Xeomin vs Dysport: What the Two Labels Actually Say
Reviewed for medical accuracy against our Medical Review Board · Last updated 23 August 2026
Part of Botox vs Other Brands
These two are further apart than any other pair of botulinum toxins, and almost none of the difference is about how well they work. Xeomin is approved for three cosmetic areas, Dysport for one. Xeomin is dosed roughly one to one with Botox, Dysport at about two and a half to one, which decides whether a per-unit price means anything. And Dysport is contraindicated in cow's milk protein allergy while Xeomin is not, which for some readers ends the discussion.
Both prescribing informations have been read in full for this comparison. Where a difference is real we say so, and where a difference looks real but is an artefact of two trials being run differently, we say that too.
1. The short answer
Choose Xeomin if you want your forehead or crow's feet treated on-label, if your clinic prices it below its Botox rate (that saving is real), or if you have a cow's milk protein allergy.
Choose Dysport if you are only treating frown lines, your clinic prices it on the Dysport scale rather than at Botox parity, and you like the idea of a product that spreads slightly further across a broad muscle.
It matters less than your injector. Both are well established, both work, and neither label supports a claim that one gives a better result. The differences below are about labels, dosing and money, not about outcome.
2. Side by side
| Xeomin | Dysport | |
|---|---|---|
| Generic name | incobotulinumtoxinA | abobotulinumtoxinA |
| Maker | Merz | Ipsen, distributed with Galderma |
| Approved cosmetic areas | Three: frown lines, forehead, crow's feet | One: frown lines |
| Frown line dose | 20 units | 50 units |
| Ratio to Botox units | about 1 to 1 | about 2.5 to 1 |
| Per-unit price comparable to Botox? | Yes | No |
| Cow's milk protein allergy | No restriction | Contraindicated |
| Unopened storage | At or below 25C, no fridge needed | Refrigerated |
| Vial sizes | 50, 100, 200 units | 300, 500 units |
| Minimum retreatment interval | 3 months | 3 months |
| Age limit on cosmetic use | Adults | Adults under 65 |
| Also approved for | Sialorrhea (2+), upper limb spasticity (2+), cervical dystonia, blepharospasm | Cervical dystonia, spasticity (2+) |
| Chronic migraine or sweating | No | No |
3. Approved areas, the biggest difference
Dysport's cosmetic indication covers the glabella and nothing else. The words forehead, crow, lateral canthal, masseter and lip appear zero times in its label, which we verified by counting them. Every Dysport treatment outside the frown lines is off-label with no published dose, as our page on Dysport treatment areas explains.
Xeomin's indication covers three areas, each with a labelled dose:
- Glabellar lines, 20 units.
- Horizontal forehead lines, 20 units.
- Lateral canthal lines (crow's feet), 24 units, 12 per side.
- All three in one session, 64 units maximum.
Off-label use is legal, routine and frequently excellent, so this is not a safety ranking. But if you are treating the forehead or crow's feet and it matters to you that a regulator reviewed the dose, that is a real distinction and Xeomin is the one that has it. Our pages on forehead lines and crow's feet cover what each treatment actually achieves.
4. Units, and why one is comparable to Botox and one is not
Every label in this class says units cannot be converted between products. Both of these do. But both also give a dose for the identical indication, so comparing those doses tells you what the manufacturers themselves think:
| Product | Dose | Implied ratio |
|---|---|---|
| Botox Cosmetic | 20 units | 1 |
| Xeomin | 20 units | about 1 to 1 |
| Dysport | 50 units | about 2.5 to 1 |
So a 50 unit Dysport treatment and a 20 unit Xeomin treatment are the same treatment. If a unit count alarms you, look at which product it is before you conclude anything, and if you are switching, tell the injector your previous brand and unit count. Being given 20 Dysport units because you had 20 Xeomin units underdoses you by around 60%, which is the commonest reason a brand switch disappoints. Our Dysport units guide covers the arithmetic.
5. Which is actually cheaper
This is where the units question turns into money, and the answer is counterintuitive.
| Rate published | Units needed | Treatment cost |
|---|---|---|
| Xeomin at $11 (Charleston clinic) | 20 | $220 |
| Xeomin at $12 (Nashville clinic) | 20 | $240 |
| Dysport at $4 (Charleston, same clinic) | 50 | $200 |
| Dysport at $13 (Nashville, Botox parity) | 50 | $650 |
Two lessons. At a clinic that prices Dysport on the Dysport scale, the two land in much the same place, and Dysport can be slightly cheaper. At a clinic that charges its Botox rate per Dysport unit, Dysport becomes roughly three times the price of the equivalent Xeomin treatment, for no benefit.
So the practical rule: a Xeomin per-unit rate can be compared with a Botox rate directly, and a Dysport rate cannot. Ask for the total either way. Our Dysport cost page works through the two pricing scales, and our city guides list what named clinics actually publish.
6. How well each one works
Both were measured the same way on the primary question, which makes this the one fair comparison available: treatment success at day 30, defined as a severity of none or mild plus at least a two grade improvement, agreed by both the investigator and the patient.
| Product | Success | Placebo |
|---|---|---|
| Xeomin (trials 1071, 1070) | 53% and 49% | 0% |
| Dysport (GL-1, GL-2, GL-3) | 55%, 52%, 60% | 0% |
Those are close enough to call a draw, and placebo was zero in all five trials, across more than 400 placebo patients between them. Whatever else is arguable, both of these work and the effect is not expectation.
One extra from Xeomin's data, because it has no Dysport equivalent: because Xeomin trialled three areas, it can report by area, and the forehead responded best, at 58% and 67%, ahead of the frown lines. Dysport has no published forehead figure at all, since the area is not on its label.
On timing, each label is strong exactly where the other is silent, which is worth knowing before anyone tells you one works faster or lasts longer.
| Xeomin | Dysport | |
|---|---|---|
| Onset | Median 2 to 7 days | No figure given |
| Duration | Up to 12 to 16 weeks | May last up to four months |
| Day-by-day data published | No, day 30 only | Yes, day 14 to day 180 |
| Minimum interval | 3 months | 3 months |
So Dysport's nominal ceiling is a shade higher, four months against roughly 16 weeks, while Xeomin is the only one of the two that puts a number on onset. The reputation Dysport has for working fast is not in its label; Xeomin's two to seven days is. And Dysport's own published curve shows only about one person in five still rated clear at day 120, with half the effect gone by day 90, which makes treating the two as equivalent in duration the defensible position. Our pages on how long Xeomin lasts and how long Dysport lasts cover each in full.
7. Side effects, and the comparison you must not make
Here are the headline numbers from each label, and then why you should not read them the obvious way.
| Product | On the drug | On placebo | Difference |
|---|---|---|---|
| Xeomin, 545 treated | 11% | 8% | +3 points |
| Dysport, 398 treated | 48% | 33% | +15 points |
Do not conclude that Xeomin is four times safer. Those two figures come from different trials, run years apart, with different reporting windows and different methods of collecting symptoms. Dysport's 48% includes 10% of patients who caught a cold, which a wrinkle treatment does not cause; it is what happens when you ask several hundred people to log every symptom for months. A trial that asks more often finds more.
The placebo-adjusted difference, +3 against +15, is more informative because each is measured against its own control. It still is not a head-to-head, and no head-to-head exists. Treat it as a hint, not a finding.
What is worth comparing is the specific reactions, because those are concrete:
- Dysport: headache 9% against 5% on placebo, eyelid drooping 2% against under 1%, eyelid swelling 2% against 0%. Full detail on our Dysport side effects page.
- Xeomin: in the controlled phase the only reaction reaching 1% and exceeding placebo was injection site bruising, at 2% against 1%. Brow ptosis was 0.7% and injection site discomfort 0.6%. Across repeat treatments, injection site bruising or bleeding under the skin was the commonest at 8%, then headache at 3% and brow drop at 1%.
Two honest observations. Xeomin's label reports brow ptosis rather than eyelid ptosis for cosmetic use, which is a different and less troubling problem: a heavy brow rather than a drooping lid. And headache, which is the most searched Dysport side effect, did not reach the threshold of exceeding placebo in Xeomin's controlled phase at all. Neither point proves a difference, but if headaches after treatment are your specific concern, it is a reasonable thing to raise.
Xeomin's label also notes that the incidence of these reactions tended to decrease with subsequent treatments, which is useful reassurance for anyone whose first session was uncomfortable.
Both products carry the identical boxed warning about effects spreading from the injection site, and the symptoms to act on are the same for both: difficulty swallowing, breathing or speaking, muscle weakness away from the injection site, or new double vision or eyelid drooping.
8. The one hard safety difference
Everything above is a matter of degree. This is not.
Dysport is contraindicated in patients with a known allergy to cow's milk protein. Its label states the product may contain trace amounts of it, and lists that allergy as an absolute contraindication alongside infection at the injection site.
Xeomin carries no such restriction. Its vials contain the toxin, human albumin and sucrose. The word lactose does not appear in its label, and its only contraindications are known hypersensitivity to a botulinum toxin product or formulation component, and infection at the injection site.
So if you have a diagnosed cow's milk protein allergy, Xeomin is available to you and Dysport is not. Note this is milk protein allergy, which is a different thing from lactose intolerance; lactose intolerance is not a contraindication for either. Nobody asks about dairy before a wrinkle treatment, so this is one to raise yourself.
9. Storage, vials and availability
A practical difference that explains why some clinics carry one and not the other. Unopened Xeomin needs no refrigeration, stored at or below 25 degrees Celsius. Dysport requires cold storage from arrival. Once reconstituted both must be refrigerated and used within 24 hours, for one session and one patient.
Vial sizes differ too, and they explain the pricing. Xeomin comes in 50, 100 and 200 unit vials; Dysport in 300 and 500. A 100 unit Xeomin vial covers five labelled frown line treatments, a 300 unit Dysport vial covers six. Similar patients per vial, wildly different unit numbers, which is exactly why the per-unit rates look so different.
On availability the gap is wide. Across the sixteen cities where we have read every clinic's own published brand list, covering 80 providers, 54 publish that they carry Dysport and 16 publish Xeomin. So Dysport is stocked more than three times as often. If your clinic carries only one, that is usually about purchasing rather than clinical preference, and it is worth asking whether they can obtain the other, particularly if you want the forehead or crow's feet treated on-label.
10. Medical uses
Both hold approvals beyond wrinkles, and they are not the same ones.
Xeomin: chronic sialorrhea, meaning excessive drooling, in patients aged two and over, at 100 units per session split between the parotid and submandibular glands. Also upper limb spasticity in patients two and over, cervical dystonia and blepharospasm in adults.
Dysport: cervical dystonia in adults, and spasticity in patients two and over.
Neither is approved for chronic migraine or for excessive underarm sweating. Botox holds both. Dysport's label goes further on sweating and says its safety for hyperhidrosis has not been established, and that it is approved for intramuscular injection only, while sweating is treated into the skin. If a medical condition rather than a wrinkle is what you are treating, see therapeutic uses for what is actually approved.
11. How to choose
Working from the strongest reason down:
- Cow's milk protein allergy: Xeomin. Not a preference, a contraindication.
- Treating forehead or crow's feet and want it on-label: Xeomin.
- Comparing prices: whichever is cheaper on the total, and remember only the Xeomin rate can be read straight against a Botox rate.
- Frown lines only, at a clinic pricing Dysport properly: either. Dysport may come out slightly cheaper.
- Over 65: worth asking. Dysport's cosmetic indication is written for adults under 65; Xeomin's has no age ceiling.
- Broad forehead and you like the diffusion argument: Dysport, accepting that it is off-label there and that the wider spread is clinical consensus rather than a labelled property.
What should not decide it: claims that either lasts longer, or that one resists antibodies better. Neither is established, and Xeomin's own label states that assay differences preclude comparing antibody rates between products. The full brand picture is in our brand comparison, and each product has its own guide: Xeomin and Dysport.
The cost side in full. Xeomin units and what it costs works through every area at real published rates, including the annual figures.
Frequently asked questions
Is Xeomin or Dysport better?
Why does Dysport need 50 units and Xeomin only 20?
Which is cheaper, Xeomin or Dysport?
Can Xeomin be used on the forehead and crow's feet?
Is Xeomin safer than Dysport?
Does Xeomin cause fewer headaches than Dysport?
Can I switch from Dysport to Xeomin?
Which one lasts longer?
Which one do more clinics carry?
Is either approved for migraines or sweating?
I have a dairy allergy. Which can I have?
Does one spread more than the other?
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.
