Both Botox (made by Allergan) and Dysport (made by Medicis) are two FDA approved injectable options to treat wrinkles and facial lines. Botox has been around for many years and has worldwide sales of around two billion dollars. Dysport only entered the USA market in April of 2009, even though it was known in Europe long before that. It is estimated that Dysport could end up gaining up to 25% market share in the USA.
Both products are botulinum toxin type A proteins, a neuromuscular blocking toxin that inhibits the communication between the nerve and the muscle to cause relaxation and skin improvements.
Do They Differ On Any Level?
Here and there, opinions vary only slightly from doctor to doctor. They mostly agree that Botox and Dysport are very similar. Some doctors say they notice little differences, others say those differences are only patient specific. One thing is for sure: as the market becomes more competitive and crowded with other type A toxins, such as Xeomin (Merz) and PurTox (Mentor/Johnson & Johnson), the differences and similarities between the products tend to become more complicated. Still, to bring some clarity, here are the noticed main differences between Dysport and Botox:
• Action – Dysport seems to act quicker (24 h to 48 h) than Botox (3 to 5 days). So unless the person needs a really quick Dysport fix because there’s a party in a couple of days, there’s not much difference in waiting for any of the results.
• Longevity – Both Botox and Dysport results last around 3 to 4 or 5 months but based on studies done in Europe, some doctors say Dysport results last a bit longer (six months to one year, against the Botox’ three months). Others say that it depends on each patient. Dysport is less protein-loaded than Botox, which clinically means that the body will create fewer antibodies against it. Our body uses antibodies to detect and destroy foreign proteins (antigens), which come with injected medications. So, it’s assumed that fewer antibodies against Dysport will make its results last longer. However, there are clinical trials that indicate that Botox has longer lasting results.
Some doctors claim that the results of both injections can be prolonged if the patient undergoes a series of about 3 initial treatments every four months. Apparently, during this period, the presence of the protein “teaches” the facial muscles to contract less actively than before, which prolongs the treatment’s response, even after the toxin has been processed and expelled from the body.
• Spreading – Dysport spreads more easily than Botox. That has advantages and disadvantages. On the one hand, larger areas can be treated (e.g. armpits and forehead) with fewer injections, reducing the chances of possible discomfort, bruising or swelling on the patient. On the other hand, extra attention is needed while treating narrower areas such as under and between the eyebrows or under the eyes, as to limit/avoid the spreading of Dysport beyond the treatment areas, which can cause side effects like droopy eyebrows and blurry vision. For this, the doctor needs to be a very experienced injector with good knowledge of the body muscles.
• Spot of treatment – Due do its wider spreading action, Dysport works better on thin, broad muscles where crow’s feet appear. Botox is more effective on concentrated, thick muscles, for example to treat the “11 wrinkles” between the brows. Both work well on the forehead. Some doctors inject both to treat the different areas.
• Dosage – Dysport is dosed based on the patient’s muscle contraction or action while Botox is dosed based on recommended rates of dilution. This means the number of units needed for each treatment varies and the more experienced the doctor, the more likely he’s capable to adjust the dilution and number of injections to each case.
• Pain – Patients seem to complain that Dysport hurts more while being injected.
• Price – Dysport is about 20% cheaper than Botox. Some doctors say that even though it’s less expensive, Dysport also has less strength and more units are needed to get the same results as Botox. Those doctors, therefore, say that there’s no big cost-wise difference to the consumer, and some clinics even sell Botox and Dysport at the same price.
Risks and side effects
None of the two injections is risk-free and by law, their labels have “black box” warnings alerting that botulinum toxin is associated with potentially (even if rare) life-threatening health problems. This is because both products are purified solutions of the botulinum toxin, which is a nerve poison, derived from the bacteria responsible for botulism. As for side-effects, the most known have been local numbness and bruising (mitigated when before and after the procedure, ice is placed on the injection area), uneven eyebrows and droopy eyelids.
Regarding the price, there’s some controversy. Since insurance companies tend not to cover such treatments, the injections are purchased by patients directly at the doctor’s office. Both Botox and Dysport offer doctor rebates, which has raised an ethical question: doctors may be tempted to buy in bulk one of the products just because it’s cheaper and force it on a patient, even if the patient responds better to the more expensive product.
Should you choose Botox or Dysport?
Doctors in general don’t see many differences between Botox and Dysport. Differences and results may come from the doctor’s experience in adjusting the dosage and number of injections to each patient. So don’t shop around for price if you’re considering any of these treatments. Choose a certified and qualified professional. Most likely, he will treat the patient with the product he’s most at ease with, but if he’s a good professional, he will also consider the patient’s needs and be honest about his skills using the two treatments.