It’s the big one. Botox versus Dysport. In Autralia, practitioners are not allowed to advertise what products are used when it comes to wrinkle relaxing injections. Cosmetic medical practitioners can only advertise ‘wrinkle relaxers’ ‘anti-wrinkle injections’ ‘cosmetic injectables’ and so on…which is why some confusion often arises when it comes to what you are actually paying for when you book in for these procedures.
So here is some background information regarding the commercially available products.
Botulinim toxin type A is a highly purified toxin which acts as a muscle relaxant and works to block the transmission of messages between a nerve and a muscle cell. The use of Botilumin toxin to relax and reduce muscle contraction leads to the decreased appearance of wrinkles and lines and hence prevents the formation of new ones.
Since its introduction into cosmetic practice over 20 years ago, botoulinim toxin type A has been developed and modified by a number of companies into the forms we see available on the market today. Due to Australia’s strict regulations governing the advertising of schedule 4 medications (prescription only medications) doctors are not allowed to advertise the brand of wrinkle relaxer used in the treatment of lines and wrinkles. Unlike the US where billboards and TV adds are plastered with brand name pharmaceuticals.
There are three products available in Australia currently, all of which have passed the strict criteria from the TGA and all of which are safe and effective in their treatment of dynamic lines. The most common brands which clients often want to discuss are Botox and Dysport.
Many clients want to know what the superior product is – what will last longer? What will give the best results? What is the best value for money?
However it needs to be known that comparing these products is difficult because they are actually very similar (they are both botulinum toxin type A – as is the third product on the market Xeomin) and it often just comes down to personal preference. A bit like comparing Pepsi and Coke.
Botox is the market leader in that it was the original brand and has been used globally since its approval for cosmetic use in 1989 (it was made available in 1999 in Australia). It is manufactured by Allergan, Dysport on the other hand was approved globally in 1999 and soon after in 2000 for use in Australia. It is manufactured in Europe and distributed by the dermatology company Galderma. Xeomin is the third approved botulinim toxin which is made in Germany and distributed by Mertz.
So like mentioned previously these products are all made of botulinim toxin type A and only differ very slightly in their chemical composition. When used correctly – with the correct dilution and injection volume – the results and longevity are almost identical. There have been hundreds of clinical studies comparing Botox and Dysport, including half face studies where the same person is treated with both products and the results remain very similar.
Dysport v Botox
Onset of action
Dysport works slightly quicker with results evident within 2-4 days (often as early as 24hrs) whereas Botox takes slightly longer with effects seen in 7-14 days. However both products show peak results after 14 days.
Longevity
Both treatments will last approximately 3-4 months if injected in the correct amounts. Dysport has been reported to last 5 months in some cases.
Diffusion of product
Clinical studies have shown that Dysport generally spreads further from the injection site. This can have benefits in less injections required eg in the forehead or negatives in that spreading of product may cause spread into other muscles resulting in side effects. Again this comes down to patient preference.
Dosages
This is where the confusion lies. Especially with many clinics charging a ‘per area’ price and then not explaining how many units are being used.
A unit is the measurement used to quantify how much product is being used to treat any area. The units of Botox and Dysport are not interchangeable. For example the recommended dose of treatment of frown lines by Allergan for Botox is 20Units, whereas the standard dose recommended by Galderma for Dysport is 50units. The end result will be the same if these doses are used.
Cost
Overall the cost of a treatment is very similar if the correct units are used. Because of the higher unit amounts with Dysport treatment this is where many clinics cut corners and given less units for a cheaper price.
In general the cost per unit of Dysport is $4-6 per unit ($200-300 for 50units for frown lines) and Botox $12-16 per unit ($240-320 for 20units for frown lines).
This also depends on the injector and clinic. Generally the conversion can be 2.5-3 units of Dysport per unit of Botox.
Side effects and pain
Theoretically because Dysport uses less injection volume (2.5ml of normal saline is used to dilute a 500unit vial leaving 200units per ml) compared to Botox (2.5ml of normal saline is used to dilute a 100 unit vial leaving 40units per ml) it is thought that the injections are slightly less painful as less fluid is injected.
The side effects are exactly the same and primarily relate to the injections (pain, bruising swelling) and the Botulinim toxin itself.
Conclusions
Overall there is very little difference between the two products. At the end of the day it really comes down to personal preference, reputation and brand recognition. As Botox has been around much longer it is the market leader however it really comes down to the skill of your injector and the correct use of the product.
Please chose carefully who you see for these procedures and ensure you know the exact quantity or what product you are receiving.