Kat Chapman RN Blog

Pros and Cons of Dysport vs Botox | Kat Chapman RN

Written by Kat Chapman, BSN, RN | Oct 19, 2026, 4:20:13 PM

Pros and cons of Dysport vs Botox, in short: they work the same way, and the research I read doesn't crown a winner for a first treatment. Both are botulinum toxin type A. Both relax the muscle that folds your skin into a line. Both FDA labels put the effect on frown lines at up to about four months. The differences that actually matter are more practical. They're FDA-approved for different areas, their units are counted differently, and one allergy rules Dysport out for some people.

I'm Kat Chapman, BSN, RN, and I'm new to aesthetic injecting. So I wrote this the way I'd want it explained to me, from the two FDA labels and the head-to-head studies, with the gaps marked.

Botox vs. Dysport side by side

  Botox Cosmetic (onabotulinumtoxinA) Dysport (abobotulinumtoxinA)
FDA-approved cosmetic uses Frown lines (the 11s), crow's feet, forehead lines treated together with frown lines, and neck bands (platysma) Frown lines (the 11s) in adults under 65
Labeled dose for the 11s 20 units, 4 units at each of 5 spots 50 units, 10 units at each of the same 5 spots
How long it lasts, per the label About 3 to 4 months for frown lines Up to 4 months for frown lines
Retreatment timing on the label Dosing more often than every 3 months hasn't been studied No more often than every 3 months
Inactive ingredients Human albumin and sodium chloride Human albumin and lactose. May contain trace cow's milk protein
Can its units be converted to the other's? No, per the label No, per the label

Everything in that table comes from the Botox Cosmetic label and the Dysport label.

The pros and cons of Dysport vs Botox, one product at a time

Botox Cosmetic

What's in its favor:

  • It has FDA approval for more of the face. The 11s, crow's feet, and forehead lines are all on the label, so the dose and injection points for each area came out of FDA-reviewed trials.
  • No milk protein warning. If you have a cow's milk protein allergy, this matters (more below).

What to know going in:

  • The label only approves forehead treatment together with the 11s, "to minimize the potential for brow ptosis," meaning a heavy or dropped brow. A forehead-only plan is outside the label.
  • Side effects in its trials depended on the area. Eyelid drooping showed up in 3% of people in the frown line trials. In the forehead trials, 9% had a headache and 2% had brow drooping.

Dysport

What's in its favor:

  • Its own trials reported an early start. A pooled look at its phase 3 trials found a median onset of 3 days, with some people noticing a change within 24 hours (Schlessinger et al., Dermatologic Surgery, 2011). There's a catch with this one, covered in the onset section.
  • It's an FDA-approved alternative for the 11s. If Botox didn't suit you, or you want to try something else, Dysport has its own FDA-reviewed trial data for that area.

What to know going in:

  • Only one cosmetic area is on its US label: the 11s. Using Dysport on the forehead or crow's feet is off-label. Off-label use is allowed, but the dose and placement then come from published studies and clinical judgment instead of the label.
  • It's not for people allergic to cow's milk protein. The label lists that allergy as a reason not to use it, because the product may contain trace amounts.
  • The label is for adults under 65. Only 8 people 65 or older were in its placebo-controlled trials, and the label says efficacy wasn't observed in that group.
  • In its frown line trials, headache came up in 9% of people on Dysport and 5% on placebo. Eyelid drooping came up in 2%, compared with under 1% on placebo.

One caution on those side effect numbers: they come from separate trials with different designs. You can't line them up and call one product gentler.

How many units of Dysport vs Botox?

On the labels, the 11s take 20 units of Botox Cosmetic or 50 units of Dysport, in the same five spots. That's two and a half times the number.

That doesn't mean Dysport is weaker or that you're getting more medicine. Each company measures its unit with its own lab test. Both labels say so directly: the units are "specific to the preparation and assay method," and they can't be compared to or converted into another product's units.

People still compare them, because patients switch products. Here's what the research says:

  • A systematic review of head-to-head trials in movement disorders found that about 2.5 Dysport units per Botox unit gave similar results and side effects. At 3 to 1, results were similar or stronger, with more side effects. At 4 to 1, side effects got out of hand (Dashtipour et al., Movement Disorders Clinical Practice, 2015).
  • A separate review says the ratios people quote are usually 3 or 4 to 1, but published ratios run all the way from 1 to 1 up to 11 to 1. Its author suggests 3 to 1 or lower (Scaglione, Toxins, 2016).
  • The one cosmetic head-to-head study I found that measured onset and duration used 3 to 1: 63 Dysport units against 21 Botox units for the 11s (Rappl et al., 2013).

Most of that ratio research comes from neurology, where doses are much bigger than anything used on a face. So treat 2.5 to 3 as a rough translation, not a recipe.

What it means for you: if you switch products, expect a different number on your chart, and ask what it works out to in the product you had before. For what a visit costs, see my Botox cost guide.

Does Dysport kick in faster than Botox?

Maybe. It depends on whose study you read.

  • Dysport's trials say 2 to 3 days. The pooled phase 3 analysis found a median of 3 days, and about 1 in 5 people noticed something by day 1. That analysis was supported by Medicis, the company marketing Dysport for cosmetic use in the US at the time. A 2020 systematic review found onset was most often reported at 2 to 3 days. It was sponsored by Ipsen, which makes Dysport (Nestor et al., Journal of Clinical and Aesthetic Dermatology, 2020).
  • The Botox Cosmetic label says the first doses start blocking the muscle "one to two days after injection, increasing in intensity during the first week."
  • The head-to-head study tells a different story. Rappl and colleagues gave 180 people one of three products, 60 per group, and timed onset against baseline video. In women, median onset was 5.29 days for Botox and 5.32 days for Dysport, which is basically a tie. The fastest was a third product, Xeomin. Editorial help on that paper was funded by Merz, which makes Xeomin.

The studies also measured onset in different ways. Some asked people to note in a diary the first day they saw any change. Others had an observer compare the face to a baseline video. Those numbers can't be lined up directly.

Where I land: I wouldn't pick Dysport for speed alone. Whichever one you get, give it two weeks before you judge it.

Does Dysport last longer than Botox?

I couldn't find good evidence that either one reliably outlasts the other.

The labels describe duration differently. Botox Cosmetic says about 3 to 4 months for frown lines. Pooled data from four Botox trials put the median at about 120 days for people who responded (Dermatologic Surgery, 2012). Dysport says up to 4 months. In its first big trial, investigators rated 43% of Dysport patients' frown lines as none or mild at day 90 and 23% at day 120, compared with 6% and 4% on placebo.

Those are different measures, so they don't compare cleanly. And in the Rappl head-to-head study, the longest duration went to Xeomin, not Botox or Dysport.

What does change how long it lasts is dose, muscle strength, and possibly how active you are. I went through that research in How Long Does Botox Last the First Time?

"Dysport spreads more." Does it?

You'll hear that Dysport spreads wider, so some injectors like it for big areas like the forehead and keep it away from the eyes. I couldn't confirm it cleanly. The comparisons depend on which unit ratio was used, and a review in Toxins notes that "several factors other than the pharmaceutical preparation are thought to affect spread," like dose, injection volume, and technique (Scaglione, 2016). From what I read, dose and technique matter about as much as the product.

Who should skip one or the other

Tell me at your consult, before anything is injected, if any of these apply:

  • You're allergic to cow's milk protein. Dysport is off the table.
  • You've reacted to any botulinum toxin product before. Both labels list that as a reason not to use them.
  • You had a different toxin product in the last few months. Both labels say the effect of giving different toxins at the same time or within several months of each other is unknown, and that weakness could add up.
  • You're pregnant or breastfeeding, or you have a neuromuscular condition.
  • You're 65 or older. Neither product's trials included enough older adults to be sure, and the Botox label notes people 65 and older responded less often.

So which one should a first-timer try?

For most first-timers with no allergy and no history with either, both are reasonable. No study I found shows one gives first-timers a better result. These are the questions that usually settle it:

  1. Where are you treating? If it's the forehead or crow's feet, Botox Cosmetic has FDA approval for those areas and Dysport doesn't. If it's just the 11s, both are labeled for it.
  2. Do you have a cow's milk protein allergy? Then it's not Dysport.
  3. Have you had one before? If you liked it, staying with what worked tells you more than any study. If you didn't, ask why before switching. In the research I read, dose had a much clearer link to how long results last than brand did.

How I set up a first neurotoxin visit

I currently see patients at Canvas & Glow in Huntersville, North Carolina. I carry Botox, Dysport, and a few other neurotoxins, and here's how a first visit works:

  • A free consult comes first. We talk through your goals, your health history, and which product fits before any needle comes out (Botox and Dysport page).
  • Medical oversight. I treat under the supervision of a medical director and follow physician-directed protocols (Botox and Dysport page).
  • I start on the light side. You can always add more at two weeks. Nobody can take it out.
  • You get a complimentary two-week follow-up. That's when the result has settled and I check my work (FAQ).
  • The Natural Results Guarantee. If you're not completely happy at the follow-up, I adjust your results at no charge. It's an adjustment, not a refund.

I'm open about being new to injecting on my About page. That's part of why the two-week check is built in and why I work under the supervision of a medical director. If you're nervous about safety in general, start with Is Botox Safe for First-Timers?

What I can't tell you from a blog post

I can't tell you which product your face will like better. The trials report averages. Many were small, and in Dysport's first big trial 85% of the people were women. A lot of the comparison research was funded by or written with one of the companies, and I've named them above so you can weigh that yourself. I also can't predict your dose without watching your muscles move. That's what the consult is for.

FAQs

Is Dysport stronger than Botox?

Not in any way the unit numbers can show. Dysport uses more units because its units are measured differently, and both labels say the units can't be converted. When doses are matched sensibly, studies find similar results.

How many units of Dysport equal one unit of Botox?

The labels say there's no official conversion. In research, about 2.5 to 3 Dysport units per Botox unit is the range most often used, mostly from neurology studies. For the 11s, the labels use 50 units of Dysport and 20 units of Botox Cosmetic.

Does Dysport work faster than Botox?

Dysport's own trials report a median onset of about 2 to 3 days. A head-to-head study found Botox and Dysport started at nearly the same time, about 5 days in women. The evidence is mixed.

Which lasts longer, Botox or Dysport?

Neither has been shown to reliably outlast the other. Both labels describe up to about 4 months for frown lines. Your dose and muscle strength matter more.

Can I switch from Botox to Dysport?

Yes, people do. Expect a different unit number, and wait until your last treatment has worn off. The labels say mixing toxins at the same time or within several months hasn't been studied.

Is Dysport OK if I have a milk allergy?

Not if you're allergic to cow's milk protein. The Dysport label lists that allergy as a reason not to use it. Botox Cosmetic doesn't carry that warning.

Which is better for forehead lines?

Botox Cosmetic is FDA-approved for forehead lines when they're treated together with the 11s. Dysport's US label covers the 11s only, so forehead use is off-label. Ask your injector which one they use there and why.

Questions about your own face? Book a free consult, call or text (704) 584-9785, or see the full services menu.

Medical disclaimer: This article is general education, not medical advice or a personal treatment plan. Results and how long they last vary from person to person. Whether Botox or Dysport is right for you depends on your health history, medications, and an in-person exam. If you have trouble swallowing, speaking, or breathing, or vision changes or muscle weakness after any injection, get medical care right away.

Disclosure: I'm Kat Chapman, BSN, RN, and I perform the neurotoxin treatments described here, including both Botox and Dysport. Practice details were checked against katchapmanrn.com on October 19, 2026.

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