Which Neurotoxin Lasts Longest? What All Six Labels Actually Say
Reviewed for medical accuracy against our Medical Review Board · Last updated 5 September 2026
Part of Botox vs Other Brands
Six botulinum toxin products are FDA approved for frown lines in the United States. Every one of them is marketed on how long it lasts. Not one of the six ran a trial designed to measure it.
That is not a rhetorical opening. It is what the six prescribing documents say when you read them side by side, and it is the reason the comparison tables circulating on clinic sites disagree with each other so freely. This page puts the actual labelled statements in one place, says which brand states what, and is honest about the fact that the question in the title does not have a clean evidence-based answer.
1. All six measured the same month
Start here, because everything else follows from it. Each product's pivotal glabellar programme had a primary efficacy endpoint, and that endpoint is when the trial was designed to prove the drug worked.
| Product | Primary endpoint |
|---|---|
| Botox Cosmetic | Day 30 |
| Dysport | Day 30 |
| Xeomin | Day 30 |
| Jeuveau | Day 30 |
| Daxxify | Week 4 |
| Letybo | Week 4 |
Week 4 is day 28. So all six trials asked the same question at the same moment: is this working at roughly one month? That is a reasonable question for an approval. It is simply not a duration question, and no amount of reading between the lines turns a one month endpoint into evidence about month four.
2. What each label actually states about duration
Separate from the trials, a label may carry a plain statement about how long the effect lasts. Four of the six carry none at all.
| Product | Stated duration | Where, and the catch |
|---|---|---|
| Botox Cosmetic | Approximately 3 to 4 months | Section 2, and it names glabellar lines specifically. The only indication-specific cosmetic duration statement in the class. |
| Xeomin | Up to 12 to 16 weeks | Section 2.9, Monitoring to Assess Effectiveness. That section follows the administration text covering chronic sialorrhea, spasticity, cervical dystonia, blepharospasm and upper facial lines, so it is a general statement about Xeomin treatment rather than a frown line claim. Real, but broader than it is usually quoted as. |
| Dysport | None for frown lines | The label's only duration of response sentences sit in the spasticity dosing text. Quoting those as a cosmetic figure is a common and material error. |
| Jeuveau | None | No duration sentence anywhere in the document. |
| Daxxify | None | No duration figure anywhere in the document. See section 4. |
| Letybo | None | No duration sentence anywhere in the document. |
Two products state something. Four state nothing. And the two that do state something state it in different units, for different scopes, from different trials, which is the second reason these figures should not be lined up as a ranking. There is also no head to head trial between any two of these products for frown lines, so nothing anywhere converts one into the other.
3. The only published decay curve belongs to Botox
One product reports what happened after the primary endpoint, month by month. The Botox Cosmetic label carries responder rates out to day 120.
| Day | Botox Cosmetic | Placebo |
|---|---|---|
| 7 | 74% | 6% |
| 30 | 80% | 3% |
| 60 | 70% | 2% |
| 90 | 48% | 2% |
| 120 | 25% | 2% |
Read day 90 and day 120 together and the label's own three to four months turns out to describe the outer edge rather than the middle. Fewer than half the trial population still met the threshold at three months. Our full breakdown of that curve goes through it day by day, including why your injector will rate your result lower than you do.
The point for this page is narrower. This is the most complete public duration dataset for any of the six, and it belongs to the product people most often assume is the short lasting one.
4. Daxxify followed subjects for 24 weeks and still has no labelled duration
Daxxify is marketed on longevity more than any product in the category, so its label is worth quoting carefully. Two facts sit next to each other in it.
First, its trials ran longer than anyone else's. Subjects "were followed for at least 24 weeks after treatment", and were "discontinued from the study when both the investigator and subject scores returned to baseline". That second clause matters: returning to baseline is precisely the thing a duration study measures, and Daxxify's programme tracked it deliberately, for about six months.
Second, the label states no duration of effect. Not six months, not four, not any figure at all.
So the longest running of the six programmes produced no labelled duration claim. Whatever the reason, the practical consequence for a patient is that the six month figure you were quoted is the manufacturer's reading of its own follow up data, and it did not become a regulated statement. That is not the same as it being false. It is a different standard of evidence, and you are entitled to know which one you are being sold. Our Daxxify guide covers the rest of the product.
5. What the manufacturers claim outside the label
Every one of these is published by the company on its own site, and each is a fair thing to cite as long as nobody calls it the label.
- Daxxify. More than 50% had no or minor frown lines until six months, from the trial diaries and assessments described above.
- Dysport. Results may last up to five months, from a post hoc analysis of two pivotal studies using a one grade improvement threshold rather than the two grade threshold of the primary endpoint. A lower bar measured later. Our Dysport duration page works through it.
- Jeuveau. Results can last up to four months, and on average people receive three treatments a year. The Jeuveau page covers why the label itself is silent.
- Xeomin. Results typically last approximately three to four months, which is a slightly narrower claim than its own label's 12 to 16 weeks. See how long Xeomin lasts.
- Letybo. Marketed in the US to providers rather than patients, with week 4 and week 16 imagery and no headline duration claim. The Letybo guide has the trial detail.
Notice the pattern. The further a claim sits from the label, the longer the number gets, and the more the measurement threshold moves. That is not conspiracy, it is what happens when a marketing department is allowed to pick the endpoint and the regulator is not.
6. The three month rule is a floor, not a fade
Every one of these labels sets a minimum retreatment interval of about three months. People routinely read that as the point at which the product wears off. It is the opposite: it is a safety limit on how often you may be dosed, set to limit antibody formation, and it exists whether your result faded at week eight or is still going at month five.
It is also the one statement that is genuinely identical across all six, which is worth seeing in one place after two tables of disagreement.
| Product | What the label says |
|---|---|
| Botox Cosmetic | Dosing more frequently than every 3 months has not been clinically evaluated |
| Dysport | Retreatment no more frequently than every 3 months |
| Xeomin | Retreatment no more frequently than every three months |
| Jeuveau | Retreatment no more frequently than every three months |
| Daxxify | No more frequently than every three months, for any indication |
| Letybo | No more frequently than every three months |
So a product cannot demonstrate a duration much beyond three months through normal use, because normal use never tests it. Retreatment happens on the schedule the label allows, not on the schedule your face requests. Note the Daxxify line in particular: a product sold on a six month result carries the same three month ceiling as the rest.
7. So which one actually lasts longest
The honest answer, and it is the one nobody selling you a treatment will give: on labelled evidence, the question is unanswered. Two products state a duration, in different units and different scopes, from trials that measured a different thing. Four state nothing. None of the six was compared against another.
What you can reasonably conclude:
- Botox Cosmetic is the best documented, not necessarily the longest lasting. It is the only one that published what happens at day 60, 90 and 120.
- Daxxify has the longest follow up in its programme and the weakest labelled support for the claim it is sold on.
- Dysport's faster onset is better evidenced than any brand's longer duration, though that too sits outside its label.
- Individual variation inside a single product is larger than the differences being claimed between products. Xeomin's own label says the duration of effect may vary in individual patients, and that sentence applies to all six.
Which means the variable most likely to change your result is not the brand on the vial. It is the dose in units, the area treated, and the injector. Our unit conversion page covers why the doses are not interchangeable between these products either.
8. What to ask
- Ask which product, and how many units. Then write it down, because your own record across treatments is better evidence about your face than any trial.
- If you are quoted a duration, ask whether it is the label or the manufacturer's own claim. Both are legitimate answers. Not knowing is not.
- If you are switching brands to get a longer result, ask what changed about the dose. Switching product while holding dose constant is a change with no labelled reason to expect more time.
- Judge any of them at about two weeks, and log the week it faded. Two logged cycles tell you more than this entire page.
Frequently asked questions
Which neurotoxin lasts the longest?
Does Daxxify really last six months?
Why do the brands all claim different durations?
Do any of the neurotoxin trials measure how long the effect lasts?
Is Botox the shortest lasting of the neurotoxins?
Does switching brands make my result last longer?
Why can I only get a neurotoxin every three months?
Sources
Every figure on this page was read from the documents below rather than from a clinic or a manufacturer's marketing. They open in a new tab so you can check any claim here against its source.
- BOTOX Cosmetic (onabotulinumtoxinA) for injection, full prescribing information, US National Library of Medicine, DailyMed
- Dysport (abobotulinumtoxinA) for injection, full prescribing information, US National Library of Medicine, DailyMed
- Xeomin (incobotulinumtoxinA) for injection, full prescribing information, US National Library of Medicine, DailyMed
- JEUVEAU (prabotulinumtoxinA-xvfs) for injection, full prescribing information, US National Library of Medicine, DailyMed
- LETYBO (letibotulinumtoxinA-wlbg) for injection, full prescribing information, US National Library of Medicine, DailyMed
- FDA-approved botulinum toxin products, US Food and Drug Administration
Know the count before the quote. The unit count is half the bill, and a low per-unit rate recovered by a high unit count is the commonest way a deal is not one. How to tell.
Deciding which area, not how many units? Botox by facial area covers what each zone actually achieves, which four are FDA approved, and the things Botox cannot fix at all.
