Is Letybo Better Than Botox? The Honest Physician Comparison

Is Letybo Better Than Botox?

No single wrinkle relaxer is universally better than another. Letybo and Botox Cosmetic are both botulinum toxin type A products that temporarily reduce targeted muscle activity, but they are different prescription products with different FDA-approved indications, formulations, clinical histories, and labeling. For someone primarily treating frown lines between the eyebrows, either may be appropriate depending on the individual’s anatomy, goals, medical history, and clinician’s assessment.

If you’re considering treatment at Azani Medical Spa in Bethlehem, Pennsylvania, the more useful question isn’t simply “Which brand is better?”

Which neuromodulator and treatment plan are most appropriate for my face and my goals?

If you’re looking for a broader overview of how these two FDA-approved wrinkle relaxers compare; including treatment areas, longevity, costs, and common patient questions- read our complete Botox vs. Letybo comparison.

At a Glance: Letybo vs. Botox

Letybo: FDA-approved in the United States for the temporary improvement in the appearance of moderate-to-severe glabellar lines in adults.

Botox Cosmetic: FDA-approved for the temporary improvement of moderate-to-severe glabellar lines, lateral canthal lines (crow’s feet), forehead lines, and platysma bands in adults.

Are they the same? No. They are different botulinum toxin type A products.

Can their units be converted directly? No. The FDA labeling states that potency units for Botox Cosmetic cannot be compared or converted to units of other botulinum toxin preparations.

Is one universally better? No. The appropriate choice depends on the treatment area, facial anatomy, goals, medical history, prior treatment response, and clinician’s assessment.

Botox vs. Letybo: Comparison Table

The FDA approved Letybo on February 29, 2024. Its current U.S. approval is specifically for moderate-to-severe glabellar lines in adults. Botox Cosmetic has broader FDA-approved cosmetic indications.

What Is Letybo?

Letybo is the brand name for letibotulinumtoxinA-wlbg, a botulinum toxin type A product manufactured by Hugel.

The FDA approved Letybo in the United States on February 29, 2024, for the temporary improvement in the appearance of moderate-to-severe glabellar lines associated with corrugator and/or procerus muscle activity in adults.

Glabellar lines are the vertical lines that appear between the eyebrows when someone frowns, concentrates, or squints. They are often called “11 lines.”

The FDA approval was supported by three randomized, double-blind, placebo-controlled clinical trials involving more than 1,200 evaluable participants.

So Letybo isn’t simply an untested “Botox alternative.” It is an FDA-approved prescription medication with clinical evidence supporting its use for its approved indication.

If you’re considering Letybo treatments, understanding its FDA-approved indications, expected results, and whether it’s the right choice for your facial anatomy can help you make an informed decision.

What Is Botox Cosmetic?

Botox Cosmetic contains onabotulinumtoxinA, another botulinum toxin type A product.

Patients interested in Botox Cosmetic treatments often choose it because of its long clinical history and multiple FDA-approved cosmetic indications in the United States.

The current FDA labeling includes temporary improvement of:

• Moderate-to-severe glabellar lines
• Moderate-to-severe lateral canthal lines, commonly called crow’s feet
• Moderate-to-severe forehead lines
• Moderate-to-severe platysma bands

in adults.

That broader FDA-approved cosmetic indication is one of the most important practical differences between Botox Cosmetic and Letybo in the United States.

Is Letybo Actually Better Than Botox?

The evidence does not support calling Letybo universally better.

Letybo has demonstrated efficacy for its FDA-approved indication of moderate-to-severe glabellar lines.

A Phase III randomized clinical trial involving 355 patients found that letibotulinumtoxinA produced significantly greater improvement than placebo. The study reported a median onset of effect of 3 days and a mean time to first retreatment of approximately 127 days.

That is evidence that Letybo works.

It is not evidence that Letybo is superior to Botox for every patient or every facial area.

That’s an important distinction.

What Does the Research Say About Letybo?

The evidence supporting Letybo includes randomized controlled clinical trials.

The FDA reports that three randomized, double-blind, placebo-controlled trials were used to evaluate Letybo’s efficacy and safety for glabellar lines. The trials enrolled adults with moderate-to-severe glabellar lines and evaluated improvement at Week 4.

In the published Phase III study, 64.7% of patients receiving letibotulinumtoxinA met the study’s composite responder definition at Week 4, compared with 0% in the placebo group.

Another Phase III randomized study directly compared letibotulinumtoxinA with onabotulinumtoxinA for glabellar lines. In that study, letibotulinumtoxinA was found to be non-inferior to onabotulinumtoxinA for the primary efficacy endpoint.

This is useful evidence because it supports the conclusion that Letybo can perform comparably to Botox for the specific treatment of glabellar lines.

It does not establish that Letybo is better.

Does Letybo Work Faster Than Botox?

This is one of the most common questions patients ask.

Short answer: Not conclusively.

In a Phase III Letybo study, patients reported substantial improvement as early as Day 2, with a median onset of effect of 3 days.

The American Academy of Dermatology states that patients receiving botulinum toxin therapy commonly see results within approximately 3 to 7 days.

Because studies use different designs, patient populations, outcome measures, and definitions of “onset,” it would be misleading to take individual study results and conclude that Letybo universally works faster than Botox.

Bottom line

Both can begin producing visible improvement within days, but individual results vary.

Does Letybo Last Longer Than Botox?

There is no universal answer.

In the Phase III Letybo trial, the mean time until first retreatment was approximately 127 days.

For onabotulinumtoxinA, a meta-analysis of four clinical trials involving 621 patients treated for glabellar lines found a median duration of approximately 120 days at maximum contraction among Day-30 responders.

The American Academy of Dermatology notes that the effects of botulinum toxin treatment for facial lines generally last about 3 to 4 months, and sometimes longer.

These data do not justify saying that Letybo always lasts longer than Botox.

Duration varies according to factors such as:

• Individual muscle activity
• Treatment area
• Dose
• Injection technique
• Individual response
• Previous treatment history

Is Letybo Better Than Botox for Frown Lines?

This is the area where the comparison is most straightforward.

Both Letybo and Botox Cosmetic have FDA-approved U.S. indications for moderate-to-severe glabellar lines.

Clinical research also provides direct evidence that letibotulinumtoxinA can perform comparably to onabotulinumtoxinA for glabellar lines.

Therefore, a patient seeking treatment specifically for the “11 lines” between the eyebrows may reasonably discuss either product with a qualified medical provider.

The choice may depend on:

• Facial anatomy
• Muscle strength
• Previous treatment response
• Desired degree of muscle relaxation
• Treatment history
• Provider experience
• Product availability
• Cost

There is no evidence-based rule that every patient should receive one brand.

Is Letybo Better Than Botox for Forehead Lines?

This is where FDA labeling becomes particularly important.

Botox Cosmetic is FDA approved for moderate-to-severe forehead lines in adults. Letybo’s current U.S. FDA-approved indication is glabellar lines, not forehead lines.

Therefore, patients specifically interested in forehead-line treatment should discuss the approved indications and appropriate treatment options with their medical provider.

Forehead treatment also requires careful attention to the frontalis muscle and brow position. Over-treatment can affect brow movement and position.

This is one reason facial anatomy and injector expertise matter as much as product selection.

Is Letybo Better Than Botox for Crow’s Feet?

Botox Cosmetic is FDA approved for moderate-to-severe lateral canthal lines, commonly known as crow’s feet.

Letybo does not currently have a U.S. FDA-approved cosmetic indication for crow’s feet.

Therefore, when the specific goal is FDA-approved treatment of crow’s feet, Botox Cosmetic currently has an important labeling distinction.

Are Botox and Letybo Units Interchangeable?

No.

This is one of the most important things patients should understand.

Although both products are botulinum toxin type A products, their potency units are product-specific.

The FDA Botox Cosmetic prescribing information specifically states that its potency units cannot be compared with or converted into units of other botulinum toxin preparations.

Therefore:

20 units of Botox should not automatically be assumed to equal 20 units of Letybo.

Clinical studies may use numerical doses for comparison purposes, but that does not create a universal conversion formula for clinical practice.

Your injector should determine the appropriate product and dose based on the specific medication being used.

Which Has More Clinical Research: Botox or Letybo?

Botox has the longer U.S. clinical history.

Botox Cosmetic has been used clinically for decades and has accumulated a very large body of published research.

For example, a meta-analysis examining the safety of onabotulinumtoxinA for upper facial lines included 5,298 participants from 18 registration studies.

Letybo has a newer U.S. history, with FDA approval in 2024, although letibotulinumtoxinA has been studied in randomized clinical trials and has been used internationally.

This difference should not be interpreted as meaning that Letybo is unsafe or ineffective.

It means simply that Botox has a longer accumulated evidence base and longer U.S. regulatory history.

What Makes a Neuromodulator Treatment Look Natural?

This may be more important to many patients than the brand name.

Natural-looking treatment depends heavily on:

• Understanding facial anatomy
• Identifying the muscles responsible for the wrinkles
• Appropriate dosing
• Precise injection placement
• Maintaining facial balance
• Considering how different treatment areas interact
• Understanding the patient’s desired degree of movement

The American Academy of Dermatology emphasizes that the skill and knowledge of the person performing botulinum toxin injections are important factors in achieving safe treatment and desired results.

Two people can receive the same product and have very different results.

The objective should not necessarily be to eliminate every visible line. For many patients, the goal is to soften unwanted dynamic wrinkles while maintaining natural facial expression.

What Does the Evidence Show vs. What Can Vary Between Patients?

This distinction is especially important when evaluating online claims about Botox and Letybo.

What the evidence shows

• Letybo is FDA approved for moderate-to-severe glabellar lines in adults.
• Botox Cosmetic has broader FDA-approved cosmetic indications.
• Letybo has demonstrated efficacy compared with placebo.
• Clinical research has found Letybo non-inferior to onabotulinumtoxinA for glabellar-line treatment in a randomized trial.
• Botulinum toxin effects are temporary and commonly last several months.

What can vary between patients

• How quickly results become visible
• How long results last
• How much muscle movement remains
• How many treatment sites are appropriate
• The dose needed
• How the patient perceives the aesthetic result

What should not be assumed

There isn’t adequate evidence to make universal claims that Letybo is:

• “Stronger”
• “Faster”
• “Longer-lasting”
• “More natural”
• “Safer”
• “Better”

than Botox for every patient.

That is why a personalized medical assessment is more useful than choosing a brand based solely on an online ranking.

Which Should You Choose: Botox or Letybo?

Rather than starting with the brand, consider the following questions.

1. What area are you treating?

For glabellar lines, both products have FDA-approved U.S. indications.

For forehead lines and crow’s feet, Botox Cosmetic currently has FDA-approved cosmetic indications that Letybo does not.

2. Have you had neuromodulator treatment before?

Your previous experience can provide useful information about how your muscles respond to treatment.

3. How much movement do you want to retain?

Some patients want substantial smoothing. Others prefer a very subtle reduction in muscle movement.

4. What does your facial anatomy require?

Different muscles, brow positions, wrinkle patterns, and facial proportions can require different treatment strategies.

5. Who is performing the injections?

The American Academy of Dermatology recommends asking about the provider’s experience and who will actually perform the injections.

6. What does the evidence say?

The best choice should be based on the specific product, indication, patient, treatment objective, and clinician’s assessment—not simply on an advertisement claiming that one brand is better.

Botox vs. Letybo: The Bottom Line

Is Letybo better than Botox?

Not universally.

Letybo is an FDA-approved botulinum toxin type A treatment for moderate-to-severe glabellar lines in adults. Botox Cosmetic has a longer U.S. history and broader FDA-approved cosmetic indications, including glabellar lines, crow’s feet, forehead lines, and platysma bands.

For patients considering treatment for glabellar lines, clinical research suggests that Letybo can provide results comparable to onabotulinumtoxinA.

The best choice for an individual patient is therefore not necessarily the newest product or the most familiar brand.

Treatment area, facial anatomy, desired result, previous treatment response, dosing, injection technique, and clinician experience all matter.

Considering Botox or Letybo in Bethlehem, PA?

At Azani Medical Spa in Bethlehem, Pennsylvania, Botox and Letybo consultations are approached as individualized medical decisions rather than a one-size-fits-all choice.

Dr. Monica Gavin, MD, and the clinical team can evaluate your facial anatomy, areas of concern, treatment history, and aesthetic goals and discuss which treatment options may be appropriate for you.

The goal is a personalized treatment plan that respects your facial anatomy and desired degree of movement.

[Book a Botox or Letybo consultation at Azani Medical Spa]

Frequently Asked Questions

Is Letybo as good as Botox?

Letybo has demonstrated efficacy for its FDA-approved indication of moderate-to-severe glabellar lines. A randomized clinical trial found letibotulinumtoxinA non-inferior to onabotulinumtoxinA for glabellar-line treatment. That does not mean the two products are identical or that one is universally better.

Is Letybo cheaper than Botox?

Not necessarily. Pricing varies according to the practice, geographic area, treatment plan, product, and amount used. Patients should compare the complete treatment plan rather than assuming one product is always less expensive.

Can I switch from Botox to Letybo?

A qualified medical provider can determine whether switching is appropriate. Tell your provider which neuromodulator you previously received, when you received it, and how you responded.

Is Letybo FDA approved?

Yes. The FDA approved Letybo on February 29, 2024, for the temporary improvement in the appearance of moderate-to-severe glabellar lines in adults.

Does Letybo work on forehead lines?

Forehead-line treatment is not currently a U.S. FDA-approved indication for Letybo. Botox Cosmetic does have an FDA-approved indication for moderate-to-severe forehead lines in adults.

Does Letybo work on crow’s feet?

Crow’s feet are not currently an FDA-approved U.S. cosmetic indication for Letybo. Botox Cosmetic is FDA approved for moderate-to-severe lateral canthal lines.

Does Letybo work faster than Botox?

There is not enough evidence to say that Letybo universally works faster. A Phase III Letybo study reported a median onset of 3 days, while the American Academy of Dermatology states that patients commonly see botulinum toxin results within 3 to 7 days. Individual results vary.

Does Letybo last longer than Botox?

There is no established universal difference. A Phase III Letybo study reported a mean time to first retreatment of approximately 127 days, while a meta-analysis of onabotulinumtoxinA studies found a median duration of approximately 120 days for Day-30 responders at maximum contraction. Individual results vary.

Are Botox and Letybo units interchangeable?

No. Botulinum toxin products use product-specific potency units. Botox’s FDA prescribing information specifically warns against comparing or converting its units directly with units of other botulinum toxin preparations.

Which is better for frown lines?

Both Botox Cosmetic and Letybo are FDA approved for moderate-to-severe glabellar lines. The appropriate choice depends on the individual patient’s anatomy, goals, history and clinician’s assessment.

Which is better for forehead lines?

Botox Cosmetic has an FDA-approved indication for moderate-to-severe forehead lines. Letybo’s current U.S. FDA-approved cosmetic indication is glabellar lines.

Which is better for crow’s feet?

Botox Cosmetic is FDA approved for moderate-to-severe lateral canthal lines, commonly called crow’s feet. Letybo does not currently have that FDA-approved U.S. cosmetic indication.

Will Botox or Letybo make me look frozen?

Not necessarily. A natural result depends substantially on treatment planning, anatomy, dosing and injection technique. The goal can be to reduce unwanted muscle activity while retaining appropriate facial movement. The AAD notes that skilled treatment aims to maintain natural facial expression.

Medical References

For transparency, I recommend keeping a visible Medical References section on this page.

FDA

FDA Drug Trials Snapshot: Letybo — approval date, indication and pivotal clinical-trial information.

FDA Letybo Approval Letter / Product Information — FDA approval for letibotulinumtoxinA-wlbg.

FDA BOTOX Cosmetic Prescribing Information — current FDA-labeled cosmetic indications and warnings concerning non-equivalence of botulinum toxin products.

American Academy of Dermatology

Botulinum Toxin Therapy: FAQs — treatment expectations, duration, safety and aftercare.

Botulinum Toxin Therapy: Preparation — provider experience, consultation and safety considerations.

Peer-reviewed research

Mueller DS, et al. Efficacy and Safety of Letibotulinumtoxin A in the Treatment of Glabellar Lines: A Randomized, Double-Blind, Multicenter, Placebo-Controlled Phase 3 Study. Aesthetic Surgery Journal.

• A Phase-III Noninferiority, Randomized Controlled Trial of Letibotulinum Toxin A for the Improvement of Moderate-to-Severe Glabellar Wrinkles in China.*

OnabotulinumtoxinA: a meta-analysis of duration of effect in the treatment of glabellar lines.

About the Medical Reviewer

Monica Gavin, MD

Medically reviewed by Monica Gavin, MD

Dr. Monica Gavin is a physician at Azani Medical Spa in Bethlehem, Pennsylvania. She earned her MD from Wayne State Medical School and provides physician-led medical care at Azani Medical Spa.

Last medically reviewed: August 2026

Medical content notice: This article is intended for educational purposes and does not replace an individualized medical consultation. FDA labeling, clinical evidence, and treatment recommendations can change. Azani Medical Spa periodically reviews medical content for accuracy.