2002 · Allergan (now AbbVie)
Botox Cosmetic
Generic name. onabotulinumtoxinA
Its label covers four areas: frown lines, crow's feet, forehead lines and platysma neck bands. The toxin is a complex of neurotoxin and accessory proteins with human albumin, in 50 and 100 unit vials. The frown-line dose is 20 units in 5 sites.[1][2][3]
Onset and duration. Onset in 1 to 2 days, building through the first week. In an open-label study, 87% had physician-rated onset by day 2. The frown-line effect lasts about 3 to 4 months.
Notes. Eyelid ptosis followed 3% of frown-line treatments in trials. Headache (9%) and brow ptosis (2%) followed forehead treatment.
2009 · Ipsen
Dysport
Generic name. abobotulinumtoxinA
Approved for frown lines in adults under 65. The dose is 50 units in 5 injections of 10 units. It may contain trace cow's milk protein and must not be used in people allergic to it.[1][2][3]
Onset and duration. The label says the effect may last up to 4 months. In a 2025 randomized trial of four brands, Dysport and Jeuveau had the fastest onset, at day 3.
Notes. In placebo-controlled trials, eyelid ptosis and eyelid swelling each followed 2% of treatments. Its units are not interchangeable with other brands.
2011 · Merz
Xeomin
Generic name. incobotulinumtoxinA
The 150 kDa neurotoxin is separated from the accessory proteins. Approved for frown lines in 2011, its label now covers frown lines, forehead lines and crow's feet, up to 64 units together. In two frown-line trials, 60% and 48% reached treatment success at day 30, against 0% on placebo.[1][2][3]
Onset and duration. In a randomized trial in women, onset came at 3.0 days with Xeomin against 5.3 days with Botox and Dysport, and the effect lasted longer.
Notes. Bruising at the injection site followed 2% of upper face treatments, against 1% on placebo. Brow ptosis followed 0.7%.
2019 · Evolus
Jeuveau
Generic name. prabotulinumtoxinA-xvfs
A 900 kDa botulinum toxin type A approved for frown lines only. The dose is 20 units in 5 sites. In two phase 3 trials, 67.5% and 70.4% improved by at least 2 grades at day 30, against 1.2% and 1.3% on placebo.[1][2][3]
Onset and duration. Fastest onset, at day 3, with Dysport in a 2025 randomized trial of four brands. In that trial it still held its effect against baseline at day 180.
Notes. Headache followed 12% of treatments, against 13% on placebo. Upper respiratory infection followed 3% and eyelid ptosis 2%.
2022 · Revance
Daxxify
Generic name. daxibotulinumtoxinA-lanm
A 150 kDa toxin without accessory proteins. It contains a 35 amino acid peptide (RTP004) and no human albumin. The frown-line dose is 40 units in 5 injections of 8 units. About 74% reached treatment success at week 4 in two phase 3 trials.[1][2]
Onset and duration. Frown lines stayed none or mild for a median of about 24 weeks, and did not return to baseline for a median of 26 to 27.7 weeks.
Notes. Headache followed 6% of treatments, against 2% on placebo. Eyelid ptosis followed 2% and facial paresis 1%. No subjects developed neutralizing antibodies to Daxxify in phase 3 studies.
2024 · Hugel
Letybo
Generic name. letibotulinumtoxinA-wlbg
A 900 kDa botulinum toxin type A approved for frown lines only. The dose is 20 units in 5 sites. In three phase 3 trials with 1,276 subjects, 47%, 49% and 65% reached treatment success at week 4, against 0% to 2% on placebo.[1][2][3]
Onset and duration. A meta-analysis of three randomized trials found the effect still significant at weeks 12 and 16.
Notes. Headache (2%) was the most common adverse reaction. The meta-analysis authors called for head-to-head trials against other brands.