What You Need to Know About Botox / Dysport
By Stephen M. Schleicher, MD, Director, DermDOX Center for Dermatology
Botox, approved for cosmetic use in 2002, is now the
most widely utilized cosmetic procedure in the United States with millions of
injections administered each year. The simplicity of administration, rapidity
of results, lack of serious side effects, and high degree of satisfaction has
combined to revolutionize the field of minimally invasive aesthetic procedures.
Botox
is a toxin produced by bacteria. Injected in dilute amounts it results in
temporary paralysis of superficial muscles. The drug is FDA approved for the
temporary correction of forehead frown lines and wrinkles about the eyes
(crow’s feet). Botox is administered through a tiny needle; the entire
procedure takes minutes and entails minimal discomfort. Desirable results are
obliteration of unsightly, age-related lines within hours to days after
injection. The effect lasts four months on average. Off-label Botox is used
about the mouth and even on neck muscles, but the results in these locations
are variable.
Side
effects of Botox are uncommon and include headache and eyelid drooping. The
latter, medically termed ptosis, is a temporary but disconcerting nuisance that
may last anywhere from a few days to a few weeks.
The
cost of Botox varies. Some providers (doctors, nurse practitioners, physician
assistants) charge based on areas treated, others by the amount (units)
administered. One vial of Botox (one hundred units) costs the provider hundreds
of dollars. A recently approved competitor to Botox is Dysport, which acts in a
similar manner. Competition is good, and the consumer can expect additional
botulinum toxins (Xeomin and PurTox are on the horizon) and, best of all, more
favorable pricing.
In 2009 the FDA added a black
box warning of possible serious side effects related to use of Botox and
Dysport. Given the millions of injections and the rarity of adverse events, it
appears that serious reactions have only occurred as a result of off-label use
for certain chronic disease states, not for the treatment of wrinkles and
lines. Nevertheless, finding a well-trained, experienced health care provider
to administer botulinum toxin is always a wise decision.