Like Kleenex, ChapStick, and Band-Aid, Botox is such a leader in its field that the brand name itself is regularly used to refer to the generic product it represents. For those who are unaware, "Botox" is actually just one branded product of botulinum toxin - an injectable neurotoxin famed for its ability to relax muscles and smooth out wrinkles - manufactured by Allergan, an American pharmaceutical company. While Botox was the first neuromodulator of its kind approved by the Food and Drug Administration (FDA) in 2009, a handful of others have since followed suit, from Dysport and Daxxify to the most recent, Letybo (letibotulinumtoxinA).
Approved in 2024 for frown lines (aka 11 lines) but also available off-label for forehead wrinkles, lip flips, and beyond, Letybo is slowly but surely making its way into more medspas and derm offices.
So, what's the deal with the newest Botox alternative on the block, and should you consider trying it out in lieu of its competitors? These questions and more, answered ahead with the help of some pros.
Experts Featured in This Article
Corey L. Hartman, MD, FAAD, is a board-certified dermatologist and founder of Skin Wellness Dermatology in Birmingham, Alabama.
Ava Shamban, MD, is a board-certified celebrity dermatologist based in Los Angeles, and founder of AVA MD and Althaea Skin. She was also a clinical trial investigator for the product before filing for FDA approval.
What Is Letybo?
"Similar to Botox and other neuromodulators, Letybo is a purified version of type A botulinum neurotoxin protein that works by blocking the nerve signals to the muscles responsible for contracting," says dermatologist Corey L. Hartman, MD, FAAD. Manufactured by medical aesthetics brand Hugel, Letybo hails from South Korea - a veritable mecca in the wide and wonderful world of beauty - with the brand boasting over 31 million successful treatments to date.
In 2024, it received FDA approval for moderate-to-severe glabellar lines (aka frown lines), or the area in between the brows that is prone to wrinkling with continuous muscle contractions.
Letybo vs. Botox
Letybo has a few unique selling points compared to Botox and other neuromodulators, says dermatologist Ava Shamban, MD, who was a clinical trial investigator for the product before filing for its FDA approval.
For starters, she says that Letybo is a more pure and stable molecule as it's produced through enzyme-free manufacturing and double chromatography. "By removing bacterial side products, nucleic acids, and lyophilization, it gives Letybo more stability," Dr. Shamban says. "New toxins entering the market are approved along with their manufacturing process, so the first generation toxins don't have the double purification, making the protein complex of Letybo slightly different."
Benefits of Letybo
Letybo is said to kick in more quickly than its competitors - sometimes as soon as one day but more commonly within 72 hours, says Dr. Shamban. This could give it an edge for those on a time-crunch or prize near-instant gratification. "It may be recommended for a more 'impatient patient' who has an event within a few days' time, for example, and looking for a more rapid onset," she says.
In terms of timing, the official consensus is that it can last for up to four months - the same ballpark as other neuromodulators, though Dr. Hartman has heard that it might have longer-lasting effects. "The glabellar lines are one of the most common areas patients see neurotoxin treatment to reduce, or fully remove, so it's always positive to give patients another option," he says. For what it's worth, Letybo is the number-one frown line treatment in South Korea, according to total reported revenue from 2016–2024. Some patients (myself included) "appreciate the standards associated with K-beauty aesthetics," says Dr. Shamban, "so Letybo may be highly considered or requested by those looking to try the South Korean product."
If you're trying to avoid the infamous frozen look, Letybo could also be up your alley. "Anecdotally, I've seen that it has been effective in helping patients achieve a natural-looking appearance," says Dr. Hartman, "But that also has to do with the proficiency and expertise of the injector."
Dr. Shamban also points out that Letybo was the first neuromodulator used to assess psychological impact in a phase-three trial, with participants reporting a more youthful appearance and more confidence post-injection. "There could be unique or additional benefits from its manufacturing, purity, or stability profile, but none have been studied at this time," she shares.
Finally, it may be easier to find Letybo offered by providers at a slightly lower cost than the likes of Botox, Xeomin, Dysport, and others, potentially making it more accessible and budget-friendly. Of course, it goes without saying you'll want to go to a reputable and experienced injector who's familiar with the product. Dr. Hartman emphasizes investing in the provider's expertise, not just the product, for optimal results. After a consultation, your doctor might recommend one option over the other and it's best to trust their judgement.
Safety Considerations of Letybo
While neuromodulator injections might be as routine as a facial for some, it's still worth exercising caution, no matter which brand you decide on. "The safety concerns for Letybo are similar to the safety concerns for other neuromodulators," says Dr. Hartman. "The side effects are rare but possible, including some sensitivity at the injection site and some minor bruising, but it [typically] goes away within a day or so."
Dr. Shamban agrees, noting that while Letybo is new to the U.S., it's been safely and successfully used in South Korea and other corners of the globe for years. "There aren't really any additional concerns or considerations. Also, the product has exceptional safety, with only two percent headaches and 0.5 percent of eyelid and brow drop [reported] - lower than any of the competitors," she says.
The Takeaway
Neurotoxins are among the most prized treatments in aesthetic medicine, so having another FDA–approved option with demonstrated safety and efficacy is exciting for providers and patients alike. "It is another tool in our toolkit of neuromodulator products to effectively manage lines and wrinkles," says Dr. Shamban.
That said, while Letybo is specifically approved for frown lines, Dr. Shamban says it's suitable in other contexts where toxins are typically used - including but not limited to forehead lines, bunny lines, masseters, platysma bands, and even underarms and hands to mitigate hyperhidrosis (excessive sweating) - in an off-label capacity. She adds that it might work better for some patients than others, so it's important to manage expectations and heed the advice from a qualified provider.
Michele Ross is a freelance writer specializing in wellness, culture, and beauty. Her work has appeared in Well+Good, Coveteur, Editorialist, GQ, Vice, and Teen Vogue, with brand clients including Peloton, Moon Juice, and Hum Nutrition. She's grateful to cover her many interests - including but not limited to self-care, self-development, skin care, coffee, travel, and Korean culture. Read More Details
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