Where the confusion over the names comes from
Vistabel, Dysport and Xeomin are three medicinal products from different manufacturers. They contain the same active substance — purified botulinum toxin type A. Their mechanism of action is identical. The substance blocks nerve signals at the injection site, so the sweat gland no longer receives the signal to work. The differences concern the protein formulation, purification process and dosing method. These details matter clinically, but not in the way most myths suggest. The confusion comes from the fact that the units of these products are not interchangeable. What one leaflet states cannot be directly applied to another. A doctor working with Dysport uses different unit conversions from one working with Vistabel — and both approaches can be correct. The problem starts when people compare “doses” based on hearsay or look for the cheapest option without asking about the brand.
Six myths — debunked one by one
MYTH 1: “One product is stronger, another is milder.” Fact: the strength of the effect depends on the biological dose administered, not the brand name. Each of the three products — in an amount selected appropriately by the doctor — can achieve a comparable clinical result. “Dysport is stronger than Vistabel” is a statement without context. Dysport uses a different unit conversion, so the number on the syringe is higher, but that does not mean a stronger effect. Comparing numbers without knowing the conversion is like comparing a price in Polish zloty with one in euros and deciding that “the euro is more expensive”.
MYTH 2: “Xeomin is purer, so it is always safer.” Fact: Xeomin does not contain additional complexing proteins, which is why it is sometimes called a “naked” toxin. This is a real difference in composition, but it does not automatically make it a better option for everyone. It may genuinely benefit people with strong resistance to other products, as it can theoretically reduce the risk of developing neutralising antibodies. However, for most people treated for excessive sweating, this difference has no practical clinical significance — especially with single or infrequent use. The decision on product selection belongs to the doctor, not to you.
MYTH 3: “Only one specific product works for excessive sweating.” Fact: all three products have indications or established clinical practice in treating primary hyperhidrosis — excessive sweating without an identifiable medical cause. Underarms, hands, feet and even the forehead or groin area are regions where botulinum toxin has proved effective in studies, regardless of manufacturer. The claim that “only Vistabel works for underarms” or “Dysport is better for hands” has no scientific basis. It may make marketing sense, but it should not determine the choice of treatment.
MYTH 4: “The effect of one product lasts longer than another.” Fact: how long the result lasts depends primarily on the anatomical area, dose and your individual metabolism — not the manufacturer. In hyperhidrosis treatment of the underarms, the result usually lasts from several to more than a dozen months. In the hands, where muscles work more intensively, it may be shorter. If you have heard that “Xeomin lasts longer” and sweating returns after five months, do not conclude that you “chose the wrong product”. Speak to your doctor about the dose and treatment plan.
MYTH 5: “The toxin blocks sweating throughout the whole body.” Fact: this is one of the most worrying myths. It creates the impression that the body “cannot cool itself down”. Botulinum toxin works only locally, at the injection site — blocking sweat glands only in the treated area. The rest of the body sweats normally. Thermoregulation is not disrupted. Your body compensates for reduced sweating in one area without any health risk. This is why the treatment is safe even in summer and for very physically active people.
MYTH 6: “If different products cannot be compared, there is no point asking the doctor about the brand.” Fact: quite the opposite. It is worth asking — not to choose the product for the doctor, but to understand the choice. Your doctor should be able to explain why they use a particular product in their practice. They may know its characteristics, have worked with it for years and know their dosing protocol, or have it within an approved cold chain. These are good reasons. “Because it is the cheapest” is not.
What really determines the effectiveness of hyperhidrosis treatment
Once we break the myths down, we are left with the factors that really matter. The first is diagnosis. Is it primary hyperhidrosis, with no identifiable cause, or secondary hyperhidrosis linked, for example, to hormonal disorders, medication or thyroid disease? Before treating the symptom, it is worth ruling out the cause. Botulinum toxin will not solve the problem if its source is internal.
The second is the treatment area and injection technique. The underarms are a relatively straightforward area. A good map of the sweat glands and systematic injection points provide predictable results. The hands are more challenging. They are more sensitive and more densely innervated, so the treatment requires greater experience and precision. The result also usually lasts for less time. The feet require particular attention during anaesthesia. The skin is thick here and painful stimuli are stronger. A good doctor will discuss this with you before starting.
The third is product authenticity and the cold chain. Botulinum toxin requires storage under strict temperature conditions. A product stored incorrectly or sourced from an unapproved supplier loses effectiveness unpredictably. A salon that takes you seriously will show you the product label on request. They will not hesitate when you ask about the manufacturer and expiry date.
Women’s and men’s perspectives — two different contexts
Hyperhidrosis can affect women and men differently. Yet both groups share one thing: the embarrassment that makes them postpone treatment for months or years. Women more often speak about difficulties with clothing. Light T-shirts, sleeveless dresses and blouses made from delicate fabrics become impossible on warm days. Sweaty hands can cause anxiety in social and professional situations. They often describe the treatment result as “regaining freedom” — being able to wear anything without planning ahead.
Men come in with similar practical concerns, but more often with what could be called “professional costs”: a handshake at a meeting, a shirt for an important presentation or visible stains in an air-conditioned office. Hyperhidrosis is statistically just as common in men as in women, but men seek help less often — because “itching and sweating are normal for a man”. They are not normal when excessive and affecting everyday decisions. It is worth recognising the difference.
Before you decide on treatment — what is worth knowing
If you are considering hyperhidrosis treatment after all this, it starts with one question: is the problem troublesome enough to justify a medical procedure? For most people who come to the salon, the answer is “yes”. Their sweating stopped being merely a cosmetic inconvenience long ago. If your answer is similar, the next step is a consultation, not choosing a product. The doctor will assess the area, discuss your expectations, select the dose and explain what to expect. This includes the fact that the full result takes several days, and sweating may increase slightly during the first 24 hours after the treatment before the substance takes full effect.
One thing worth knowing before entering the salon: hyperhidrosis treatment with botulinum toxin is a treatment that needs repeating — the effect is temporary. This is not a disadvantage. It is precisely what makes the treatment safe and reversible. With each subsequent session, you can decide whether you want to continue. There is no “addiction” or “point of no return” — simply an effective treatment for a specific period, repeated if it works for you.