Comparison

Letybo vs Xeomin

Both use 20 units for frown lines. The real difference is that one of them is FDA-approved for the forehead and crow's feet and the other is not.
Written & medically reviewed by the Dermapedia team
At a Glance

Letybo and Xeomin are both botulinum toxin type A, and both use the same 20-unit dose for frown lines.

The difference that actually matters is what each is approved to treat. Xeomin is approved in the US for frown lines, horizontal forehead lines, and crow's feet. Letybo is approved for frown lines only. If you want the upper third of your face treated by the label rather than off it, that is the whole comparison.

Their make-up differs too. Xeomin is a bare toxin with the helper proteins stripped away. Letybo comes as a full protein complex, like most brands.

Letybo
letibotulinumtoxinA-wlbg
Xeomin
incobotulinumtoxinA

What it is

Botulinum toxin type A

Made by Hugel. US approval in 2024, launched here in 2025.

Botulinum toxin type A

Made by Merz. On the US market since 2010.

What it is approved to treat

Frown lines only

No medical approvals in the US.

Frown lines, forehead lines, and crow's feet — plus several medical conditions

The forehead and crow's feet approvals were added in July 2024.

Both
This is the biggest practical difference between these two. Botox Cosmetic also holds all three approvals — crow's feet since 2013, forehead lines since 2017 — so Xeomin is not the only option, just the newest to get there. Dysport, Jeuveau, Daxxify and Letybo are approved for frown lines only.

The dose for frown lines

20 units, in 5 injections of 4 units
20 units, in 5 injections of 4 units
Both
The numbers match, but that is a coincidence of how each brand set its scale. Units still cannot be converted between brands.

The dose for forehead lines

Not approved for this area
20 units, in 5 injections of 4 units

Approved only when the frown lines are treated at the same time.

Both
Xeomin's label caps treatment of all three upper-face areas at 64 units in one session.

What is around the toxin

A protein complex, about 900 kDa
Bare toxin, about 150 kDa

The helper proteins are removed during manufacturing.

Both
Xeomin's stripped-down form is often described as an advantage for people who stop responding to other toxins. That idea is reasonable but has not been settled by strong evidence.

Track record

New to the US in 2025

Approved on three placebo-controlled trials in about 1,270 people.

In US use since 2010

Also approved for medical conditions including cervical dystonia and excessive drooling.

Both
Neither has been tested against the other.

Who tends to be happy with it

Best for
Frown lines, especially where it is offered at a lower price.
The mindset
You are only treating the one area.
Best for
Anyone treating the forehead or crow's feet inside the approved use.
The mindset
You want the treatment to sit inside the approved use.

Why the forehead approval is the deciding fact

Most people asking about the forehead are surprised to learn that treating it with botulinum toxin is off-label for nearly every brand. That is normal, legal, and extremely common — but it means the FDA never reviewed the dose or the safety data for that area for those products.

There are two exceptions. Botox Cosmetic has been approved for crow's feet since 2013 and for forehead lines since 2017. Xeomin joined it in July 2024, approved for horizontal forehead lines at 20 units and crow's feet at 24 units alongside the frown lines. Letybo has no such approval, and neither do Dysport, Jeuveau or Daxxify.

If you are treating frown lines only, this does not affect you. If you want your whole upper face treated, it is the single clearest difference between these two products.

The "Xeomin for toxin resistance" idea

Xeomin has no helper proteins around the toxin. The argument runs that fewer foreign proteins means less for the immune system to react to, so people who have stopped responding to another brand may do better on it.

It is a plausible argument and injectors use it. It is not a proven one. If a toxin has stopped working for you, it is worth raising with your injector — but treat it as a reasonable thing to try, not as a guaranteed fix.

One thing worth knowing: Xeomin is not the only product without helper proteins. Daxxify is also a bare toxin, so if this argument holds, it applies to both.

Worth asking before you book

  • Which areas are you treating, and is that use approved for this brand?
  • What does the whole treatment cost?
  • How many units, and where?
  • Is a two-week check included?

Get emergency help now if

  • You have trouble swallowing, speaking, or breathing
  • You feel weakness spreading to muscles you did not have treated

Go to an emergency department or call 911. Do not wait for a call back. These are rare, but they are the symptoms named in the FDA boxed warning that every botulinum toxin product carries, deaths have been reported, and they can begin hours or even weeks after treatment.

Call your injector if

  • One eyelid or eyebrow starts to droop, or your vision changes
  • One side sits noticeably higher than the other at two weeks

If a vision change is sudden or severe, seek urgent care rather than waiting.

Questions people ask+
Is Xeomin better than Letybo?They have never been compared in a trial, so no one can say. The one clear, factual difference is that Xeomin is approved for forehead lines and crow's feet as well as frown lines, and Letybo is approved for frown lines only. Botox Cosmetic holds those same three approvals.
Do they use the same dose?For frown lines, yes — both use 20 units in five injections of 4 units. That match is a coincidence of how each brand set its own scale, not a sign they are equivalent. Units still cannot be converted between brands.
What does "no complexing proteins" mean?Xeomin has the helper proteins that normally surround the toxin removed. Letybo keeps them. Xeomin's form is sometimes said to be less likely to trigger the immune response that makes a toxin stop working, though the evidence for that is not strong.
I have stopped responding to my usual toxin. Will Xeomin work?It may be worth trying, and injectors do switch people to it for this reason. There is no reliable evidence guaranteeing it will work. Discuss it with your injector rather than assuming.
Is Letybo new?In the United States, yes — approved in 2024 and launched in 2025. It was used in South Korea and other markets before that.
Can Letybo be used on the forehead?Injectors can and do use it there, but it is off-label. In the US, Letybo's only approved use is frown lines.