Who hasn’t wished they could freeze time—or at least make it look that way when it comes to their face? There’s a reason those wanting to hit pause on aging have turned to neuromodulators, like Botox and Dysport, which are wrinkle-relaxing injections.
“In aesthetic medicine, botulinum toxin type A is most often used to reduce the appearance of fine lines and wrinkles caused by facial expressions (think: frowning, squinting, smiling, and the like) by injecting it into the muscles underlying the affected area,” explains board-certified facial plastic surgeon William A. Kennedy III, MD. “In turn, the lack of muscle contraction prevents the face from forming lines and wrinkles. The result is smoother skin until it wears off.”
So how do Botox and Dysport work, exactly? “They are both neuromodulators, which means they affect the transmission of signals from the nerve to the muscle,” says board-certified facial plastic surgeon Amir Karam, MD. “What this means in simple terms is they both block the signal to the muscle so the muscle doesn’t work or is weakened. They both work in the exact same way using slightly different molecules to block the transmission at the neuromuscular junction.”
Can’t decide whether Botox or Dysport is best for you? We asked Kennedy and Karam to break it down. Read on for what they had to tell us.
Meet the Expert
What Is Botox?
Botox is one of many trade names for botulinum toxin type A (BoNT-A), which is naturally produced by the bacterium clostridium botulinum, explains Kennedy. “When injected, it blocks the ability of nerves and muscles to communicate in the area where treatment is administered. By preventing nerve signals from reaching the muscle, a flaccid paralysis is induced, resulting in little to no movement.”
So, what makes Botox different from the other neuromodulators out there? It is formulated with unique protective proteins, according to Kennedy. It’s FDA-approved to treat the glabellar lines, horizontal forehead lines, and crow’s feet around the eyes. Botox goes more than skin deep, as it’s also FDA-approved to treat more than aesthetics, including chronic migraines, overactive bladder, hyperhidrosis, and cervical dystonia.
What Is Dysport?
Dysport is the brand name for another type A botulinum toxin, called abobotulinumtoxinA (ABO). “Dysport features the same primary active ingredient as Botox, but the added proteins in the Dysport formulation make its molecular weight slightly lower,” Kennedy says. “Due to this slightly less heavy and potent formulation, Dysport may be better for treating larger areas of concern such as the forehead. Some people feel that they experience a less ‘frozen’ aesthetic with Dysport. It is FDA-approved to treat facial wrinkles and for therapeutic uses like limb spasticity.”
How They're Similar
For starters, botulinum toxin type A is the primary active ingredient in each product. “And, while BoNT is considered one of the strongest and most lethal toxins discovered to date, small doses have the ability to temporarily paralyze muscles for cosmetic effect,” Kennedy says. “They are used to reduce the appearance of fine lines and wrinkles caused by facial expressions by injecting them into the muscles underlying the affected area.”
Dysport and Botox work the same way to smooth fine lines. “They can weaken the strength of muscle contraction thereby reducing the severity and depth of the crease in the upper face or other affected muscles, reducing the formation of a static wrinkle (a wrinkle that is there even when you aren’t moving your face),” Karam says. “That is the whole point: Soften the lines and prevent dynamic wrinkles from becoming static ones.”
The potential side effects for Dysport and Botox are similar. The most common ones are temporary bruising, pain, and redness at the injection site. It is also possible to experience dizziness, weakness, or headache. These symptoms usually resolve within 12 to 48 hours. While rare, Kennedy cautions that it is possible that the toxin may spread beyond the treatment area, which could lead to botulism-like symptoms including trouble breathing and swallowing, muscle weakness, and slurred speech.
To minimize the potential side effects, icing right after getting injected greatly minimizes swelling and bruising; discontinuing certain medications and supplements that increase bleeding in the days leading up to treatment can also reduce the possibility of bruising. Karam recommends avoiding lying down for at least four hours after being injected and holding off on exercising until the next day.
Post-treatment care for Dysport and Botox is also similar. “How you take care of your skin in-between appointments is key,” Kennedy says. “I recommend all my patients develop a consistent skincare regimen that includes, first and foremost, a daily sunscreen with SPF 30 or higher. From there, using skincare with active ingredients that stimulate collagen production and increase cell turnover (like vitamin C, retinol, and hydroxy acids) will keep the skin healthy.”
The results from Dysport and Botox will last about the same amount of time. “It’s typically three to four months but this is dose-dependent,” Karam says. “Lower doses won’t last that long but a max dose can only last three to four months in most people. In other words, more doesn’t mean longer and longer duration.”
How They Differ
Dysport and Botox don’t really function differently, Karam says. “They only differ at the molecular level because they are slightly different structurally,” he explains.
Since they are made by different manufacturers, that leads to different costs, formulations, and dosages. “While the active ingredient in each product is botulinum toxin type A, they also feature protein blends that may affect the diffusion and efficacy of the injection,” Kennedy says. “This is why it is important to find a provider who is well versed in the market. I personally prefer to use Botox for the majority of my patients, but each neurotoxin has subtle differences that may be more or less appealing to some. Dysport is believed to have a slightly faster onset time than Botox (about two to three days compared to three to five). For people who find that one neuromodulator is no longer producing the desired effect, switching to one of the others may help.”
Picking the Right One For You
The best way to determine whether Dysport or Botox is right for you is by asking the experts. “All cosmetic neurotoxins on the market today have similar safety and efficacy profiles, but subtle differences do exist that may make one a better option for you,” Kennedy says. “Meeting with a physician for a consultation in order to address your specific goals is key to finding the best treatment option.”
The Final Takeaway
“It’s really like Coke and Pepsi—very similar,” Karam says. “The dosing units are different but that is a technical point, not a consumer-level difference. Sometimes Dysport can diffuse more, which may be better for forehead lines, but you don’t necessarily want to diffuse in specific areas like the crow’s feet or upper lips. Both are excellent. Use whatever has been working. You don’t need to switch from one to the other. If you are starting out, seek an excellent injector, not someone who uses one or the other. Both will give excellent results in experienced and capable hands.”
Botulinum toxin risks and safety. American Society of Plastic Surgeons.
Hamman MS, Goldman MP. Minimizing bruising following fillers and other cosmetic injectables. J Clin Aesthet Dermatol. 2013;6(8):16-18.