Published Nov 3, 2026
5 minute read
At a glance
All four use the same active ingredient and do the same job. They differ in how they are made and how they are dosed, and their units are not interchangeable — one Botox unit is not one Dysport unit. The variable most people overlook is dose: within a product’s licensed range an adequate dose lasts longer, and an underdose is one of the most common reasons results fade sooner than expected.
At Boulder Skin Bar we treat with Botox, Dysport, Xeomin and Letybo. All four relax a specific muscle so the skin above it creases less, and all four use the same active ingredient. What separates them is smaller than the marketing suggests, and less important than how much of it you are given.
If you have been comparing them on price per unit, that is the one number that means least on its own. Here is what actually differs, and the part that matters more than the name on the vial.
What actually differs between them?
Botox and Dysport carry the active ingredient alongside some extra proteins. Xeomin is stripped back to the active ingredient and very little else. For most people that difference is invisible, and it only really becomes worth discussing if you have been treated for years and feel it no longer holds the way it once did.
Dysport tends to spread a little further from each injection point, which some injectors like across a broad area such as the forehead and treat more carefully near the eyes.
Letybo is the newest of the four and the one most people have not heard of. In practice it behaves much like Botox, with results appearing within a few days and lasting a similar three to four months.
The practical catch is that the units are not interchangeable. It takes roughly two and a half to three Dysport units to do the work of one Botox unit, Xeomin runs about one to one, and Letybo’s own labelling says its units cannot be converted to another product’s at all. So a lower price per unit can simply mean a product that needs two or three times as many of them. The number that tells you anything is the cost of treating your areas, not the cost of a unit.
Why your dose decides how long your results last
Brand differences are real but modest. Dose is the bigger lever, and it is the one most patients are never told about.
Within a product’s licensed range, duration tracks dose closely. Treated at the lower end of a range, results commonly begin to fade near the three month mark. Treated at the upper end of that same range, the same product on the same patient can hold considerably longer. The relationship is consistent enough that how much you were given usually predicts duration better than which brand you were given.
Why underdosing costs you twice
Underdosing is not the cautious choice. Treating below an adequate dose is associated with shorter duration, a weaker response and lower satisfaction, and it does not buy a reduction in side effects in exchange. There is no safety dividend for going light.
It also costs you a second time, further out. An underdose wears off sooner, which means returning sooner, and frequent small exposures are the pattern most associated with developing the immune response that makes toxin work less well in future. The cheaper looking appointment can quietly shorten both this result and your future ones.
This is why we would rather dose your areas properly than quote you the lowest number. If budget is the constraint, treating fewer areas well is a better trade than treating everything thinly, and our membership options exist to make an adequate dose affordable on a schedule.
Why two people get different results from the same product
Two patients can receive the same product, the same units and the same technique and still report different outcomes. That is expected, and it is not a sign something went wrong.
Muscle strength and mass matter, because a strong, frequently used muscle metabolises through a given dose faster than a finer one. Treatment area matters too: forehead lines often return before crow’s feet in the same person. Metabolism, exercise intensity and how long you have been treated all contribute. And immune response genuinely varies between individuals for reasons that are partly genetic, which is one real mechanism behind the familiar complaint that a friend gets five months where you get three.
It is also why switching products is sometimes worth trying rather than simply adding units. If your results have shortened over years of treatment, the question is whether the dose was adequate, whether the interval was too short, or whether a protein-free option like Xeomin suits you better. That is a conversation, not a formula.
How we decide with you in Boulder
We start by looking at the muscle, not the menu. Which of the four we reach for depends on the area, how strong the muscle is, what you have responded to before and how long you want it to hold. Each of these products carries its own approved indications, and not every area is covered by every label. That is part of what we go through before we treat, so you know what you are agreeing to.
If you are new to this, how Botox works and when to start are the two things worth reading first. If you are already treated and wondering about longevity, how long Botox lasts goes deeper on duration, and aftercare covers the first 24 hours. If your concern is volume or hollowing rather than movement, that is filler territory rather than toxin: Botox versus fillers is the honest comparison, and our injectables and fillers page covers the rest of the range.
Ready when you are
Tell us what you want to soften and we will tell you which of the four we would use, and why.
Book a Consultation Call (303) 901-1867Frequently Asked Questions
Botulinum toxin type A is the active ingredient in Botox, Dysport, Xeomin and Letybo. It temporarily reduces the nerve signal to a treated muscle, so the muscle moves less and the skin above it creases less. It acts only where it is placed, and the effect is temporary by design.
No, and this is the most common misunderstanding in neurotoxin pricing. Dysport uses its own unit scale, and it typically takes roughly two and a half to three Dysport units to match one Botox unit, depending on the area. Xeomin is generally used close to one to one with Botox. Compare the total cost of treating your areas, not the price per unit.
Letybo is a botulinum toxin type A product and the newest of the four we offer in the United States. In practice it behaves much like Botox, with onset often within a few days and duration in the same three to four month range. Its labelling is explicit that its units cannot be converted to another product’s, so dosing is decided per product rather than carried across.
Within a product’s licensed range, yes. Duration tracks dose closely, and dose usually predicts how long a result holds better than brand does. Treating below an adequate dose tends to produce a shorter, weaker result without any reduction in side effects, which is why we would rather dose your areas properly than quote the lowest number.
Several reasons, and none of them mean anything went wrong. Dose is the first thing to check. Beyond that, muscle strength, the area treated, metabolism, how often you have been treated and genuine individual variation in immune response all affect how long a result holds.
Yes, and sometimes it is the right move. Switching is worth discussing if your results have shortened over years of treatment, because Xeomin in particular carries a lower total protein load, which is thought to reduce the immune response that can blunt results over time. We will look at dose and treatment interval first, since both are common explanations.
