Dysport Vs. Botox - What's the Difference?

How is Dysport different from Botox? Is it cheaper? Is it better?

Doctor Answers 90

Dysport - new competition for Botox?

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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 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 Dysport and is currently under review by the FDA for distribution and utilization within the US.

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

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

2. Dysport has less of a protein load than Botox. Clinically this means that Dysport will result in the formation of fewer antibodies against it. Antibodies are what our bodies use to detect and destroy foreign proteins aka antigens (the injected medications). Hence the assumption is that with fewer antibodies being formed the clinical effects of Dysport 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 Dysport "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 Dysport could spread into unwanted areas causing untoward side effects (blurry vision, droopy eyebrows).

4. Dysport 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 Dysport is $300.00.

5. At this stage no significant "red flags" have been raised about the safety of Dysport. 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 Dysport 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.

New York Facial Plastic Surgeon

Botox Battles Latest Contender: Dysport

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Dysport may be new in the U.S. (on the market since only April, 2009), but it has been battling Botox head to head in Europe and elsewhere for several years already. Here's what we know so far about the battle of these big boys in the nonsurgical esthetic arena: Both Botox and Dysport are botulinum toxin type A proteins and work in a similar fashion. Dysport may be minimally less expensive, but not enough so to make any significant difference cost-wise to the consumer.

Dosing is different than Botox, but this is a technical consideration for the doctor to know and is not really relevant to the patient. Dysport may begin to work a bit faster than Botox, by as much as one to two days earlier, which may be an advantage if you have a big party a couple days later and need a really quick fix; otherwise, this isn't of much practical importance. Botox and Dysport may last about the same time, although there are some who claim that Dysport lasts a bit longer, but not significantly much longer.

The beneficial effects of both Botox and Dysport can be prolonged, sometimes for quite some time longer than the ordinary four to six month duration, by suggesting that the patient undergo a series of three or four initial treatments, spaced at four month intervals. It seems that the continual presence of the Botox or Dysport in the muscle tissue during that period "teaches" so to speak the muscles of facial expression not to contract as actively as they did before treatment. It is this learned "lesson" that is believed responsible for the more prolonged response seen in many people, even after all the toxin has been metabolized away by the body.

At least theoretically, some people who have become "resistent" to Botox, usually after repeated treatments, may respond to Dysport. I have already had one such patient in my Manhattan practice. Dysport may diffuse (spread) over a wider from the injection sites than Botox. The advantage here may be that you can treat broader areas, such as the forehead and underarms (for hyperhidrosis, i.e. excessive sweating), with fewer needle sticks.

The flip side is that tighter narrower areas, for example, under the eyes or under the eyebrows, must be carefully treated to insure limiting spread beyond the desired treatment areas. In conclusion, the jury is still not in on any significant differences between the two products other than they are produced by different manufacturers. For now, the choice of which agent you will be treated with may depend upon the doctor's comfort level and experience with each product and the particular needs of the patient.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Dysport and Botox Same but Different

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Both are the same product botulinum toxin A, a derived proteitn that works by relaxing targeted muscles. The Dysport protein is slighlty smaller so it works quicker. The differences I have seen and that are reported in the literatue include a faster onset and a cheaper price... We are getting the product cheaper so we can pass it on to the patient. Botox prices have gone up every year and now we have an equivalent or perhaps better product (initial studies showed it lasting at least 4 months) that comes in at a better price point. Dysport has been used in Europe for many years and now has arrived via Medicis the makers of Restylane and Perlane.. Be sure you see someone who is trained in injecting and knows the differences in using these products as they are diluted and dosed differently. The end result is the similar from the patient standpoint except for the pocketbook. In short, it is great to have another option and we are always looking for something better for our patients. I now use Dysport almost exclusively in my practice because patients love their rapid results and the price point.

Shawn Allen, MD
Boulder Dermatologist

Options at last!

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Dysport was FDA-approved for use in the US on April 30, 2009. At last, we have options for injectable wrinkle treatment! Dysport was originally to be marketed in the US under the name "Reloxin", but the FDA decided that the original name should be used and did not allow the new name.

Dysport and Botox are made by different companies, but they have the same basic structure and they work in the same way. There are some slight differences between the two:

1. Dysport "kicks in" a little more quickly than Botox. Botox usually takes effect after 5-7 days, while Dysport's effects are noticable as early as 1-2 days after treatment.

2. Dysport and Botox "units" are not the same, so you can't expect to use the same number of Dysport units that you are used to using in Botox units. The ratio of Dysport to Botox units is generally 2.5-3: 1 (2.5-3 times more Dysport units per Botox unit).

3. Dysport lasts at least as long as Botox does (3-4 months), but there have been some studies in Europre which show Dysport lasts longer than Botox. We'll just have to see how it plays out here in the US.

I have personally used Dysport and have found it to be quite comparable to Botox regarding results. The cost of Dysport is favorable, and I think we'll see Allergan (the makers of Botox) offering more rebates and incentives to keep people loyal to their brand.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 46 reviews

Similar But Different

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Both Botox and Dysport are injectable neuromodulators, which means they work by temporarily blocking the nerve impulses of the target muscle. The main difference between the two occurs at the molecular level and by the depth of injection. Both Botox and Dysport are made from botulinum toxin type A however, they differ by the number of proteins that surround the active molecules. Dysport has fewer proteins that surround the molecule. This is positive in two ways. First, it allows for quicker absorption by the body which ultimately means that it takes effect sooner than Botox (1-2 days vs. 3-5 days). Second, it remains active in the body for slightly longer than Botox, which means you shouldn’t have to be treated as often.

Another primary difference between Botox and Dysport is the depth of injection. Dysport injections are administered slightly deeper than Botox and as a result, tend to “spread” more easily throughout the treated area. Dysport spreads approximately 2cm further than Botox. Highly trained plastic surgeons use this to their advantage to create a more natural looking result. However, when practitioners do not use the product extensively, there is an increased chance for drooping eyelids or brows when injected in the forehead and crowsfeet. This is one of many reasons why it is essential to find an experienced practitioner for treatment.

Dysport is better in my eyes.

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Dysport is FDA approved and works great. I essentially use it exclusively. Here's why

1. Dysport takes effect in 24-48h. Compare to Botox - 4-7 days

2. Dysport last 4 months, compare to 3 months for Botox

3. Dysport is cheaper!!!!

Raghu Athre, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 94 reviews

What is the difference between Botox and Dysport

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Botox and Dysport are both Botulinum Toxin A but are made by different companies. Botox has been available for longer, but Dysport is now FDA approved and has been found to be as effective and safe as Botox. It is a bit different to use from a physician standpoint, but for the patients it is pretty much the same as Botox. Best yet, Dysport is less expensive for the same effect. This is the great thing about competition.

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 56 reviews

Botox wars

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There is no doubt that the BoNTxAs are here to stay, in the armentarium of the cosmetic provider. For those patients who have been content with Allergan's product, I haven't tried to convert them.

For those patients who specifically requested Dysport, the onset has been quicker, (averaging 48hours for full blockade) and the "smoothness" more appreciated. From the injector's perspective, Dysport is a little trickier to dose because the manufacturer suggests that a 300Unit bottle is mixed with 2.5cc saline, compared to a 100 unit bottle with 3-4cc. Hence drawing up minute volumes requires a little more attention.

The manufacturing standards of both companies is excellent, so Botox fans should celebrate. Hopefully, we will soon see price wars. good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Dysport versus Botox

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Dysport is the newest competitor to Botox in the U.S., but has been used in Europe in for several years. There's also 2 other Botox competitors currently being studied for release in the U.S., one made by Mentor and the other by Merz. All of these products seem relatively similar, with no huge differences between any of the products. Competition can only be a good thing for pricing, however, and hopefully that will become evident over the next couple of years.

That being said, the major differences between Dysport and Botox seem to be the following:

1) A faster onset of effects is noted with Dysport in about 30% patients. Whereas Botox may take 3-7 days to take effect, some patients who receive Dysport see effects in a day.

2) Some studies indicate a slightly longer duration of effect, but not all of them. Clinical experience in the U.S. over the next several months will help guide consensus on this.

3) Dysport is slightly cheaper. The cost per bottle to the physician is about 5-10% less.

4) The dosing for Botox and Dysport is different. A Botox unit is not equivalent to a Dysport unit. The converision is approximately 2.5 Dysport units to 1 Botox unit, but there is some variation between the upper and lower face.

Hope this helps! Best of luck!

Dysport vs Botox

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This is a hot topic because Dysport is soon likely to receive FDA approval and be widely available.

Dysport is currently being used in Europe.

Dysport consists of the same basic ingredient as Botox which is Botlulinum Toxin A. This would be similar to asking what is the basic difference between Bayer Aspirin, Bufferin, Excedrin, Anacin, etc.? The answer is that they are all basically the same: Aspirin.

In a recent study, Dysport was shown to last of equal duration during multiple injections. However, in another, it was shown to spread farther than Botox when injected. This is both an advantage and disadvantage. In large muscles such as the forehead, you want the toxin to spread whereas in small muscles you do not want it to spread because it could affect neighboring muscles unfavorably.

Johnson and Johnson will soon be releasing another toxin named Purtox.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.