Reloxin vs. Botox - What's the difference?

The word Botox has become a part of our everyday lexicon.  With over 3 million Botox procedures performed in the US alone last year, ever increasing applications of the "wonder drug" and increasing consumer demand and awareness of its inherent safety profile, there is no question that Botox (Allergan, www.botox.com) has secured its place in every aesthetic Physician's medication fridge.

The last few months however have produced an increasing number of reports that Botox may finally be presented with competion in the battle against wrinkles.  As has become the norm,  a new product has been clinically tested and utilized in Europe and South America with promising results.  The "new" injection is being marketed as Reloxin (Dysport) and is currently under review by the FDA for distribution and utilization within the US.

After reviewing the available literature on Reloxin this much can be said so far:

1. Reloxin and Botox have similar mechanisms of action (neuromuscular blocking toxin)

2.Reloxin has less of a protein load than Botox.  Clinically this means that Reloxin will result in the formation of fewer antigens against it.  Antigens are what our bodies use to detect and destroy foreign proteins (the injected medications).  Hence the assumption is that with fewer antigens being formed the clinical effects of Reloxin should last longer than those of Botox.  That being said, some clinical trials indicate that Botox has longer lasting results.

3.In clinical studies,  author's noted that Reloxin "spreads more" during injection.  This is both a good and a bad thing.  It is good in that large areas that need injection (forehead, armpits) would require fewer injections due to the spreading.  This would mean less likelihood of potential discomfort, swelling or bruising for the patient.  It is bad in that unless the Physician is an experienced injector with a good understanding of more complex musculature (around the eyes, between the eyebrows), the Reloxin could spread into unwanted areas causing untoward side effects (blurry vision, droopy eyebrows).

4.Reloxin is diluted more than Botox which may cause some confusion for Clinicians not adept at determining how many units to inject in each anatomical area with the new product.  However in the United Kingdom, this dilution has resulted in more cost effectiveness where 100 units of Botox goes for $525.00 and 500 units of Reloxin is $300.00.

5.At this stage no significant "red flags" have been raised about the safety of Reloxin.  Of specific concern,  allergies and infections have not been seen to a clinically significant degree.

As always competition is a good and healthy thing.  The emergence of an alternative drug to Botox should spur on pricing competition that will benefit both Patients and Physicians alike.  Also new research and development is already under way to provide the next "bigger and better" product (anyone heard of Purtox? If not you will soon).

Time as always will tell.  While Reloxin awaits final FDA approval (which may take a few more months but is an inevitable certainty), continued growth in Botox is expected.

The wait should be worth it....and any wrinkles that appear in the mirror during that time will have at least two options to help address it.