Botox Cosmetic™ vs. Dysport™

Dysport™ is a new injectable treatment that can be used to relax muscle actions that are responsible for the formation of dynamic lines and wrinkles of the face. Dysport™ is abobotulinum toxin A, and works in a fashion similar to Botox Cosmetic™: both Dysport™ and Botox Cosmetic™ inhibit the release of acetylcholine, a neurotransmitter, from peripheral cholinergic nerve endings, which reduces muscular action. Dysport™ has been used in the United Kingdom since 1991, and is now approved for the treatment of wrinkles in 23 countries.

The FDA approved Botox Cosmetic™ in April 2002 for improvement in the appearance of moderate to severe glabellar lines (the wrinkles of the forehead and between the eyebrows). Botox Cosmetic™ has been steadily increasing in popularity, and is now the leading cosmetic treatment in the United States, with nearly 2.5 million treatments performed in 2008.  Dysport™ was FDA approved in April 2009 for similar indications, introducing what is felt to be a competitive alternative to Botox Cosmetic™.

There are in fact many more similarities between Botox Cosmetic™ and Dysport™ than there are differences.  Although the unit-for-unit potency of Dysport™ is less than that of Botox Cosmetic™, and the cost of Dysport™ unit-for-unit is less than the cost of Botox Cosmetic™ (for example, a treatment area with Botox Cosmetic may require 17.5 units, and the identical treatment area with Dysport™ would require 50 units), when all factors of concentration and cost are adjusted, the cost of Dysport™ and the cost of Botox Cosmetic™ are almost identical.

There are as yet unsubstantiated reports of a longer duration of action with Dysport™ compared with Botox Cosmetic™ Botox Cosmetic™ and Dysport™ are felt to produce effects that last for approximately three months; as Dysport™ use becomes more popular, the longevity of the treatments will be better defined.  It does appear that the onset of the effects of Dysport™ are more rapid than Botox Cosmetic™, with Dysport™ wrinkle-reducing effects becoming evident at 24-48 hours compared with 2-5 days with Botox Cosmetic™.  Whereas both Botox Cosmetic™ and Dysport™ may stimulate the formation of antibodies, rendering the wrinkle reducing treatments less effective over time, Dysport™ may be more prone to do so.  The clinical implications of this have yet to be seen.

In summary, Botox Cosmetic™ has an amazing track-record, and is a fantastic treatment for the relaxation of dynamic lines and wrinkles, and is the predominant treatment in our practice and across the United States, but it appears that Dysport™ is proving to be equal to the task.  For those who need “quick results”, the rapid onset of Dysport™ may make this wrinkle relaxer the treatment of choice.