by Jennifer Stieber, 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
- Botox (onabotulinumtoxinA)
2. Dysport (abobotulinumtoxinA)
3. Xeomin (incobotulinumtoxinA)
4. Daxxify (daxxifibotulinumtoxinA)
5. Jeuveau (prabotulinumtoxinA)
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.
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).
CONCLUSION
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.
Nashville and Chattanooga Med Spa Recommendations
If you are considering botulinum toxin type A injections in Nashville or Chattanooga, visit a licensed medspa to determine the most suitable option for your unique needs. They will be able to perform a physical assessment and recommend the best brand and dosage for your face.
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.
BOOK YOUR FREE CONSULTATION at our SLK Nashville or Chattanooga locations.
References
- 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.
- DaxibotiulinumtoxinA for Treatment of Facial Wrinkles: A Review of Clinical Studies. Skin Therapy Letter. 2019;24(10):8.
- 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.
