Author: Patrick Byrne, MD FACS
Dysport is an injectable drug used to lesson wrinkles on the face. It is made of botulinum toxin type A. Dysport can reduce the appearance of lines and wrinkles by constricting the movement of muscles that it is injected into. It is the same active agent as Botox, a very popular wrinkle reducer. Dysport was approved for use in the United States in 2009.
Since Botox was approved in the United States in 2002 for the treatment of frown lines of the glabella (the area between the eyebrows), it has been an enormously popular and successful product. Botulinum toxin type A is a potent neurotoxin, and injecting it into muscles renders that area unable to move for several months. Thus, any folds or wrinkles that are created or accentuated by muscle movement can be smoothed, typically for several months duration. After several months, the muscle movement returns to normal and the lines will return unless the treatment is repeated. Over the years, the use of these neurotoxins has evolved beyond simply reducing wrinkles in the glabella. Many practitioners also use these products to alter and improve the shape and position of the eyebrows, the contour of the corners of the mouth, and even how open the eyelids are.
Dysport is FDA approved for the treatment of moderate to severe wrinkles of the glabella. The use in other areas is considered “off label.” This means that the Food and Drug Administration has not approved its use in these other areas. The FDA regulates how any drug is marketed, but does not have the legal authority to regulate the practice of medicine. Thus, a physician can legally choose the use Dysport in other areas of the face.
The mechanism of action for the two medications is the same. They may have some differences in their onset of action (Dysport may take effect more quickly than Botox) and field of effect (Dysport may constrict movement over a greater area than Botox). However, the effects are felt to be largely similar.
Anyone with moderate to severe glabellar folds or wrinkles is a candidate. It can be effective in men and women, of any ethnic background or skin type. When the creases are very deep, Dysport is less able to provide a noticeable improvement.
Dysport is injected directly through the skin, into the muscles, with a very small needle. Most patients do not require any form of topical anesthetic, as the discomfort is minimal. It is performed in the doctor’s office, takes a few minutes of time, and usually produces no visible bruising.
Dysport does not work right away. The effects begin in a day or two, and maximal effect is seen within one week in most patients.
Serious side effects are rare. The drug is contraindicated in those who have previous allergic reactions to abobotulinumtoxin A. The safety in pregnancy has not been established, so it is not recommended (category C drug). Relative contraindications include those patients with diseases of the neuromuscular junction (such as myasthenia gravis) as the drug can exacerbate underlying weakness. Certain other drugs decrease neuromuscular transmission and should be avoided in patients treated with botulinum toxin, such as calcium channel blockers, aminoglycosides, penicillamine, and quinine.
The most common side effect is the creation of a drooping “ptosis” of the eyelid or brow. This is reported to occur in about 2% of cases.