but your clinic uses Dysport — which one is better?” It is one of the questions we hear most often in our Markham clinic. Behind it is a real and fair confusion: there are several Health Canada–approved type A botulinum toxin brands that appear to do the same job, yet carry different names, different unit systems and sometimes very different price tags. This guide explains, from a physician’s chair, how Botox, Dysport and Xeomin actually differ — how each one works, who it suits, how fast it acts, how the units compare, and why comparing “price per unit” across brands is misleading — so you can walk into a consultation already asking the right questions.

Botox vs Dysport vs Xeomin — at a glance

Unit conversions are clinical reference figures, not fixed formulas — an experienced physician sets your actual dose by treatment area and individual response. Prices vary by the number of units and areas treated; book a consultation for an exact quote. (Cost figures to be confirmed by the clinic before publishing.)

A quick note before we go deeper: this is general information, not medical advice. Botulinum toxin is a prescription medication that should only be assessed, prescribed and injected by a qualified, licensed physician after an in-person evaluation.

Which one is right for you?

• Choose Botox if you are new to injectables or want the most predictable, heavily-studied option — particularly for precise areas such as frown lines (the “11s”) and crow’s feet, where its moderate, controlled spread is an advantage.
• Choose Dysport if you are treating a broad, even muscle like the forehead and want a smooth, natural relaxation with fewer injection points — or you have an event in a few days and want the fastest onset.
• Choose Xeomin if you inject regularly and feel your results have weakened over time, or you simply prefer a formulation with no accessory proteins — Xeomin is the only Health Canada–approved “naked” toxin.
• Let your physician decide if you are unsure. Brand selection is a clinical judgement based on your treatment area, injection history and goals — not a decision you have to make alone, and never one that should be driven by price per unit.

Botox: the original benchmark

Botox is the pioneer of the type A botulinum toxin category, made by Allergan (now part of AbbVie) in the United States, and it carries some of the richest long-term clinical data of any brand. Decades on the market and extensive follow-up research have made Botox the reference standard — other brands often describe their dosing relative to Botox units.

• How it works: Botox contains the active toxin surrounded by accessory (complexing) proteins that aid stability and storage. After injection, those proteins are metabolised and only the core toxin molecule blocks the nerve-to-muscle signal, relaxing the targeted muscle.
• Best for: precise areas that need controlled, predictable spread — frown lines (the glabella), crow’s feet and lip lines — and for first-time patients, where Botox’s deep dose-response data makes the result easier to predict.
• What it feels like: a few fine-needle pinpricks; most patients rate it 2–3 out of 10. No anaesthetic is usually needed.
• Onset & results: typically begins working in 3–5 days, with full effect by 10–14 days, lasting about 3–4 months. There is minimal downtime.

Note: Dr. Dan Xu is an official Allergan/Juvéderm trainer in North America, which means our Markham clinic teaches other providers on this product family and works with it daily.

Dysport: fast onset, great for larger areas

Dysport is made by Ipsen in France and is one of Europe’s longest-used botulinum toxins, with more than a decade in the North American market. Its molecular complex is slightly different from Botox, which gives it a somewhat wider spread in tissue — both an advantage and something that calls for skilled placement.

• How it works: the same core mechanism as Botox, but the wider diffusion means that across a broad, even muscle the product distributes more uniformly, sometimes with fewer injection points and a smoother, less “banded” result.
• Best for: the forehead and other larger areas where even relaxation matters. In delicate zones (such as the lower eyelid or upper lip) the same wider spread calls for careful dosing and precise placement, which is exactly where physician experience earns its keep.
• What it feels like: the same brief fine-needle sensation as the others — 2–3 out of 10, minimal downtime.
• Onset & results: often the fastest of the three, with effects felt in 1–3 days — about a day or two sooner than Botox. This can genuinely matter before a wedding or event. Full results land by ~10–14 days and last about 3–4 months.

The unit conversion matters. A Dysport unit is defined differently from a Botox unit: to reach the same clinical effect, you typically need roughly 2.5–3 units of Dysport per 1 unit of Botox. This is essential to understand before comparing prices — we explain why in the “unit-price trap” section below.

Xeomin: the “naked” formulation

Xeomin is made by Merz in Germany, and its defining feature is in the formulation: it is the only Health Canada–approved botulinum toxin with no accessory proteins — which is why it is sometimes called the “naked” toxin.

• Why accessory proteins matter: in theory, repeated long-term exposure to accessory proteins could prompt the body to form neutralising antibodies, gradually reducing effectiveness (clinical “resistance”). By removing those proteins, Xeomin may lower that theoretical risk — making it a reasonable option to discuss for patients who have injected for years and feel their results have faded.
• An important reality check: true antibody-driven resistance is uncommon. Far more often, “it doesn’t work like it used to” comes down to under-dosing, placement, or the muscle adapting — problems a physician fixes by adjusting the plan, not by switching brands. A proper assessment tells the two apart.
• Spread & onset: similar to Botox, with a roughly 1:1 unit conversion, so an experienced injector switching to Xeomin makes only small adjustments. Removing the accessory proteins also gives Xeomin strong room-temperature stability, with no cold-chain storage required.
• What it feels like & results: the same comfortable fine-needle experience, minimal downtime, full effect by ~10–14 days, lasting about 3–4 months.

A quick word on Letybo and other newer brands

You may also see Letybo (made by Hugel in South Korea), a newer Health Canada–approved type A toxin with a long usage history in Korea and parts of Europe. It contains accessory proteins, behaves much like Botox with a roughly 1:1 conversion, and gives patients another regulated option. As with any brand, what matters most is that the product is genuine, properly sourced, and injected by a licensed physician — not whether it is the newest or cheapest name on the menu. If a newer brand interests you, raise it at your consultation and let your physician advise whether it suits your situation.

Can you combine or switch between them?

You would not usually mix two different toxin brands in the same area at the same visit — there is no benefit and it muddies dosing. What is common, and perfectly safe, is switching brands over time: for example, moving a long-term Botox patient to Xeomin to assess for reduced response, or using Dysport on the forehead and Botox on finer areas within one treatment plan. When switching, an experienced physician re-assesses your dose rather than applying a flat conversion, so your results stay consistent. Botulinum toxin also pairs well in a broader plan with dermal fillers, skin-tightening and resurfacing — each addresses a different concern, and the right sequence is set during your consultation.

Who is not a good candidate?

Botulinum toxin is one of the most studied medications in aesthetics, but it is not for everyone. You may need to wait or choose a different option if you:

• are pregnant or breastfeeding;
• have a known allergy to any botulinum toxin product or its ingredients;
• have an active skin infection or breakout in the treatment area;
• have a neuromuscular disorder such as myasthenia gravis, Lambert–Eaton syndrome or ALS, which can heighten the effect of the toxin;
• take certain medications (for example, some antibiotics or muscle relaxants) that can interact with botulinum toxin — tell your physician everything you take;
• have a bleeding disorder or are on blood-thinners (manageable, but plan with your physician);
• have unrealistic expectations, or are seeking treatment of an area not suited to a toxin.

This is general information, not medical advice — a qualified physician should confirm your suitability in person before any injection.

What results should you realistically expect?

Whichever brand you choose, the experience is broadly similar: a gentle softening of dynamic lines begins within days, the full effect settles by about two weeks, and it lasts roughly three to four months before gradually fading. Toxin relaxes the muscles that create expression lines — so it works best on lines that appear when you move (forehead, frown, crow’s feet) and less on deep lines etched at rest, which may also need filler or resurfacing. A natural result that still lets you express yourself depends far more on the physician’s dosing and placement than on the brand name on the vial. Honest expectations are the single biggest predictor of satisfaction.

The “price-per-unit” trap — why you can’t compare brands by unit

When patients compare clinic quotes, they often line up the “price per unit” of each brand side by side. This is one of the most common mistakes in shopping for injectables — because one unit does not mean the same amount of effect across brands.

The Botox unit is the original benchmark. A Dysport unit is defined differently: to match the effect of 1 unit of Botox you typically need about 2.5–3 units of Dysport. That means:

• if frown lines take 20 units of Botox, the equivalent Dysport plan might need roughly 50–60 units;
• Dysport’s price per unit can look lower on paper, but because the same treatment needs many more units, the total cost often lands in a similar place.

The right way to compare is by the total cost to treat an area — not the isolated price per unit. And beyond price, injection technique, physician experience, the clinic’s medical standards, and follow-up all shape the real value of your treatment. A quote that looks far below market often means fewer units or an inexperienced injector — which usually means a weaker, shorter result.

(Exact ID Cosmetic Clinic pricing to be inserted before publishing.) Always ask for the cost to treat the whole area, not just the per-unit rate.

Why choose ID Cosmetic Clinic for botulinum toxin?

A toxin is only as good as the physician choosing and placing it. At ID Cosmetic Clinic in Markham, every treatment plan is led by Dr. Dan Xu, M.D., CCFP — a CPSO Licensed Physician, official Allergan/Juvéderm trainer in North America, Clinical Preceptor at McMaster University’s medical program, and Founder & Medical Director of the clinic since 2017, with 8+ years and 5,000 clients · 80,000 treatment areas of experience. Our practice primarily serves Asian faces, and brand and dose are tailored accordingly — because the muscle anatomy, expression patterns and aesthetic goals that matter for a natural result are individual, not one-size-fits-all. We do not pick a brand by which is cheapest per unit; we pick the one best suited to your treatment area and your face.

Frequently asked questions

What is the real difference between Botox, Dysport and Xeomin?

All three are Health Canada–approved type A botulinum toxins that relax muscles the same way, so the differences are in the details: Dysport tends to spread a little wider and act 1–2 days faster, Xeomin contains no accessory proteins, and Botox has the most clinical data and is the unit benchmark the others are measured against.

Is one brand better than the others?

No brand is objectively “best.” They share the same core mechanism and similar safety. What matters most is that an experienced physician selects the right brand for your treatment area and goals, uses genuine product, and injects with accurate dosing and placement.

How many units of Dysport equal Botox?

As a clinical reference, roughly 2.5–3 units of Dysport are needed to match 1 unit of Botox, because the two brands define a “unit” differently. Your physician sets the exact dose for your treatment area rather than applying a fixed formula.

Which brand is fastest to start working?

Dysport often has the fastest onset, with effects felt in about 1–3 days, while Botox and Xeomin typically begin in 3–5 days. All three reach full effect by about 10–14 days. Faster onset can matter if you have an event coming up.

I’ve had Botox many times and it doesn’t work as well — will Xeomin help?

It might. Xeomin contains no accessory proteins, which in theory lowers the chance of forming neutralising antibodies, so some long-term patients respond better after switching. But true resistance is uncommon — a physician should first check whether the issue is actually under-dosing or placement, which is fixed by adjusting the plan rather than changing brands.

How does my physician decide which brand to use?

By weighing the treatment area (precise versus broad coverage), which brand you have used before and how you responded, any allergy or antibody concerns, and your preference. Most clinics have one or two everyday brands their physicians know best, with flexible choices reserved for specific situations.

Are the three brands equally safe?

Yes — all are approved by regulators and carry similar side-effect profiles at appropriate doses. The differences are in molecular characteristics and approved uses, not in safety tier. Choosing a licensed physician and a proper medical setting matters far more than debating which brand is “safer.”

Will my results look different if I switch brands?

Possibly — mainly in onset speed and spread. Some patients feel a brand kicks in faster or covers a slightly wider area. When you switch, an experienced physician re-assesses your dose instead of converting one-to-one, to keep your results consistent and safe.

Which brand is best for the forehead versus the frown lines?

For the broad forehead muscle, Dysport’s wider spread can give a smooth, even relaxation; for precise areas like frown lines and crow’s feet, Botox or Xeomin’s more controlled spread is often preferred. Many plans use more than one brand across different areas.

How much does each brand cost in Toronto?

Cost depends on the number of units and areas treated, not on the per-unit rate alone — remember Dysport needs more units to match Botox. Always compare the total cost to treat an area, and book a consultation for an exact quote.

Related at ID Cosmetic Clinic

• Treatment: Botox & anti-wrinkle injections · Dysport · Xeomin
• Concern: Forehead lines · Frown lines (the “11s”) · Crow’s feet
• Learn more: How many units of Botox do you need? · How long does Botox last?

Choosing between these products is only part of the decision. For how botulinum toxin is dosed by treatment area, and which concerns respond to it at all, see our botulinum toxin treatment overview. We also carry Letybo®, which is not covered in the comparison above.