TOXIN WARS: Botox vs. Dysport

Pick your Poison...carefully!

Pick your Poison...carefully!


I can’t help it.  One of my English friends refers to her BOTOX as “TOX” and I just think it’s the cutest thing!  So, as you all have probably heard, there is a new botulinum toxin that received FDA approval in the United States called “Dysport.”  This has been a long time in the making, and here is the deal as to the action behind the scenes.  You see, a long, long, time ago a company by the name of Allergan developed a botulinum toxin type A for the treatment of medical problems such as facial dystonia [involuntary facial squeezing] and blepharopsasm [uncontrollable squeezing of the eyelids].  One day, some lucky dermatologist’s receptionist got her forehead shot up with the miracle substance and “Viola”—BOTOX was born.  Up until now, Allergan had sole rights of distribution in the United States for botulinum toxin type A.  Meanwhile, another company in Europe named Medicis had a fabulous filler called Restylane.  Not to be outdone in their quest to rule the world, Allergan decided to come up with their own filler, which they cleverly named Juvederm.  In response, Medicis bought the rights to the European Botox (known as Reloxin), changed the name to the more familiar “Dysport” and imported Dysport to the United States!  So you see, it’s been a real war of the Toxins!

Although BOTOX and Dysport are both botulinum toxin type A, some differences do exist:


1.    The manufacturing process is slightly different, which leads to some potential, subtle differences in clinical practice.

2.       Some people feel that Dysport may provide a slightly faster onset of action (24 hours versus 72 hours for BOTOX).

3.       Some people claim that Dysport lasts longer than BOTOX (sometimes by a month or longer), but no “head-to-head” trials have been conducted to prove this claim).

4.       Dysport has been shown to “drift” more than BOTOX, increasing the chances of an accidental droopy eyelid or unintentional relaxation of a neighboring muscle due to diffusion of the product [friendly fire].

All in all, I have been working with BOTOX for the past 10 years and I understand precisely how it works.  The key to that statement is precision, because once I have placed the BOTOX, it stays where I injected it.  I don’t need the wildcard of unpredictable drift keeping me up over the weekend worrying about a droopy eyelid.  As I’ve often said, I won’t treat anybody with anything that I wouldn’t use myself.  So for my patients, the “TOX” will remain BOTOX.  By any other name, it is not as sweet…


Stay Beautiful!

-Dr. Zdinak


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