Botox has become a household name and a beauty staple in the battle against wrinkles for millions of women and men. And the arsenal continues to grow — first wth Dysport and now with the latest injectable alternative to gain FDA-approval, Xeomin — all of which bodes well for people who want younger-looking, smoother skin without having to go under the knife.

All three non-invasive wrinkles-fighters contain botulinum toxin type A — a neurotoxin that’s become incredibly popular. According to the American Society for Aesthetic Plastic Surgery, more than 2.4 million people received Botox or Dysport injections last year to reduce fine lines on the face. Neurotoxins block the transmission of impulses from nerve cells to the muscle. This paralyzes the muscle, preventing certain facial expressions, such as frowning, that can cause wrinkles to form over time, while smoothing the skin’s appearance.

With the latest addition of Xeomin, there are more options than ever to turn back the clock. Here’s what you need to know about each anti-aging injectable:


Botox is the gold standard of wrinkle-fighting neurotoxin injectables and has a long safety record. The popular injectable was FDA-approved in 2002 to lessen the frown lines between the eyebrows (also known as the “11’s”). However, many dermatologists use Botox “off-label,” to eliminate crow’s feet (wrinkles around the outer eye) and horizontal forehead creases, as well as to reduce the appearance of a down-turned mouth and to treat bands across the neck. Botox is also approved to treat hyperhidrosis, a condition that produces overactive sweating, such as on the palms and underarms, as well as migraines, according to Howard Sobel, MD, a dermatologist in New York City.

Cost: Around $500 per area

How long it lasts: Three to four months


The injectable, which was approved in 2009, was Botox’s first taste of competition. So how does Dysport stack up against the reigning champ Botox? Researchers from the Maas Clinic in San Francisco and the University of California at San Francisco conducted a study to find out whether Botox or Dysport was more effective at reducing wrinkles. In the study, which was published in the Archives of Facial Plastic Surgery, doctors randomly injected 90 study participants with Botox on one side of the face and Dysport on the other side.

Both the researchers and the study participants evaluated the results using a five-point scale. The result? Dysport significantly improved crow’s feet better than Botox did. However, it’s worth noting that study participants only saw the difference when they contracted their facial muscles (such as squinting) as much as possible. There was no difference when their faces were relaxed.

With Dysport, some doctors find the neurotoxin spreads or migrates a bit more than Botox when injected, so less is more when it comes to this injectable. “Dysport also acts more quickly than Botox,” says Dr. Sobel. “You’ll see an effect in two or three days rather than three to four days.”

Cost: Around $500 per area

How long it lasts: Three to four months


The new kid on the block was recently approved by the FDA to get rid of severe frown lines between the eyebrows. Although the drug may seem new, Xeomin has been used to fight fine lines throughout Europe since 2008, and was already approved in the US to treat adults with cervical dystonia, a condition marked by abnormal neck pain and movements, and blepharospasm, a condition characterized by abnormal, involuntary eyelid blinking or spasms.

“Xeomin is very similar to Botox and Dysport,” notes Dr. Sobel. “The only difference is it doesn’t have to be refrigerated, which makes it easier to transport it and may affect its price point.” Xeomin won’t be available until spring 2012, so the jury is still out as to whether it will cost less than its competitors and whether Xeomin will knock Botox off its pedestal as the most popular anti-aging injectable.

Cost: Around $400-600 per area

How long it lasts: Three to four months