Why Should a Person Not Use Dysport or Botox if They Have an Allergy to Cow Milk?

Question

People with allergies to cow milk should avoid Botox and Dysport. Assuming the same is true for Xeomin. What is the link? Are there currently any alternatives that someone with milk allergies could consider?

Sam Naficy, MD, FACS · Answer

It is not an allergy to cow's milk, it is actually an allergy to the cow's milk protein.  This is only in Dysport and not in Botox.

John Bitner, MD · Answer

Lactose intolerance causes bloating after consuming milk products.  This is not a true milk allergy.  If this is what you have, Botox, Dysport and Xeomin should all be safe to use.

Stephen Prendiville, MD · Answer

The incidence of allergy to neuromodulators like Botox and Dysport is extremely low. In fact, after treating thousands of patients, I have never seen an occurrence. In years past, bovine collagen (Zyderm, Zyplast) was the only FDA approved filler available, and skin testing was required to make sure that patients with bovine allergies would not suffer adverse effects. There are no such precautions or cross-reactivities with neuromodulators.

Ramona Behshad, MD · Answer

Botox and Xeomin are safe for people with a true milk allergy. The neurotoxin in Dysport is suspended in lactose (milk sugar), which will not result in problems for individuals who are lactose intolerant (becoming gassy, bloated when eating dairy). This is because lactose intolerance is specific for gastrointestinal system and is not a true allergy (hives, difficulty breathing, low blood pressure).

Gary Motykie, MD · Answer

Dysport has a small amount of cow's milk protein so anyone allergic to cow's milk protein should therefore avoid Dysport. This allergy is very rare and it is not the same as the more common condition known as lactose intolerance.

Juan Carlos Caballero, MD · Answer

People with a true milk protein allergy (not lactose intolerant) should not receive Dysport injections as this is used during the manufacturing process of Dysport. There is no such contraindication with Botox and definitely not with Xeomin. These can be safely injected in patients which such an allergy

Francis R. Palmer, III, MD (retired) · Answer

Dysport has a small amount of Cow milk protein and if someone's allergic to the protein, they should not have Dysport. Botox would not be an issue. Although the allergic response is possible, I have not heard of such a reaction happening.

F. Victor Rueckl, MD (in memoriam) · Answer

It's actually not if you are allergic to cow's milk (which would be lactose intolerance). It's if you are allergic to cow's milk protein. These are not the same thing. And it's only in Dysport. It's one of the bonding molecules used. I haven't seen or read about one person whom this potential allergy has affected.

Marc Cohen, MD (retired) · Answer

Botox, Dysport and Xeomin are very similar products. However, they are not identical. Dysport has a very small amount of cow's milk protein. This is not present in Botox or Xeomin. If you are allergic to cow's milk then you should avoid Dysport. It is important to understand that a cow's milk protein allergy is pretty rare and is different from the much more common problem called Lactose intolerance. Lactose intolerance is not a problem with Dysport.

Why Should a Person Not Use Dysport or Botox if They Have an Allergy to Cow Milk?

Answers (9)

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