Dysport vs Botox: Units, Results and How to Choose

Dysport vs Botox is a common question, usually from people who have seen two very different prices per unit. In this guide I explain what the FDA labels say about each product, how the unit conversion works, what head-to-head trials found on onset, duration and spread, and how to think about which one suits which area.

What is the same and what is different

Dysport (abobotulinumtoxinA) and Botox Cosmetic (onabotulinumtoxinA) are both botulinum toxin type A, and both soften lines by blocking the nerve signal to the muscle underneath. They are made by different companies with different manufacturing and potency tests, so a unit of one is not a unit of the other. Dysport’s label states that its units “cannot be compared to or converted into units of any other botulinum toxin products,” and the Botox Cosmetic label says the same in its own words.

Their FDA-approved cosmetic uses also differ. Dysport is approved for frown lines (the “11s”) in adults under 65, along with medical uses such as cervical dystonia and spasticity. Botox Cosmetic is approved for frown lines, forehead lines, crow’s feet and, since 2024, platysma bands in the neck. Using Dysport on the forehead or around the eyes is common and well studied, but it is off-label, and that is explained before treatment.

	Dysport	Botox Cosmetic
FDA-approved cosmetic areas	Frown lines (adults under 65)	Frown lines, forehead lines, crow’s feet, platysma bands
Labeled frown-line dose	50 units in 5 injections	20 units in 5 injections
When it starts	Median 2 to 3 days across studies	Usually 1 to 2 days, building over the first week
How long it lasts (label)	Up to four months	About three to four months
Eyelid droop in frown-line trials	2 percent	3 percent

The eyelid droop figures come from each product’s own trials and are not a head-to-head comparison, but they show that this side effect is uncommon with both.

How the unit conversion works

The working ratio most injectors use is about 2.5 to 3 units of Dysport for every unit of Botox. That is a clinical rule of thumb, not a figure on either label. A 2015 systematic review in Movement Disorders Clinical Practice by Dashtipour and colleagues looked at randomized trials comparing the two and concluded that a Botox-to-Dysport ratio “between 1:2.5 and 1:3.0 provides comparable safety and efficacy.” Ratios higher than 1:3 were linked to more side effects. Those trials were in neck and eyelid spasm, at much higher doses than cosmetic treatment, so the range is a guide and the dose is adjusted for each face.

This is why a straight comparison of price per unit is misleading. Dysport costs less per unit at KORA, but you need more of its units. The fair comparison is the total for the same treatment plan.

Onset and duration: what head-to-head trials found

Dysport may start slightly sooner, and the evidence on which lasts longer is mixed and depends on the dose ratio used. A 2020 systematic review in the Journal of Clinical and Aesthetic Dermatology by Nestor and colleagues gathered 42 studies of Dysport in the upper face and found a median onset of 2 to 3 days; in one trial, 55 percent of patients had a response by day 2. In a head-to-head study within that review, Dysport reached its effect about half a day faster than Botox. The review was sponsored by Ipsen, which makes Dysport.

On duration, the results point both ways:

• Favoring DysportIn a 2011 split-forehead study by Nestor and Ablon, 20 women had Dysport on one side and Botox on the other at a 2.5 to 1 ratio. Full effect lasted a median of 119 days with Dysport and 77 days with Botox.
• Favoring BotoxIn a 2006 randomized trial in the Journal of the American Academy of Dermatology by Lowe and colleagues, 62 patients received 20 units of Botox or 50 units of Dysport for frown lines. At 16 weeks, 53 percent of the Botox group still had at least a one-point improvement, compared with 28 percent of the Dysport group. That trial was manufacturer-supported.

My reading is that at the usual ratios both last roughly three to four months, and the ratio and the injector’s dosing make more difference than the brand. Your own timeline is covered in our Botox timeline guide.

Spread: why the area matters

At the usual conversion, Dysport tends to affect a wider area around each injection point than Botox. A 2025 split-face trial in Dermatology and Therapy by Bennek and colleagues measured the zone where sweating stopped, a standard proxy for toxin spread, after forehead injections at a fixed 1 to 2.5 ratio. The spread was largest with Dysport (about 62 square centimeters), then Botox (about 46), with a third toxin smallest. Wrinkle improvement was similar for all three. The study was small, 26 people finished it, and it was funded by the maker of the third product.

A wider field can be helpful on a broad, even muscle like the forehead, where it can smooth the area with fewer injection points. Close to the eye and brow, where a few millimeters decide whether a brow or lid drops, the effect should stay tight. Dilution and depth also change spread, so technique matters as much as the product.

Which suits which area

For most patients, both products work well, and the area being treated is what tips the choice.

• Frown linesBoth are FDA-approved here. This is the area with the most head-to-head data, and both perform well at their labeled doses.
• ForeheadBotox Cosmetic is FDA-approved for forehead lines; Dysport use here is off-label but common. A wider field can suit a broad forehead, as long as the brows are protected.
• Crow’s feetBotox Cosmetic is FDA-approved at 24 units. Dysport is off-label here, and tighter spread is an advantage next to the eye.
• Masseter or jawOff-label for both. See my Dysport vs Botox for the masseter guide.
• Over 65Dysport’s frown-line approval is for adults under 65. In its trials, none of the 8 patients aged 65 or older reached the success threshold, so if you are 65 or older, ask about this at your consultation.

What it costs at KORA

Dysport has the lower price per unit, but a plan needs about 2.5 to 3 times as many Dysport units, so compare totals for the same plan.

Prices come from our current price list. Your plan and total are confirmed at a complimentary consultation before anything begins.

Learn more about Dysport and Botox at our clinic on the Scottsdale and Paradise Valley border, or read how Xeomin compares with Botox.