Botox/Dysport/Xeomin… How Do They Work!


That’s what they call them now! This is the name of the group of medications like Botox, Dysport, Xeomin, etc that we all love and adore! But that wasn’t their common name few years back. These medications used to be called… wait for it…. Neurotoxins!!! Yes, TOXINS! Because of the way these medications work, they used to believe they worked to poison the muscles, when in fact all they did was modifying their action, hence called Neuromodulators! Pretty cool right?!

So what do they really do?

Over time, fine lines and wrinkles naturally develop in areas of the face due to repetitious muscle contractions from normal everyday facial movements or expressions. For example, smiling and squinting create ‘crow’s feet’ around the eyes, while raising your eyebrows results in forehead lines. Neuromodulators address fine lines and wrinkles by relaxing muscle tissue to the point where they prevent the muscle from contracting. ​But how do they do that?

In simple terms, Botox/Dysport/Xeomin compete with the nerve signals that cause a muscle to move. They occupy the receptors and stop the nerve signals from getting to the muscle! So now the muscle just sits there relaxed! When the muscle is relaxed, the wrinkle doesn’t develop on the skin overlying it. Many people may still report slight movement in the first 4-6 days, similar to muscle twitching. But after 2 weeks, the full effect of your treatment should take place, and you wouldn’t be able to move that muscle at all.

Unfortunately, the neuromodulators’ effect is temporary. Eventually, the body realizes what’s going on and tries to get rid of this neuromodulator by increasing its breakdown and excretion. And your Botox slowly starts to wear off. Thankfully, this takes time, about 3-6 months, and this is how long the modulators can last! But wait! Why the range? well, because there are different factors that affect how long a neuromodulator can last!

What Makes Botox/Dysport/Xeomin wear off faster?

First, if a neuromodulator is injected in a muscle that you use a lot, like the lips, the effect might even wear off sooner than 3 months! Sorry! This is mainly due to the increase in neuro-signals sent to that muscle and to the increase in blood supply to that area. which leads us to number two…

Second, Exercise! If you are like my friend Jessica who goes to the gym five times a week, exercises until she can no longer breath, then your neuromodulator will likely wear off pretty fast! There’s an increase in the blood supply to almost all the moving muscles in our body during exercise, and guess what? Increase the blood supply, increase the clearance of the medicine!

Third, neuromodulators are dose dependent. So if your doctor was trying to save you some money by decreasing the amount of Botox he/she is giving you in your frown-lines, then your “elevens” will come sooner than usual. Giving 2 units of Botox in one area may achieve the same effect as injecting 4 units on the short term, but the 4 units will surely last longer!

Fourth, Smoking! Do you smoke? Stop! If you smoke, you will wrinkle faster than your peers who don’t smoke (just think of that “smoker’s pucker”). Not only that, but you also will need a higher dose of neuromodulators to get better results. In addition smoking, just like alcohol and spicy food, increases your risk of bruising after the procedure!

The good news though is that, keeping up with your treatment every 3-6 months was found to result in longer lasting effects with time, and increased patient satisfaction. 


Athough Botox is the most famous brand among neuromodulators, newer and equally effective ones are introduced every day. Some of those are Dysport and Xeomin. But what’s the difference between each one of them? Well, in concept, they are derivatives of the main chemical component “Botulinum Toxin“… Oh here goes the toxin again! But no worries, these medications are safe in the experienced, well-trained hands.

The difference between these drugs comes down to varying formula characteristics; like dilution, molecule size, diffusion, the onset of action, and additives to the main ingredient.

Eventually, it comes to personal preference and your injector’s experience to decide which one is better for you. Your injector may even consider combining them in the same treatment depending on what you need to achieve in your perfect look.

There are many places where a neuromodulator can be injected to achieve a more youthful & relaxed look

… and there are many placed where it shouldn’t be injected!!! That’s why choosing a provided with a detailed knowledge of Anatomy is very important to avoid unnecessary complications. As of now, There is no known way to reverse the effect of the neuromodulators.


Remember these tips on Dos & Don’t for your treatment:

Before Botox/Dysport/Xeomin:

After Botox/Dysport/Xeomin:


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