Move over Botox Cosmetic™ , there’s a new wrinkle fighter in town! Approved in Spring 2009, Dysport® was recently made available in the US through Medicis, the company that manufactures Restylane. Dysport has been approved and used all over Europe and Asia for ten years to prevent wrinkles, and showed significant clinical safety and efficacy. Only recently has it made is way into clinics here in the US.
So what’s the difference between Botox Cosmetic and Dysport? Dysport is a type A botulinum toxin that was approved by the FDA for the improvement of lines in the glabellar complex (the “frown lines”). The main difference between the two is how they are purified. Botox is purified by repeated precipitation and redissolution, and Dysport is done by utilization of a column separation method. Because of the differences in this purification process, it affected how the protein complex that surrounds the neurotoxin (the protein “coat”) in Dysport acts. Essentially, the active part of Dysport and Botox are housed in a protein coat, and the purification process affected how these coats “shed” once introduced into a muscle. I like to compare them to regular M&M’s and Peanut M&Ms. In this sense, Dysport acts kind of like the regular M&M, whose coat is much thinner, and Botox similar to the thicker peanut M&M. Because of the differences in these coats, Dysport acts a little faster, and spreads out a little more to surrounding areas than does Botox. Also, there’s a difference in reconstitution. One vial of Botox yields 100 Units when reconstituted in 2.5 mL of normal saline (Dose= 4 Units per 0.1mL), while 2.5 mL normal saline yields 300 units of Dysport per vial (Dose= 10 Units per 0.08 cc mL). While this may seem as if you get more bang for your buck with Dysport, this isn’t necessarily so, considering the fact that 1 Unit of Botox will work the same as 2.5 – 3 Units of Dysport.
So which is better? There’s really no telling which toxin is superior to the other. After all, both practically work the same way. I guess it depends on the area that needs to be treated. For areas like crow’s feet and upper forehead lines should be treated with something that spreads out a little more for greater softening effect, so Dysport might be a the winner here. On the other hand, pinpoint areas such as “smoker’s lips” or areas nearer to the brow line might work better with Botox because you may need more precision. Personally, I think this wrinkle-fighting war is a stalemate, as both Dysport and Botox are expected to work together to achieve frown-less faces everywhere.
Principles of Cosmetic Dermatology. Baumann, 2009.
Botox vs. Dysport IAPAM Discussion. www.iapam.com