A great unbiased article by Dr Novick (NYC Dermatologic Surgeon). Of particular note is that for people who become ‘resistant’ to Botox® injections, Dysport® provides an alternative.“Botox® Battles Latest Contender: Dysport®” By Nelson L. Novick, MD – New York City Dermatologic surgeonDysport® may be new in the U.S. (on the market since only April, 2009), but it has been battling Botox® head to head in Europe and elsewhere for several years already. Here’s what we know so far about the battle of these big boys in the nonsurgical esthetic arena: Both Botox® and Dysport® are botulinum toxin type A proteins and work in a similar fashion. Dysport® may be minimally less expensive, but not enough so to make any significant difference cost-wise to the consumer.Dosing is different than Botox®, but this is a technical consideration for the doctor to know and is not really relevant to the patient. Dysport® may begin to work a bit faster than Botox®, by as much as one to two days earlier, which may be an advantage if you have a big party a couple days later and need a really quick fix; otherwise, this isn’t of much practical importance. Botox® and Dysport® may last about the same time, although there are some who claim that Dysport lasts a bit longer, but not significantly much longer.The beneficial effects of both Botox® and Dysport® can be prolonged, sometimes for quite some time longer than the ordinary four to six month duration, by suggesting that the patient undergo a series of three or four initial treatments, spaced at four month intervals. It seems that the continual presence of the Botox® or Dysport® in the muscle tissue during that period “teaches” so to speak the muscles of facial expression not to contract as actively as they did before treatment. It is this learned “lesson” that is believed responsible for the more prolonged response seen in many people, even after all the toxin has been metabolized away by the body.At least theoretically, some people who have become “resistant” to Botox®, usually after repeated treatments, may respond to Dysport®. I have already had one such patient in my Manhattan practice. Dysport® may diffuse (spread) over a wider from the injection sites than Botox®. The advantage here may be that you can treat broader areas, such as the forehead and underarms (for hyperhidrosis, i.e. excessive sweating), with fewer needle sticks.The flip side is that tighter narrower areas, for example, under the eyes or under the eyebrows, must be carefully treated to insure limiting spread beyond the desired treatment areas. In conclusion, the jury is still not in on any significant differences between the two products other than they are produced by different manufacturers. For now, the choice of which agent you will be treated with may depend upon the doctor’s comfort level and experience with each product and the particular needs of the patient.