Dysport® vs. Botox® – Which is better for wrinkles?

May 8, 2018

You’ve probably heard of Botox®, so what is Dysport®?

Dysport® is a newer competitor of Botox®, distributed by McKesson – the same company that distributes the popular dermal filler Restylane®. Dysport® was approved for use by the FDA in 2009, however, it has been available in Europe and other countries since 1990. Dysport® is very similar to Botox® but there are some slight differences that may make it a preferred choice in the reduction and elimination of facial wrinkles.

Dysport® is administered in exactly the same way as Botox® – via injection with a very fine needle into facial muscles. However, as with all injectables, the injection technique and skill level of the provider is as critical as the product itself to ensure the best final result. Your provider must also be aware of the subtle differences between the two products to ensure they use correct injection technique. For example, Botox® and Dysport® are not dose-equivalent products and require the provider to understand the standard dosing equivalent ratio to ensure a correct and safe dose of each product is used.

There are many similarities between Dysport® and Botox®.

The basic function and active ingredient in Dysport® and Botox® are essentially the same. But each brand has a slightly different formulation of the same active ingredient — botulinum toxin A – which is injected into the muscles of the face and neck, causing those muscles to relax, resulting in smoother skin and a reduction in the appearance of fine lines and wrinkles.

Both products work by preventing the release of the neurotransmitter acetylcholine, disrupting the communication channel between the nerve and the muscle. The muscle causing the wrinkle then relaxes, and the skin becomes smooth. Over time, this effect wanes, and the muscles regain the ability to contract, causing the fine lines to form again. Both Dysport® and Botox® are temporary and require repeated treatments approximately every 3-6 months.

What are the differences between Dysport® compared to Botox®?

The differences between the two treatments can be summarized by comparing their characteristics:

Onset and longevity of treatment: Dysport® has a faster onset of effects, 2-5 days, compared to 4-7 days for Botox®. For each product, the anticipated time for the results to achieve a final full effect is approximately 3-4 weeks. The more rapid onset of action by Dysport® was initially discovered in the clinical trials, and has since been replicated in studies looking at patient reports of onset of action occurring in 1-2 days, and average onset of action in 3 days. As for duration, Botox® treatment effects may last up to 3 – 4 months, while the Dysport® treatment effects may last up to 4 months.

Diffusion into skin: When Dysport® was first debuted, there was much discussion that the “diffusion” circle of Dysport® was greater than that of Botox®, and that it would cause significant problems including brow or lid ptosis or other side effects. This was based on studies done on hyperhidrosis, in which the products were injected into the skin, not the muscle. Subsequent studies have not shown a significant difference in the diffusion circle of the two products if equivalent doses and identical injection techniques were used.

Dosage: Just as with any medication, not all dose measurements of medications in the same drug class are identical, as the process by which each company determines dose and efficacy is proprietary to each company. Because the two products were manufactured by two different companies, there is a difference in the measurement of units between the products. As such, the two products are not unit for unit interchangeable with each other, and a standard dose equivalence ratio that ensures the same efficacy and safety between both products is a clinical standard. It is important for your clinical provider to understand this dosing equivalence ratio and utilize it correctly and safely to ensure the best treatment outcome for you based on the product you choose.

Dilution: Both products require the provider to instill a small amount of normal saline to reconstitute the product, both of which are contained in a glass vial as a dry powder or film. Each provider may reconstitute the products to their own preferences and may choose a different diluent volume for each product depending on their injection preferences and practice. Although there are some standard guidelines for reconstitution, it is well known that if more diluent was used, then more volume of product must be placed in order to ensure that the correct number of units of the product has been placed. This holds true for both products. Our office uses the smallest diluent amount possible to allow small volumes of concentrated product to be injected. By doing so we can ensure very accurately that a correct dose of the product is administered. It is very important for your provider to understand how to properly reconstitute each product in such a way that you receive an appropriate dose of either product and to ensure that you do not experience side effects.

So which is better? Dysport® or Botox®?
Although there are differences between Dysport® and Botox®, there are also many similarities. They contain the same active ingredient, both require reconstitution and must be injected accurately and safely. Many of our patients develop a preference for one over the other depending on their experience with either product. In our office, we typically will have a new patient begin treatment with Dysport®, as there is a possibility that the effects will be seen sooner, and possibly last a bit longer. If a patient is no longer realizing the same aesthetic benefits from one product that they were previously experiencing (ie: doesn’t last as long, reduce the lines as much) then we will typically change to the alternate product to see if that will remedy the issue.

Ultimately, your provider will assist you with deciding on which treatment is best suited to your needs. You may even need to have a combination of both depending on the desired results. At our clinic, your treatment will be performed by Jennifer Fick, FNP-C, CANS, a Board Certified Aesthetic Nurse Specialist. You can read more about Jennifer here, or on her personal website.