Botox vs Dysport vs Xeomin: What's the Difference (And Why I Only Use One)
If you've been thinking about anti-wrinkle injections, you've probably heard the names. Botox. Dysport. Xeomin. There is also a new one out, but for the simplicity of this blog, I will not be including it. They get used almost interchangeably in conversation, and honestly, I understand the confusion. They all do the same thing, they all come from the same family of medicine, and they're all used in clinics across New Zealand every single day. Feel safe knowing that they are all approved by MEDSAFE to be used for cosmetic treatments.
But they are not the same product. And the differences matter more than most people realise.
At Skin Poet, I use one product exclusively: XEOMIN®. That's not a default choice or a supplier arrangement. It's a deliberate clinical decision I made after researching the formulations carefully. I want to explain why, and to do that, I need to walk you through what each product actually is.
The short version: all three are botulinum toxin type A. All three temporarily relax the muscles that cause dynamic wrinkles. All three last roughly three to four months. The differences lie in how they're formulated, and those differences have real implications for your skin over time.
How Anti-Wrinkle Injections Work
Before we get into the brand differences, it helps to understand the basics.
All three products contain botulinum toxin type A, a purified protein that works by blocking the release of acetylcholine at the neuromuscular junction. In plain terms: it temporarily stops the nerve signal that tells your muscle to contract. When the muscle relaxes, the overlying skin smooths out. The effect is not permanent. As the nerve junction recovers over time, muscle movement gradually returns, which is why treatments are typically repeated every three to four months.
The active molecule in all three products is identical. What differs is everything around it.
Botox: The household Name
Botox (onabotulinumtoxinA) was approved for cosmetic use in 2002 and became so dominant that people started using the brand name as a verb. That ubiquity is both its greatest strength and, in my view, part of the reason clients don't always ask enough questions about what they're actually receiving.
Botox is a neurotoxin complex. That means the active botulinum toxin is surrounded by accessory proteins that travel with it into your tissue. These proteins don't contribute to the wrinkle-relaxing effect. They're essentially packaging.
What this means in practice:
The accessory proteins can trigger an immune response over time
With repeated treatments, some clients develop antibodies that neutralise the toxin
When that happens, Botox becomes less effective, and higher doses are needed to achieve the same result
This is sometimes called "toxin resistance," and it's a real clinical phenomenon
Botox has a strong safety record and an extensive body of research behind it. I'm not dismissing it. But for clients who plan to maintain their results long-term (which most of my clients do), the antibody question is one worth taking seriously.
Dysport: The spreader
Dysport (abobotulinumtoxinA) arrived in 2009 and brought a slightly different formulation to the table. Like Botox, it's a neurotoxin complex with accessory proteins. But its protein structure is smaller, which affects how it behaves once injected.
The key characteristic of Dysport is diffusion. It spreads more widely from the injection point than Botox does. In certain situations, that broader spread can be useful. For large, flat areas like the forehead, some injectors prefer it for that reason. And works well in male clients.
A few things to know about Dysport:
It requires significantly more units than Botox or Xeomin to achieve the same result (roughly 2.5 to 3 times more)
The lower per-unit price can look attractive, but the total treatment cost usually ends up comparable
Because it spreads further, precision placement becomes even more important
It contains lactose and is contraindicated for anyone with a cow's milk protein allergy
Dysport also carries accessory proteins, so the same long-term resistance concern applies as with Botox. It's a legitimate product, used well by experienced injectors. But the diffusion profile and the protein load are reasons I've chosen not to work with it.
Xeomin: Why I Choose the naked injectable
XEOMIN® (incobotulinumtoxinA) is what I use at Skin Poet. It was approved in 2011 and it takes a fundamentally different approach to formulation.
Xeomin is often called "the naked injectable" because it contains only the pure, active 150 kDa botulinum toxin. No accessory proteins. No extra packaging. Just the ingredient that does the work.
Merz Aesthetics developed a proprietary purification process that strips away the surrounding proteins, leaving only the active neurotoxin core. This isn't a marketing claim; it's a structural fact about how the product is made.
Follow this link to read more on our website > https://www.skinpoet.co.nz/anti-wrinkle-treatments-north-shore-auckland
Why this matters for long-term clients
The absence of accessory proteins means there is significantly less to trigger an immune response. Clients who have been receiving anti-wrinkle treatments for years, and who want to continue doing so for years to come, have a much lower risk of developing resistance to Xeomin than to protein-carrying alternatives.
This is particularly important to me because I work with clients on a long-term basis. I'm not interested in a treatment that works beautifully for two years and then starts to underperform. I want the same quality of result at your tenth appointment as at your first.
If you have had a consultation with me for anti-wrinkle, you would have heard my speel on protecting your future use of botulinum toxin - so many people need to be able to safely use it for medical reasons, why mess with that?!
The precision advantage
Because Xeomin doesn't carry the protein complex that causes broader diffusion, it behaves predictably and precisely at the injection site. For the delicate work I do around the eyes, brow, and upper face, that precision is everything. No two faces are the same, and I need a product I can place with confidence and accuracy. It may feel and look different if you are used to Dysport, but we will work out your dosage in a slow and safe way.
One more thing worth noting: Xeomin is the only product in this group that doesn't require refrigeration before reconstitution. That's a quality and logistics advantage that speaks to how stable the formulation is and how much better for the environment it is to not have to be shipped in a refrigerated truck and to be left at the clinic in a polystyrene box.
What About the Price?
I know price is a real consideration, and I want to be transparent about it.
At Skin Poet, XEOMIN® is priced at $17 per unit. Most anti-wrinkle treatments use between 20 and 50 units depending on the areas treated and your individual muscle activity. I'll always give you a clear unit estimate during your consultation before we begin.
The per-unit price of Dysport often looks lower, but because it requires 2.5 to 3 times more units to achieve the same clinical result, the total treatment cost is usually similar. Comparing neurotoxin prices by unit alone, without understanding the dosing differences, is one of the most common sources of confusion I see.
What I'd encourage you to think about is value over time. A product that works consistently, precisely, and with a lower risk of resistance is worth more than a marginally cheaper unit price that may become less effective with repeated use.
The Bottom Line
All three products are effective. All three are used safely by injectors around the world. But they are not identical, and the choice of product reflects something about how your injector thinks about your care.
I chose Xeomin because I believe in doing less, exceptionally well. I want to use the purest formulation available, placed precisely, in a way that serves your skin not just today but for the long term. The "naked injectable" isn't a gimmick. It's a considered clinical choice, and it's one I'm confident in.
If you'd like to talk through what anti-wrinkle treatment looks like for your face, I'd love to meet you. Consultations at Skin Poet are always personalised, always unhurried, and always honest.
Botox®, Prescription Medicine
For the treatment of frown lines and crow’s feet round the eyes Botox® has risks and benefits. Ask your doctor if Botox is right for you Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Allergan, Auckland.
Xeomin® (incobotulinum toxin ) Prescription Medicine
For the treatment of upper facial lines: glabellar frown lines, crow’s feet round the eyes, horizontal forehead lines Xeomin has risks and benefits. Ask your doctor if Xeomin is right for you (incobotulinum toxin A, purified Botulinum toxin type A 50 Units and 100 Units For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Merz, Sydney. Distributed by Healthcare Logistics, Auckland.
Dysport® is a prescription medicine for the treatment of frown lines, horizontal forehead lines, and crow’s feet around the eyes. Dysport® has risks and benefits. Ask your healthcare professional if Dysport is right for you. If you experience side effects, seek medical advice. Payment for Dysport® and clinic fees apply. For details on precautions and side effects, consult your healthcare professional or the Consumer Medicine Information (CMI) at www.medsafe.govt.nz. Dysport® treatment usually lasts about four months; repeat treatments may be necessary. Should only be administered by trained medical professionals. (Contains botulinum toxin A) Ipsen Limited, Auckland.