Botox gets competitition in war against wrinkles: Dysport

Face it, Botox. A new wrinkle reduction breakthrough is injecting some competition into the quest for the fountain of youth. 

The latest age-defying injectable is called Dysport (pronounced “Diss-port”), which the Food and Drug Administration approved for cosmetic use in the U.S. in April. 

Drawn from the same botulinum toxin A as Botox, Dysport has been used in Canada and Europe for almost 20 years. But is it better than Botox? 

Area physicians view them as virtual twins. 

“They are essentially identical,” said dermatologist David A. Amato of Lower Paxton Twp. The only difference is the solution in which they are mixed. He said Dysport might start to work faster — perhaps a day sooner than the four days that Botox takes to kick in — but the difference is almost “negligible.” 

Camp Hill-based plastic surgeon Samir J. Srouji said the only difference he sees is that Dysport diffuses slightly more than Botox, so that Dysport covers a slightly larger area, but it is virtually the “same product with the same duration.” 

Like Srouji and Amato, Peter J. Sakol, a Mechanicsburg-based ophthalmologist, plans to offer both Dysport and Botox to patients who request them.

First approved in 1989 for medical usage for the treatment of twitching eyelids and crossed eyes, botulinum toxin A was approved for cosmetic use in 1992 by the FDA to treat frown lines, Sakol said. 

Botox and Dysport injections work by blocking communication between the nerve and muscle, thereby relaxing the wrinkles that normally appear when muscles move. 

Although the squeamish may cringe at the mention of needles, Sakol said the pain is minimal. Some doctors offer ice or a topical anesthetic during the injections, but most patients have an “Is-that-all?” reaction when the session is over.

Last year, more than 2.4 million Americans used Botox. “Botox is a great product,” Sakol said. “I love it. My clients are happy, there is minimal down time, and it works so well.” 

Srouji lauded his patients’ ability to “just do it and then go back to work.”

One middle-aged woman said, “I don’t know about making me look younger, but Botox definitely makes me look more relaxed and well-rested. Now that I see how it transforms my appearance like no fancy face cream can, I don’t plan to stop or switch. It is one of the only things I do for myself.” 

The doctors expect patients to be equally happy with Dysport. Both products share similar side effects, which could include mild redness or soreness at the injection sites, and, rarely, bruising. Patients may feel slight burning sensations during the injections and experience temporary numbness. More uncommonly, a headache may strike. Serious heart problems and allergic reactions have been reported rarely. 

Sakol noted that in his 20 years of practice, he has not seen any significant problems in his patients. Amato said some of his patients have experienced minor headaches. 

So in the wrinkle wars, which product is the smoothest operator?

“There does appear to be a slightly quicker onset of action with Dysport,” Sakol said, but he emphasizes that it is really too soon to tell. Both are approved to relax frown lines for up to four months.

Amato said, “To me, it’s going to come down to pricing.” He expects Dysport to drive down prices, since Botox is no longer the only game in town.

In this region, Botox costs about $525 for a vial and Dysport, about $495. Amato charges patients between $350 and $400 an application, based upon the units delivered. But price shouldn’t drive your choice of provider.

“These days, it seems as if everyone is injecting Botox and Dysport, including pediatricians, family physicians, obstetricians, gynecologists and dentists, and there have even been ‘Botox parties,’” Sakol said. “You need to choose your cosmetic surgeon very carefully.” He cautions patients to use an experienced provider who is familiar with the products and the anatomy of the face.

“The good news is: If you don’t like the effect, it wears off,” Sakol said. “The bad news is: If you like the effect, it wears off. You have to keep doing it.”

By Body and Mind staff

September 30, 2009, 12:00AM