Previously, we talked about the history of both BOTOX® and Dysport®, and how each of these products actually work once they’re administered to a patient. In the second post of our three-part series, I’d like to shift focus and talk about the FDA-approved cosmetic uses of both products. It’s also going to be helpful to compare these uses to other cosmetic treatment options.
What Does FDA Approval Mean?
First, let’s discuss what we mean when we say a product or medical device is “FDA approved”. The Food and Drug Administration has been tasked with protecting public health by overseeing human and animal drugs, medical devices, cosmetics, food (for human and animal consumption), and other products (1). Not all of these products go through the pre-market approval process – that is, the FDA doesn’t look at the safety of certain products, like cosmetics, before they go to market. When we talk about products like Botox and Dysport, however, we’re talking about drugs that went through rigorous testing in order to prove that they were safe to use on humans.
The FDA has high standards, and while the agency doesn’t actually develop new drugs or products themselves, it does review the results of laboratory, animal and human testing in clinical trials before granting approval on any new drugs. If a product is given FDA approval, it means that the benefits of using the product on human beings outweighs the risks associated with its use.
As we learned before, Botox was approved for use by the FDA on April 15, 2002. Dysport wasn’t approved for use in the USA until April 29, 2009.
Cosmetic Uses of Botox and Dysport
Conveniently, both Botox and Dysport have been FDA approved for a variety of uses, many of which are not strictly cosmetic in nature. We’ll focus on the products’ cosmetic uses.
Let’s start with Botox. This prescription medication is used to treat several types of cosmetic problems, and procedures using Botox are usually quick and minimally invasive. During these simple procedures, the product is administered by an injection under the skin, using extremely small needles targeting the area being treated. Commonly, Botox is used to treat glabellar lines – those moderate to severe frown lines that appear between the eyebrows. These frown lines are caused by repeated muscle contractions from frowning or concentrating. Botox is injected directly into thesemuscles between the eyebrows at five specific points, causing them to be temporarily paralyzed (2). This results in a reduction in appearance of these lines.
When we squint to see something better, the muscles around our eyes contract and, over time, can produce crow’s feet. These are the little lines and wrinkles that can appear at the corner of each eye. To eliminate these lines, at least temporarily, Botox can also be injected around the sides of the eyes to smooth out the skin and improve the look of crow’s feet. The product is administered to the muscles on the side of the eye in a series of three small injections.
In a cosmetic sense, Dysport is also used to treat moderate to severe frown lines. It’s also administered in a series of five small injections into specific muscles between and above the eyebrows (3). Just like with Botox, this temporarily paralyses the muscles and prevents their contraction, which smooths out the skin.
Other Treatment Options
So how do Botox and Dysport stack up against other cosmetic treatments? There are many alternatives to both products, but since every individual is unique, there is no one size fits all answer to the best solution for you. There are benefits and risks to any cosmetic treatment, and a thorough discussion with your healthcare provider is necessary in order to determine the best option for your particular concern.
First, let’s talk about topical products that can be used to reduce the appearance of wrinkles. There are many different facial creams that are marketed to reduce the appearance of facial lines and wrinkles: one of the more popular prescription creams is Retin-A, a product that contains a form of Vitamin A that helps the skin renew itself with exfoliation (4). Other topicals include products that contain alpha-hydroxy acids, antioxidants, growth factors and simple moisturizers. While all these products can be easily applied to the face, they must also be continuously used in order to reduce the appearance of wrinkles. Also, these types of products are used to reduce the appearance of fine lines – typically, they are not used for moderate to severe lines like both Botox and Dysport.
Beyond topical products and medications, there are a variety of procedural options used to treat cosmetic lines and wrinkles. Chemical peels can be used to penetrate into the skin and smooth out fine lines. Microdermabrasion is a procedure that may make the skin feel smoother by removing the top layer of the skin, but it doesn’t address the underlying problem of frequent muscle contraction that makes lines and wrinkles in the first place. Lasers can be used in several ways to remove targeted areas of skin and stimulate the body to make collagen, which helps to fill in wrinkle lines and sagging skin (5). Finally, dermal fillers can be administered to patients in order to reduce facial lines by actually “filling up” the lines with one of several different substances.
We can’t talk about alternative cosmetic treatments without also discussing surgical options. The term cosmetic surgery encompasses the most invasive treatment options when it comes to dealing with cosmetic lines and wrinkles. Procedures such as surgical facelifts, brow lifts and eyelid lifts are commonly performed alone or together with other surgical options to achieve smoother skin and reduce the occurrence of lines and wrinkles on the face. Patients must undergo these procedures at approved surgical facilities, which can be office-based, outpatient surgery centers or hospitals, and general anesthesia is used for each of these procedures. As with every surgical procedure, significant risks are associated, and patients must discuss these risks with their healthcare providers before making the decision to undergo cosmetic surgery.
So now that we’ve seen what the common cosmetic uses of Botox and Dysport are, and how they compare to other cosmetic treatment options, are there any other uses of both products that we haven’t discussed? In the third installment of this blog series, I’ll talk about off-label treatment options using both Botox and Dysport, including options that are available at Azura Skin Care Center!