Which Botox Lasts the Longest? A Comparison of Botulinum Toxins

Which Botox lasts the longest, and can you get longer lasting Botox no matter the brand? It’s the question I hear most often. This guide compares all five botulinum toxin type A brands (Botox, Dysport, Xeomin, Daxxify, and Jeuveau) side by side, with the clinical duration data for each and the factors that make some options the longest lasting, so you can pick the right brand for your goals. As a nurse practitioner in aesthetic medicine, I’ll walk through what actually influences how long results hold and why dose matters as much as brand. By Jennifer Steinberg, NP

As a nurse practitioner in the aesthetic medicine industry, I’m frequently asked by clients which Botox lasts the longest. In this blog post, I will explore the five different brands of botulinum toxin type A that are available on the market, and dive into the factors that influence a toxin’s duration of effect.

The Five Botulinum Toxin Type A Brands

 

  1. Botox (onabotulinumtoxinA)
Botox onabotulinumtoxinA vial

 

    2. Dysport (abobotulinumtoxinA)

Dysport (abobotulinumtoxinA)

 

    3. Xeomin (incobotulinumtoxinA) 

Xeomin (incobotulinumtoxinA)

 

    4. Daxxify (daxxifibotulinumtoxinA)

Daxxify daxxibotulinumtoxinA vial

 

    5. Jeuveau (prabotulinumtoxinA)

Jeuveau prabotulinumtoxinA vial

Research Bias Amongst Botulinum Toxins

Most of the research published about botulinum toxin has been funded by one of the major pharmaceutical companies who manufacture the toxins. And, usually, each clinical trial only studies 1 or 2 toxins at a time, rather than comparing multiple toxins head-to-head. Thus, unbiased data is lacking. Botulinum toxins are extremely expensive (as patients are well aware), so a large-scale trial comparing all five preparations simultaneously would require an extensive budget. Research bias is important to keep in mind when weighing your choice of toxin.

Man receiving Botox injection in forehead.

Duration of Botox, Dysport, Daxxify, Xeomin, and Jeuveau

There exist several clinical studies measuring duration of the aforementioned toxin type A’s: 

According to a 2018 study published in the British Dental Journal, the duration of botulinum toxin type A injections varies depending on the brand and the dose used. The study found that Botox injections lasted an average of 4.14 months (17.99 weeks), while Dysport injections lasted an average of 3.87 months (16.8 weeks), and Xeomin injections lasted an average of 4.42 months (19.2 weeks.)

A 2023 study published in the journal Skin Therapy Letter found that Daxxify injections lasted a median duration of 6 months and as long as 9 months in some patients.

Another study found the average duration of Jeuveau for crow’s feet was found to be 11.11 weeks as compared with 11.22 weeks for Botox. Glabella (frown lines) injections of 20 units showed wrinkle improvement up to 12 week post-injection but did not measure results past 12 weeks. Jeuveau toxin is still in need of additional studies to see if results may persist past the 12 week mark.

Dose Changes Everything: Hyperconcentrated toxin 

According to the above data, Daxxify seems to be the frontrunner in terms of longevity. However, the latest research indicates the duration of botulinum toxin type A injections is heavily influenced by the dose strength. Higher doses of toxin tend to exhibit longer-lasting effects compared to lower doses. 

For instance, a study published in the journal Toxins found that Dysport duration increased to 9 months’ median duration when the FDA on-label dose was about doubled (about 2–2.5-fold). Similarly, Xeomin reached a duration of 9 months with a 5-fold increase in units. A 2–4-fold increase of the Botox on-label dose showed a median duration of around 6 months. 

A 2023 Jeuveau study showed hyperconcentrating the dose from 20u to 40u resulted in longevity of 6 months (26.1 weeks).

Botox injection into face

Research Bias Amongst Botulinum Toxins

In summary, the duration of botulinum toxin depends on both the brand AND the dosage used. Selecting one brand over another will not be advantageous to the patient if the proper dose isn’t received. Reduced dosages will generally result in unhappy patients and unwanted touch-up visits. No matter the brand, if longevity is your main goal, it’s best to receive a higher or more concentrated dose.

Duration of Botox, Dysport, Daxxify, Xeomin, and Jeuveau

If you’re considering botulinum toxin type A injections, our injectors carry Botox, Dysport, Xeomin, Daxxify, and Jeuveau at both locations and will recommend the right brand and dose for your face after a physical assessment. See Botox in Nashville or Botox in Chattanooga for pricing, injectors, and booking.

Individual biology varies from person to person and can affect duration, so a consultation is the right first step no matter which brand you’re leaning toward.

It is also important to remember that individual biology varies from person to person, and this may affect duration as well. It is important to consult with a qualified professional to discuss your specific needs and expectations prior to Botox treatment.

Frequently Asked Questions

At standard on-label doses, Daxxify tends to lead. A 2023 study in Skin Therapy Letter found a median duration of about 6 months, and up to 9 months in some patients. That said, dose matters as much as brand, so the longest-lasting result depends on both the product and the units your injector uses.

There are five FDA-approved botulinum toxin type A brands: Botox (onabotulinumtoxinA), Dysport (abobotulinumtoxinA), Xeomin (incobotulinumtoxinA), Daxxify (daxxibotulinumtoxinA), and Jeuveau (prabotulinumtoxinA). Our injectors carry all five at both the Nashville and Chattanooga locations.

A 2018 review in the British Dental Journal reported average durations of about 4.14 months (17.99 weeks) for Botox, 3.87 months (16.8 weeks) for Dysport, and 4.42 months (19.2 weeks) for Xeomin. Daxxify has shown a median of roughly 6 months. Individual biology varies from person to person, so your results may differ.

Yes, in many cases. Research shows that higher or more concentrated (hyperconcentrated) doses tend to last longer. For example, a study in Toxins found Dysport reached a median of 9 months when the on-label dose was roughly doubled, Xeomin reached 9 months at a 5-fold increase, and Botox reached about 6 months at a 2-4-fold increase. A 2023 Jeuveau study saw longevity of about 6 months (26.1 weeks) when the dose went from 20u to 40u.

If longevity is your main goal, the brand matters less than receiving an adequate, more concentrated dose. Reduced dosages usually lead to shorter results and extra touch-up visits. During a consultation, your injector will assess your face and recommend the brand and dose most likely to give you lasting results.

It has real limitations. Most published studies are funded by the manufacturers, and trials typically test only one or two toxins at a time rather than comparing all five head-to-head. Large simultaneous comparisons are rare because the products are expensive to study. Keep this potential bias in mind when weighing your options. Reviewed by Jennifer Steinberg, NP

BOOK YOUR FREE CONSULTATION at our SLK Nashville or Chattanooga locations.

References

  1. Guinevere Smith, B.M., Alistair Lax, B., & Shamir Mehta, B.B. (2018). A review of the longevity of effect of Botulinum Toxin in wrinkle treatments.
  2. DaxibotiulinumtoxinA for Treatment of Facial Wrinkles: A Review of Clinical Studies. Skin Therapy Letter. 2019;24(10):8.
  3. Kaufman-Janette, J., Cox, S. E., Dayan, S., & Joseph, J. (2021). Botulinum Toxin Type A for Glabellar Frown Lines: What Impact of Higher Doses on Outcomes?. Toxins, 13(7), 494.

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