Dr. Martin's Blog

Botox vs Dysport vs Xeomin

Dysport is one of the “new kids” on the block in Canada. The brand is gaining popularity because it is very similar to Botox, but it is important to know that they are not the same.

Dysport is cheaper – costs about $300 a vial rather than $380CA. The vials are 300 units vs Botox 100 units. Since Dysport is diluted with three times the amount of normal saline, one unit of measurement on the diabetic syringe is the same for both.

At this time, the product monograph for Dysport limits its use to glabella, therefore you must explain to clients that use in any other area is “off label”. Botox has been present in Canada for longer and therefore it’s indications include all areas of the face.

There is some question in my mind about the range of effect and the appropriate dilution of Dysport. Although the manufacturers suggest that it has the same range as Botox – about 1cm, it has been my experience that it actually diffuses further, which is good news for crows feet and hyperhidrois, but one must use extra caution in glabella and forehead.

Botox is also officially indicated for hyperhydrosis. Dysport at this time is not “indicated” for hyperhidrosis. There is no question that it works well for HH – but technically it is still “off label”.

Xeomin has a lower molecular weight than either Botox or Dysport and, due to lower protein count, it has a theoretical lower risk of allergy or tolerance. In our experience, it is more similar to Botox in effect, but it has the price point of Dysport. At this point, the Canadian public is still not as aware of it, but I suspect that it will gain momentum over the next few years.

Botox vs Xeomin vs Dysport

So, all of these versions of neuromodulators are now available in Canada – how do you choose which one to use?

Well, Botox has been around for longer, so the product recognition is higher in the mind of the patient. However, Dsyport and Xeomin are cheaper. Dilemma !

They are telling us now that Dysport can be used almost interchangably with Botox, except the dilution of solution is different. My experience has been that dysport diffuses a little further than Botox, so it is a little harder to be artistic in the way that I am used to, but for the decrease in cost… maybe it is worth it.

Xeomin is “naked” botox – it is the same structure without all the extra proteins attached ot it. So theoretically, it should cause less allergic reactions. But I have seen maybe one allergic reaction to Botox in the past 8 years, so I am not too concerned abou that. Yes, it is cheaper. :)

Contact the reps and try it for yourself. For now, I am sticking with Botox, but as Dysport gets more advertising, patients will be hearing about it and asking, so you need to figure it out.

Change to Botox Needles

Medical Mart
Botox Syringe issue – July 2013
We have always ordered our Botox Needles/syringes from Medical mart.
I use A: 29 gauge 0.3 cc syringe for intradermals
B: 31 gauge 0.3cc syringe for the intramusculars, like corrugators.
The problem now is that “A” is not available unless you buy it with a safety top, which does’t fit inside the botox vial to draw up solution… Our Plan is to stock up on the 31 gauge while it is still available and buy the 29 gauge 0.5cc syringes without safeties.

Has anyone got any other ideas?

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