Botox vs. Dysport

By Warren B. Seiler III MD

Overall, Botox has a greater efficacy and greater patient satisfaction than Dysport. 

The following 7 points from published journal articles point out the main reasons why:

  1. Botox lasts longer: most studies show that with adequate treatment dosing amounts of both, Botox will last three months or longer (greater efficacy), while Dysport begins to quickly fade after about 8 weeks. And, at weeks 12 and 16, the number of patients needing re-dosing with Dysport double those needing re-dosing with Botox.
  2. When asked how attractive patients felt and how satisfied they were, Botox patients are consistently more satisfied at 16-week follow-up.
  3. While both products are well tolerated with no significant difference in pain or downtime, Dysport (in adequate treatment doses) “spreads” more and is more difficult to keep localized. Therefore, there is a higher incidence of side effects with Dysport such as “heavy brow” and lid ptosis (aka “dropped eyelid”). This also occurs more with Dysport when more of it is used per dose to attempt longer lasting effect (i.e. when trying to get it to last as long as Botox).
  4. Botox has a higher efficacy with both the 2.5:1 Dysport:Botox ratio (where Dysport doesn’t last as long) and with the 4:1 ratio attempting longer lasting treatment which increases risk of complication (“frozen look” or “heaviness”).
  5. As stated above, Dysport “migrates” more so there is risk of other areas receiving effect without desiring effect in those areas (i.e. heavy brow or lid ptosis)
  6. Botox results in lower exposure to neurotoxin protein than Dysport. This results in a lower potential for antibody development (loss of result).
  7. Areas where there is not much difference:  there is no significant difference in pain during injection, immediate redness and swelling, or cost.

In conclusion, studies show that Botox lasts longer, has been FDA approved longer, is not more expensive, and is more locally controllable in regards to spreading, and has an overall higher patient satisfaction than with Dysport.

Lowe P, Patnaik R, Lowe N. Comparison of Two Formulations of Botulinum Toxin Type A for the Treatment of Glabellar Lines: A Double-Blind, Randomized Study.  JAAD Dec 2006, Vol 55, Number 6: :975-980.

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