This is an article about the differences between BOTOX, BOCOUTURE and DYSPORT, the three types of Botulinum Toxin Type A available for cosmetic use in New Zealand. For information about wrinkle relaxing treatments at Wellington Cosmetic Clinic please click here
BOTULINUM TOXIN TYPE A
In New Zealand patients commonly ask for BOTOX injections for treatment for their lines and wrinkles. BOTOX itself is the brand name for a specific form of the medicine, rather than the name of the medicine itself which is called Botulinum Toxin Type A (often abbreviated to BTx).
BOTOX was the first Botulinum Toxin to be licensed for cosmetic use to treat glabella lines and is therefore probably the most well-known, however other Botulinum Toxin Products are also available, It’s a bit similar to Hoover being synonymous with a vacuum cleaner, when Hoover is just one company that makes a vacuum cleaner.
SO IS THERE ANY DIFFERENCE BETWEEN THEM, DOES IT MATTER WHICH BRAND IS USED?
In one sentence, yes there are slight differences and no, it does not matter which brand is used.
Firstly, all the forms contain the active medicine, Botulinum Toxin Type A. This medicine is a biologically active medicine made by a process called fermentation. It is produced by a bacteria (clostridium botulinum) and each company that produces the medicine uses the same strain of the bacteria, meaning the active part is identical between different formulations. The differences between them are in the manufacturing process that extracts and purifies the medicine, and in the excipients (other added ingredients) in the finished product.
What that means is the different brands, whilst having the same active component, have different amounts of the non active proteins mixed in.
The amount of the additional proteins can be measured in terms of the weight of a complex, the complex being the active molecule and its associated proteins.
- For BOTOX the complex weighs 900 kD*
- For Dysport the medicine seems to be a combination of two different complex sizes, one of 600 kD and one of 300 kD*
- Bocouture weighs in at 150 kD*, this is the weight of the active component itself meaning that the Bocouture preparation has no additional complexing proteins in the mix, containing only the active compound.
* kD stands for kilodalton, which is a measure of weight used for molecules
The other difference other than the amount of actual protein, or biological material in the vial is the excipients. These are other things added to the vial to help maintain the stability of the medicine before it is reconstituted and injected.
BOTOX has added Human Albumin and Sodium Chloride, BOCOUTURE contains Human Albumin and Sucrose, whilst Dysport contains Human Albumin and Lactose Monohydrate.
None of the excipients have any medical or biological activity.
SO THAT IS THE DIFFERENCES, WHAT ABOUT THE SIMILARITIES?
There have been numerous studies performed to assess the differences between the different preparations, and there is the wealth of anecdotal evidence collected as expert opinions from doctors who have performed thousands of treatments. The duration of effect has been studied, the side effect profile, the spread, the diffusion, patient and practitioner satisfaction. So far, no significant reproducible difference in the clinical effect between all three preparations has been identified.
For the patient, there is no significant clinical difference between the formulations, they are all good! The important thing is to make sure your practitioner is familiar with the formulation they are currently using. At Wellington Cosmetic Clinic we have experience with all three formulations and currently use mainly BOCOUTURE because, not only does the superior purity of the product produce exceptional results for us, this purity, with less proteins and additives indicates for a far lower risk of adverse reaction. We are happy, however, to use another preparation at the patients request.
If you would like to know more about the products we use at Wellington Cosmetic Clinic contact us on 04 385 9555 / 0800 111 111 or on firstname.lastname@example.org.
REF: Content of Botulinum Neurotoxin in Botox / Vistabel, Disport / Azzaulre, and Xeomin/Bocouture. Jurgen Frevert, Drugs R D, 2010 jul; 10(2) 67-73