Botox vs Dysport: Which Wrinkle Relaxer Is Right for You?

Botox and Dysport are different brand names and formulations of the same active ingredient—botulinum toxin type A. They work similarly, though studies show that they tend to exhibit slight contrasts in performance.

Both have FDA approval for treating various conditions resulting from muscle hyperactivity or overuse, including some facial wrinkle types.

Should you choose a wrinkle treatment as if you were just picking between grocery items? With a lot more than just cosmetic transformation on the line, probably not, and we explain why in this article.

What’s in a Botulinum Toxin Injection?

Botulinum toxin is produced by Clostridium botulinum, a bacterial species that frequently contaminates canned food. It blocks the release of acetylcholine, a nerve chemical that controls various body processes.

In the skin, acetylcholine regulates oil and sweat secretion and contributes to the sensation of itchiness. It also stimulates muscles to move, including the ones in the face. Skin folds arising from repeated muscle movement are called “dynamic wrinkles.”

The active ingredient of Botox and Dysport is the naked protein botulinum neurotoxin type A, which has a molecular weight of 150 kilo-Daltons (kDA). Newly synthesized botulinum toxin contains a mixture of different size proteins, and processing variations render different versions of the neurotoxin.

In large doses, botulinum toxin causes botulism, a potentially fatal condition resulting from paralyzing the head and neck muscles. Much smaller doses are used for medical applications, so the treatment is generally safe for intended users.

What Is Botox?

Botox is a botulinum toxin version with a molecular weight of 900 kDA. It is manufactured by the American company Allergan, and their processing method ends up with the neurotoxin coupled to a bigger protein molecule. Each Botox vial has 100 units of this protein complex in a medium containing human albumin and sodium chloride.

The FDA approved Botox cosmetic treatments in 2002, although doctors were already using it for relaxing severe muscle spasms long before that.

Where on the Face Can You Inject Botox?

The FDA approved Botox treatment for moderate to severe wrinkles in the following areas:

• Glabellar lines or the frown lines between your eyebrows
• Forehead wrinkles
• Crow’s feet or the fine lines beside the eyes

These facial wrinkles often result from years of repeated muscle contraction.

Another FDA-approved dermatologic application of Botox injection is excessive sweating of the armpits.

However, doctors with vast expertise using this drug may use it “off-label,” or without FDA approval, for other conditions and in other body areas.

For instance, acne and some forms of “static wrinkles” may respond to Botox. Static wrinkles are those fine lines that persist without muscle movement and result from reduced collagen and elastin.

Off-label drug use is totally legal but should only be entrusted to highly-skilled, board-certified medical professionals.

What Is Dysport?

Dysport is made of protein complexes of different weights, ranging from 500 to 900 kDA. You may think of it as a “lighter” version of Botox. The European company Ipsen manufactures Dysport using a different processing technology. Each vial of this drug has 300 units of the protein complex along with human albumin, cow protein and lactose.

Where on Your Face Can You Get Dysport?

The FDA approved Dysport treatment for moderate to severe wrinkles in the glabellar area in 2009. Currently, its only other authorized use is the relaxation of muscle spasticity in the neck (cervical dystonia) and limbs.

Dysport is not approved for other wrinkle types, although an experienced dermatologist may also use it off-label for such blemishes.

In What Ways Are Botox and Dysport Similar?

Botox and Dysport are both powerful nerve signal blockers and muscle tissue relaxers. They have the same neurotoxin core, so many parts of these treatments are essentially the same.

Pretreatment Care

Your doctor will give you a full medical examination to make sure that the procedure is safe for you and will give you the best possible results.

Pretreatment recommendations for bruising-prone individuals are basically the same. Your dermatologist may advise you to avoid blood thinners a few days before your session. You may also start taking bruise-preventing supplements like arnica and bromelain at this time.

You may apply an ice pack on the treatment area 15 minutes before Botox or Dysport injection to minimize discomfort and bruising.

What to Expect During and After the Treatment

The injection procedure for both drugs usually takes only a few minutes. Their aftercare regimen and side effects are also similar.

You may check out our article on the Botox recovery process for more information about these parts of the treatment.

Botox vs Dysport: What Are Their Key Differences?

Botox and Dysport may have the same active ingredient, but their formulation disparities seem to impact their clinical performance.

Which Facial Muscle Relaxant Acts Faster?

Studies show that Dysport beats Botox in this respect. But the difference is not that great because it’s only by half a day on average. Most patients observe skin changes by the third day after injection of either drug. Some experts believe that Dysport’s lighter weight and, consequently, greater tendency to diffuse may be the reason for this finding.

Of note, both reach their peak effects at about the same time, which is 2 weeks after injection.

Which Lasts Longer, Dysport or Botox?

Research has also shown that Dysport’s effects last longer than those of Botox, the difference being 2 weeks on average. Botox relaxation lasts 3-4 months for most patients, but a duration of 5 months has been more frequently reported for Dysport.

One possible explanation is the difference in their immunogenicity or the ability to induce antibody formation. Antibodies can destroy and inactivate botulinum toxin. Lighter protein molecules dodge the immune system more effectively, and this may be why Dysport has an apparent advantage.

Additionally, Dysport was also found to have greater specific neurotoxin activity per unit weight. Simply put, a gram of Dysport paralyzes more than a gram of Botox.

Which Neurotoxin Formulation Is More Effective?

Split-face studies reveal that more patients are more satisfied with the cosmetic appearance of Dysport-treated areas than those injected with Botox. Clinical observers likewise report that Dysport-injected sites tend to have fewer wrinkles than those treated with Botox.

Which Is Safer, Botox or Dysport?

There are some concerns about Dysport’s faster rate of diffusion and potentially greater side effect risk, specifically, spreading to distant muscles and causing botulinum toxicity. But studies do not support this possibility. Moreover, it is not typically observed at the FDA-recommended doses.

However, patients allergic to cow’s milk or meat are better off avoiding Dysport since it contains cow proteins.

Other Dysport contraindications are similar to those of Botox, which we mentioned in our article on Botox treatment recovery.

How Many Units of Dysport Are Equivalent to One Unit of Botox?

Botox and Dysport units are not interchangeable because their chemical properties are different, and field experts believe that this influences their clinical effects. But for purposes of discussion, you may use what studies have found—that 2-3 Dysport units yield comparable results to 1 Botox unit.

Which Wrinkle Treatment Is Cheaper?

Dysport treatment is generally less pricey. You may use the table below to estimate the costs. Total charges differ from area to area and from doctor to doctor.

Here is a table summarizing the clinically relevant differences between Botox and Dysport.

Regardless of what wrinkle treatment you get, remember that you don’t have to make the decision alone. You can trust your beauty injection specialist at BHSkin Dermatology to answer all your questions about skin health.

Botox vs Dysport: Which One Is Better for You?

Despite what studies say, the one that looks better on paper may not necessarily be the better choice for you.

Everyone has a different treatment response, set of allergies, immune sensitivity and what have you. Besides the cost, the sum of these medical factors should weigh heavily when you make your decision.

You must also consider your doctor’s expertise in using these drugs. Botox has been in the market longer than Dysport. You can expect more doctors to be more comfortable using the former than the latter.

Looking Younger Does Not Have to Be Painful or Expensive

You don’t have to see a plastic surgeon to take years off of your face. Inexpensive cosmetic injectables like Botox and Dysport are scientifically proven to be effective in treating fine lines and coarse wrinkles. And our award-winning skincare professionals at BHSkin Dermatology are experts in both treatments.

Don’t wait long to get back the gorgeous, youthful you. Book your appointment today at our Glendale or Encino clinic or our virtual portal.

Sources:

1. https://doi.org/10.1155/2013/686329
2. https://doi.org/10.1111/j.1524-4725.2008.34375.x
3. https://dx.doi.org/10.1007%2Fs13555-013-0033-y
4. https://doi.org/10.1016/j.toxicon.2009.03.020
5. https://www.aafp.org/afp/2014/0801/p168.html

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online