Botox® and Its Rivals: A Straightforward Guide to What Sets Them Apart
Botulinum toxin is one of those terms that sounds terrifying if you’ve never heard of it, yet it’s quietly transformed both cosmetic and medical treatments over the past few decades. Botox® is the name just about everyone recognises, but there’s a whole family of injectable wrinkle relaxers out there—each with its own strengths, quirks and ideal use cases. So, if you're starting to notice frown lines that hang around longer than you'd like, or you're just a curious type who likes to know what’s what before anything gets near your face, here’s what you should know.
Botox®: The Original Wrinkle Smoother
Botox® has been around longer than most people realise. Its story actually starts in the 1970s when an American ophthalmologist, Dr Alan Scott, began using it to treat eye muscle conditions like strabismus (crossed eyes). Originally marketed as “Oculinum”, it wasn’t until Allergan (now part of AbbVie) bought the rights and rebranded it as Botox® that things really took off.
In the early 2000s, something interesting happened. While treating medical conditions, doctors noticed patients’ frown lines were also softening. That serendipitous discovery led to Botox® being FDA-approved in 2002 for treating glabellar lines (the “11s” between your brows), and approvals for crow’s feet and forehead lines followed soon after.
Botox® works by temporarily blocking the nerve signals that cause muscles to contract. By softening that constant muscle movement, it allows the overlying skin to relax and smooth out. It doesn’t add volume (so it’s not a filler), and it’s not permanent—results typically last three to four months, though some people find they can stretch to six.
Manufactured in Ireland, Botox® is still considered the gold standard by many practitioners thanks to its long track record, consistent results and robust safety profile.
Dysport®: The Fast-Acting One
Dysport® is often thought of as Botox’s cousin. It’s been used in Europe since the early 1990s and got the green light for cosmetic use in the U.S. in 2009. In New Zealand, it's increasingly popular—especially among those who want faster results.
One of the things that makes Dysport® a bit different is how it spreads. It tends to diffuse more from the injection site than Botox®, which can be a great thing if you’re treating larger areas like the forehead. But that wider spread also means your injector needs to be highly skilled to avoid accidentally relaxing muscles that weren’t meant to be touched.
Results can kick in as quickly as two to three days post-treatment, and some patients report their Dysport® results lasting slightly longer—up to five months. It all depends on how your body processes the product.
Xeomin®: The “Naked” Neurotoxin
If you’ve heard of Xeomin®, it’s probably because it's often described as the “clean” or “naked” version of botulinum toxin. That’s because it doesn’t contain the accessory proteins that other brands do. It’s just the pure neurotoxin (incobotulinumtoxinA) and nothing else.
Why does that matter? In theory, having fewer proteins means your body is less likely to develop antibodies against the product, which can reduce its effectiveness over time. While true resistance is rare, it’s something to consider for people who’ve had many treatments or who are planning to use botulinum toxin for years to come.
Xeomin® doesn’t need to be refrigerated before use, which makes storage and transport easier, and some clinics like the idea of a less “bulky” formula. The downside? It’s newer to the market, and although clinical trials show it works just as well as Botox®, it hasn’t been around quite as long.
Daxxify™: The Long-Lasting Disruptor
Daxxify™ is the most recent player on the scene and probably the one causing the most buzz in the industry. Released in 2022, it promises something that’s long been the holy grail in wrinkle-relaxing treatments: longevity.
Thanks to a clever bit of biotech called Peptide Exchange Technology™, Daxxify™ ditches traditional stabilisers like human serum albumin in favour of proprietary peptides. This change not only makes the product vegan-friendly, but also helps it last longer. Clinical trials show that Daxxify™ can last six months on average, and in some patients, up to nine. That’s nearly double the duration of Botox®.
Sounds amazing, right? It is, with one small catch: if you don’t like your result, you’ll be living with it a bit longer. That’s why it’s especially important to see an experienced injector if you’re considering Daxxify™—you want someone who gets it right the first time.
Jeuveau®: The Newcomer That Looks Familiar
Jeuveau®, sometimes called “Newtox”, entered the U.S. market in 2019 and is designed exclusively for cosmetic use. It’s very similar to Botox® in terms of how it works, what it’s made of and what it treats (primarily glabellar lines).
What sets Jeuveau® apart is that it’s manufactured in South Korea and marketed purely for aesthetics—unlike Botox®, which also has a long list of medical applications. Some patients say they see results slightly faster than with Botox®, but in practice, the differences are subtle.
It’s early days for Jeuveau®, and while it’s gaining traction overseas, it's less widely used in New Zealand at this stage. Still, it’s one to watch.
So, Which One’s Right for You?
Honestly? That depends on a lot of factors—your age, skin type, the area being treated, how your body metabolises the product, and, importantly, your personal preferences. Some people love the faster onset of Dysport®. Others prefer the “clean” formulation of Xeomin® or the long-lasting results of Daxxify™. And plenty stick with Botox® because it’s familiar, trusted and consistently delivers.
This is exactly why a consultation with an experienced injector matters. It’s not about finding the “best” product overall—it’s about finding the best product for you.
As practitioners, we’re lucky to have so many excellent tools in our toolbox. And the good news is, whichever one you choose, you’re getting a product that’s been rigorously tested, widely used, and continually monitored for safety.
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Important Disclaimers
Botox®
Botox® is a prescription medicine for the treatment of frown lines , horizontal forehead lines and crow’s feet round the eyes. Botox® has risks and benefits. Ask your doctor if Botox is right for you. If you have side effects, see your doctor. You will need to pay for Botox® and clinic fees will apply. For details on precautions & side effects consult your healthcare professional or the Consumer Medicine Information (CMI) at www.medsafe.govt.nz . Botox® treatment lasts about 4 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals. (contains botulinum toxin A 50,100 & 200 units) Allergan (NZ) Limited, Auckland.
Juvederm Ultra™ & Juvederm Ultra Plus™
Juvederm Ultra™ & Juvederm Ultra Plus™ are medical devices Class III for the filling of medium size and deep facial wrinkles by injection into the skin and for creating definition and volume in the lips. Contains 24mg/mL. cross-linked hyaluronic acid Juvederm has risks and benefits. Cautions: Use in an area that has been treated with another dermal filler, people with autoimmune disease, or who are pregnant, breastfeeding, under 18 years of age or have an increased susceptibility to keloid formation and hypertrophic scarring. People on blood thinning medicines. Possible side effects: injection site inflammatory reactions (redness/swelling, itching/pain on pressure) induration or nodules; discolouration; weak filling effect. If you have side effects or concerns speak to your doctor. Product and treatment costs will apply.
Dysport®
Dysport® is a prescription medicine for the treatment of frown lines, horizontal forehead lines and crow’s feet round the eyes. Dysport has risks and benefits. Ask your doctor is Dysport is right for you. If you have side effects see your doctor. You will need to pay for Dysport, and clinic fees will apply. For details on precautions & side effects consult your healthcare professional or the Consumer Medicine Information (CMI) at www.medsafe.govt.nz Dysport lasts about 4-6 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals. Contains 500 units of clostridium botulinum Type A toxin. Galderma (NZ) Limited, Auckland.
Belotero®
Belotero® is a Class III medical device to smooth facial wrinkles and folds, correct facial atrophic scars, restore of enhance the lips or restore facial volume Belotero has risk and benefits. Ask your specialist if Belotero is right for you. Contains transparent cross-linked sodium hyaluronate gel of nonanimal origin with lidocaine 0.3% to reduce local pain. Do not use if you have a skin inflammation or a skin infection or until the infection is healed. Precautions. There is a risk of infection. Tell your doctor if you are on blood-clotting medicines as there could be an increased risk of bruising or bleeding at the injection site. Possible side effects: swelling, bruising, redness hardening of the skin, pain, altered colour or itching. Lasts 6-12 months You will need to pay for this product and doctor’s fees apply. Merz, Sydney. Distributed by Healthcare Logistics, Auckland.
Xeomin®
Xeomin® is a Prescription Medicine containing 50, 100 units of incobotulinum Type A, purified Botulinum toxin type A complex for injection. It is used for the treatment of frown lines on the forehead, lateral periorbital lines and horizontal forehead lines in adults. It should be administered only by trained medical professionals. Talk to your specialist about the benefits/risks of this procedure in appearance medicine. Xeomin treatment lasts about four months and further courses of treatment may be necessary. Cautions: people receiving blood thinning medicines, care at the proposed injection sites, pregnancy and lactation. Possible side effects: headache, pain, swelling or infection at injection site, local muscle weakness including drooping eye lids, lack of feeling & nausea. Treatment last for up to 4 months.