Botox® Cosmetic was the first commercially available diluted and purified botulinum toxin type A product that had received the approval of Food and Drug Administration (FDA) for cosmetic use. BOTOX® Cosmetic is produced by Allergan, Inc., of Irvine, California. It is the most studied brand of botulinum toxin type A in the world.

​

The cosmetic outcome of Botox® injections is typically visible within 3-7 days and lasts for 3-6 months, depending on the dose of the product, the type and size of the muscle that is injected, and the quality and the age of the skin overlying the muscle. In general, fewer injections are needed after the second or third year.

Dysport® is made from the same active ingredient as Botox® Cosmetic (made by Allergan), botulinum toxin type A, however, the manufacturing process of Dysport® is slightly different, resulting in slight differences in its clinical use for cosmetic purposes. For instance, Dysport® may provide a little faster onset of action and has a greater ‘spread’ (giving a more ‘natural’ look) compared to Botox® Cosmetic . Botox®, on the other hand, tends to remain more localized, allowing for greater precision in the treatment area, but possibly requiring more injections in the course of a treatment. There are also claims and suggestions that Dysport® results might last up to a month or even two beyond that of Botox®. The unit dosage of each product is also different and accordingly different number of units have to be used to achieve comparable results.

Xeomin®, manufactured by Merz Pharmaceuticals, was the latest contender in the growing list of botulinum toxin products intended for the correction of glabellar lines. The Food and Drug Administration (FDA) approved Xeomin® in July 2011 for the treatment of severe frown lines or “11’s” between the eyes. Like Botox® and Dysport®, Xeomin® is a Botulinum type A formulation, but with a longer shelf-life without refrigeration. This is accomplished by the removal of complexing proteins present in Botox® and Dysport® during the manufacturing process. Xeomin® is more like Botox® Cosmetic than Dysport®. It takes about one week for the full effects of Xeomin® injections to be realized, and once this occurs, the results last from three to six months