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Botox has long since been the industry leader in cosmetic botulinum toxic injectables, but with new products continuing to be FDA approved, will Botox continue to dominate the market in the fight against wrinkles? Botox was the first botulinum toxin to receive its FDA approval for cosmetic purposes in 2002, but since then others, such as Dysport, have received the same approval and have now provided Botox with some much needed competition. So what are the differences between Botox and its competitors?

While both Botox and Dysport injectables use the botulinum toxin type A to relax facials muscles to help improve the look of fine lines and wrinkles, the major differences between the two can be found in the cost, recommended dosage, dosage forms, formula, and usage. Botox Cosmetic, which has also been licensed under the name Vistabel, is primarily used to prevent and reduce the appearance of expression related wrinkles (Glabellar Lines).  Botox is equally distributed between five separate injection sites, blocking nerve impulses which paralyzes the muscles that cause wrinkles and allows the skins surface to smooth out as a result. The effects of Botox have been shown to last up to 4 months and should not be received more often than every 12 weeks.  Botox is available in single use vials of 50 units or 100 units, while Vistabel is only available in vials 50 units.

Just like Botox, Dysport, and its cosmetic counterpart Azzalure, are also injected into the facial muscles surrounding expression lines causing these muscles to smooth out and relax the appearance of facial lines and wrinkles. While the recommended dose of Botox is 20 units equally distributed between 5 injection sites, both Dysport and Azzalure have a recommended dose of 50 units. The results of both Dysport and Azzalure have been shown to last up to 4 months and just like Botox, should not be received more often than every 12 weeks. It has been said that both Dysport and Azzalure are lower in concentration then Botox, and has fewer proteins surrounding the toxin, which should not only stimulate a weaker immune response but some also claim that it works faster and lasts longer than Botox. Dysport is available in single use vials of 300 units or 500 units and Azzalure comes in a customized single use vial of 125 units and is available in packs of 1 or 2.

While Botox and Dysport have gained popularity for cosmetic purposes, both products have been used for medical conditions as well.  Both Botox and Dysport have not only been FDA approved for the treatment of Glabellar lines, also known as brow furrow lines, but as well for the treatment of Cervical Dystonia, a condition that causes neck muscles to tighten or spasm without control. In addition to Botox and Dysport, Xeomin and Neurobloc have also been approved by the FDA to treat Cervical Dystonia. Though there has been no clear indication of the difference between Botulinum Toxin Type A or B, each of the above mentioned products fall under these two categories. Botox, Dysport, and Xeomin are all forms of Botulinum Toxin Type A, while Neurobloc is a form of Botulinum Toxin Type B. Both Toxins work to inhibit the release of acetylcholine, a neurotransmitter responsible for the activation of muscle contractions. Administering either Toxin results in the weakness of the injected muscle allowing for improved posture and function of the dystonic muscle(s).

Each of these above mentioned products differ in their recommended dose, for example Neurobloc’s recommended starting dose is 10,000 units (2.0ml), Xeomin’s is only 120 units, Botox is 200 units and Dysport is 500 units. The other significant difference between these products is the way in which they are stored. Botox, Dysport and Neurobloc all need to be kept refrigerated and only have a 2 year shelf life, while Xeomin does not need to be refrigerated allowing for less risk of developing antibodies and has a shelf life of 3 years. Each of the products come in a variety of single use vials, Dysport is available in 300 unit or 500 unit vials, Botox and Xeomin are available in 50 unit or 100 unit vials, and Neurobloc is available in 3 sizes starting at 2500 unit vials. All products are effective in treating Cervical Dystonia and though some have shown faster and longer results, all effects will gradually diminish and the treatment will need to be repeated in intervals of a duration no less than 12 weeks.

When it comes down to the decision of choosing which product is the right choice please keep in mind that all products mentioned above are minimally invasive and affordable ways to achieve effective treatment whether being used for cosmetic or medical purposes. Whether a product has been shown to take effect quicker, or have results that may last longer should not be the number one factor in making a decision as to which product is right for you. The most important thing to consider when making a decision on which product to use is the practitioner that will be administering the injection.   Choosing a practitioner who is knowledgeable and experienced will ensure you have chosen the product that is best suited for you and your individual needs.

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