In addition to Botox, the original botulinum toxin, we now have two other FDA-approved neurotoxins: Dysport and Xeomin. All botulinum toxins work the same way—by inactivating motor nerve endings where they interface with muscle cells. Inactivated nerve endings are unable to transmit the signal to the muscle that stimulates muscle contraction; thus, the muscle becomes paralyzed. Paralysis of undesired muscle activity, such as frowning and squinting, significantly improves the corresponding wrinkles in the frown line area (between the eyebrows) and the “crows feet” area (to the side of the eye). The neurotoxin effect is temporary, however, because within a few months the nerve cells generate new nerve endings, which are able to restore the muscle activity. Patients usually require additional treatment after 3 to 4 months.
Botulinum toxins are proteins that are produced naturally by Clostridium botulinum bacteria. One of these bacterial toxins is the basis for Botox, Xeomin, and Dysport. There are minor chemical differences between these three products based on their respective manufacturing processes. In clinical practice, Dysport usually inactivates the targeted muscles more quickly (within 2 to 3 days) compared to Botox (within 3 to 5 days). In most patients, the duration of the effect of Dysport is longer than that of Botox. There seems to be individual variation, however, because some people find that Botox has a longer therapeutic effect then Dysport.
Worldwide, Dysport is the most commonly used neurotoxin and its use is “catching up” to that of Botox in the United States. At the Langdon Center we use both Dysport and Botox. If you’ve never tried Dysport you may want to give it a try—you might find that it acts faster and lasts longer than Botox.