Botulinum Toxin Wars

Now that Dysport, which was going to be named Reloxin, has been approved by the FDA, you can expect to see extensive advertising by Allergan (Botox) and Medicis (Dysport) implying that theirs is the better product. Dysport has been used for years in Europe and Canada, and the differences between the products are less than the differences between fillers. Although they both have Botulinum Toxin A as their active ingredient, they are manufactured differently and there are some differences in their makeup and action.

One clear difference is in the units by which the toxin is measured. One unit of Botox equals 2-3 units of Dysport. Probably, for most areas injected, 3 units will be the equivalent dose.  The speed of onset is different in the two products. Dysport has a more rapid and sudden onset of action, when compared to Botox. It is also roumored that in comparable doses, Dysport lasts slightly longer than Botox, perhaps by several weeks. Some studies suggest that Dysport spreads further from the site of injection. In some cases this can be an advantage, as when treating increased sweating (hyperhidrosis) on the hands, feet and armpits. This feature can also be a disadvantage, since the most common side effect of Botox (a droopy upper eyelid) is most commonly due to unwanted spread of the Botox. In theory, at least, this could be more of a problem with Dysport. The reaserchers studying Dysport that I have questioned about this say this is not a significant problem. Only time will tell.
The most noteable difference between Dysport and Botox may well be price. Botox is a well established product and Mentor will probably price Dysport lower than Botox. The rumor is that Dysport will cost physicians 10% less than a comparable vial of Botox. At least some physicians will pass that discount on to patients.

Gerlad N. Bock MD
California Skin & Laser Center
Stockton & Lodi, CA