Crows’ feet, frown lines, and forehead creases are all signs of a life full of facial expressions. And while some may be reminders of happy memories, it’s also totally fine to want to smooth them away. That’s where injectable treatments such as Botox come in. But did you know that Botox isn’t your only option? Other neuromodulators do essentially the same thing as Botox, as they “have the same active ingredient: botulinum toxin type A,” explains Jazmyn Manzouri, PA-C, a physician’s assistant, but may offer some other benefits that could be better suited for what you’re looking for.
Similar to Kleenex and Band-Aid, which are the brand names we associate with tissues and bandages, Botox has become the brand name reference when we speak of injectable wrinkle-smoothing treatments. To better familiarize yourself with the other neuromodulators on the market, we went to top injectors, including Manzouri, along with a dermatologist, plastic surgeon, and nurse practitioner. Below, experts break down the similarities and differences between Botox, Dysport, and Jeuveau and share how to pick the best option for you.
Meet the Experts
- Sonia Badreshia-Bansal, MD, FAAD, is a board-certified dermatologist and dermatologic surgeon at Elite MD in Danville, California.
- Alexes Hazen, MD, is a New York-based, board-certified plastic surgeon and the founder of skincare brand, Zen Essentials.
- Barret Bestard, DNP, is a board-certified nurse practitioner and master injector at JECT.Â
- Jazmyn Manzouri, PA-C, is a physician’s assistant and injector at TREAT Medspa in NYC.
What Are Neuromodulators?
A neuromodulator refers to a substance that works by blocking the release of acetylcholine, a neurotransmitter that triggers muscle contraction. That’s why treatments such as Botox, Dysport, and Jeuveau create a smoothed-out effect—they restrict the muscles from moving. Plastic surgeon, Alexes Hazen, MD, points out similarities in Botox, Dysport, and Jeuveau, saying they’re all FDA approved, can be used for aesthetic purposes (wrinkle reduction) and medical conditions (migraines, muscle spasticity, excessive sweating, etc.), and last around the same time, three to four months.
However, Manzouri adds, “While Botox, Dysport, and Jeuveau serve a similar purpose—temporarily reducing wrinkles by relaxing facial muscles—each neuromodulator has subtle differences in formulation, diffusion rate, and how it interacts with individual patients.” This is why it is beneficial to do your research to determine the neuromodulator that’s best for you.
What Is Botox?
“Botox is the original brand of neuromodulator and the most widely known brand name,” explains nurse practitioner Barrett Bestard, DNP. Created by Allergan and first approved by the FDA in 2002, Botox is the most widely studied neuromodulator with decades of safety data and predictable results, points out dermatologist Sonia Badreshia-Bansal, MD, which is part of the reason it’s the best known and most commonly used.
In terms of specifics, Bestard says, “Botox takes four to seven days to start working after treatment and is suitable for most people.” She likes to use it for her first-time patients, so they know what brand they are using. It also tends to be the most pricey of the injectables mentioned here.
What Is Dysport?
Dr. Hazen says that Dysport, whose parent company is Galderma, is very similar to Botox, but it’s faster acting (the fastest of all neuromodulators, with most patients seeing results in as little as two to five days). “Dysport tends to be the ‘strongest’ of neuromodulators and most commonly used for people with strong expression and muscles,” Bestard adds. “This is the most common neuromodulator used in men due to their stronger muscle tone.”
It also “tends to diffuse a bit more widely, making it useful for larger areas like the forehead,” points out Dr. Badreshia-Bansal. Dr. Hazen agrees, however, she flags that this requires precision, as “too much spread can cause side effects (e.g., eyelid droop).”
An important thing to note is that Dysport units are not interchangeable with Botox or Jeuveau units, so if you do switch from another neuromodulator to Dysport or vice versa, you will require a different number than you may be used to.
What Is Jeuveau?
Manufactured by Evolus and sometimes referred to as “Newtox,” Jeuveau is the newest of these three neuromodulators, having been introduced to the market in 2019. Dr. Badreshia-Bansal says, “It was designed specifically for cosmetic use and is often more cost-competitive while providing very similar results to Botox.”
Since it was designed for cosmetic use, specifically for frown lines, it has fewer FDA approvals than Botox and cannot be used for medical indications, such as migraines, muscle spasms, and sweat reduction.
However, “It is the most precise and has the least amount of spread when injected compared to other neuromodulators,” says Bestard, who adds that they use it on “patients who want a softer look.”
How to Choose
The overarching sentiment among the experts we spoke to was to find a practitioner that you trust and discuss what you’re looking for with them. If factors like cost and pain are among your top concerns, they should definitely be taken into account when developing your treatment plan. “Some folks think Dysport hurts less and in some cases Jeuveau is more affordable,” says Dr. Hazen.
If you’re looking for something that kicks in faster, all of our experts noted that Dysport has a speedy onset. However, if you want the most trusted option, Dr. Hazen points out, “Botox has the longest and most reliable track record, so that appeals to many.”
For the most part, you can switch between the three neuromodulators as you see fit and to find out whether one works better for you than another—under the guidance of a professional, of course. Manzouri adds, “Also, while rare, development of tolerance or resistance is possible and may be a reason to transition to another brand option.”
The Final Takeaway
While it’s good to do your homework and know what’s available to you, it’s ultimately a decision to make with your injector regarding which neuromodulator treatment will be your best choice. Our experts assured us that for the most part, you won’t be able to tell much of a difference between the three, especially in photos. You might just notice a different “feel” (“some describe Botox as a tighter feel, compared to other brands,” says Manzouri) with some setting in earlier or lasting longer, or vice versa.
And if you don’t like whichever one you choose, the good news is that they’re all temporary (all requiring maintenance, typically every three to six months, depending on the dosing, says Manzouri). In the end, if you do your research, find a trusted professional, and share you’re specific aesthetic goals, you’ll set yourself up for success.
