Botox®, Dysport® and Xeomin®

What is botulinum toxin type A?

Botulinum toxin type A is a neurotoxin produced by the bacterium Clostridium botulinum. It is the active ingredient in products like Botox®, Dysport®, and Xeomin®, which are used for various medical and cosmetic purposes. Here are some key points about botulinum toxin type A:

Mechanism of action

Botulinum toxin type A works by blocking the release of acetylcholine, a neurotransmitter that signals muscle contractions. By inhibiting muscle contractions, the toxin causes temporary muscle paralysis, which can help reduce the appearance of wrinkles and treat certain medical conditions.

Medical uses

Botulinum toxin type A is used for various medical purposes, including treating muscle spasms (such as in cervical dystonia or spasticity), chronic migraines, overactive bladder, and excessive sweating (hyperhidrosis). It is also used to treat certain eye muscle conditions, such as strabismus (crossed eyes) and blepharospasm (eyelid spasms).

Cosmetic uses

Botulinum toxin type A is commonly used for cosmetic purposes to reduce the appearance of facial wrinkles, such as frown lines, crow's feet, and forehead lines. It is injected directly into the muscles responsible for causing wrinkles, causing them to relax and smooth out.

Safety

When used appropriately and administered by trained healthcare professionals, botulinum toxin type A is considered safe. However, it can have side effects, including pain at the injection site, bruising, headache, and temporary muscle weakness. Rarely, more serious side effects such as difficulty swallowing or breathing can occur.

Duration of effect

The effects of botulinum toxin type A are temporary and typically last for several months, depending on the dose and treatment area. Repeat injections are usually required to maintain the desired effect.

Precautions

Botulinum toxin type A should not be used in pregnant or breastfeeding women, or in individuals with certain neuromuscular disorders. It should be used with caution in people with certain medical conditions, such as swallowing difficulties or breathing problems.

What are the differences between the major brands of botulinum toxin type A?

Botox (onabotulinumtoxinA), Dysport (abobotulinumtoxinA), and Xeomin (incobotulinumtoxinA) are all neurotoxins derived from the bacterium Clostridium botulinum. Despite their shared origin, there are differences in their formulations and how they are used in clinical practice:

Botox®

Botox was the first botulinum toxin type A to be approved by the FDA for cosmetic use. It is used to temporarily reduce the appearance of facial wrinkles, such as frown lines, crow's feet, and forehead lines. Botox is also used therapeutically to treat conditions such as chronic migraines, muscle spasms, and hyperhidrosis (excessive sweating). It typically takes a few days to see the full effects of Botox, and the results can last for several months.

Dysport®

Dysport is another botulinum toxin type A that is used for cosmetic purposes to reduce facial wrinkles. It is similar to Botox but has a slightly different formulation. Some studies suggest that Dysport may have a quicker onset of action compared to Botox, with some patients seeing results within a few days of treatment. Like Botox, the effects of Dysport are temporary and typically last for several months.

Xeomin®

Xeomin is a newer botulinum toxin type A that is also used for cosmetic purposes to reduce facial wrinkles. It is different from Botox and Dysport in that it does not contain any complexing proteins, which may reduce the risk of developing antibodies to the toxin. The onset of action and duration of effect of Xeomin are similar to those of Botox and Dysport.

While Botox, Dysport and Xeomin are all effective treatments for reducing facial wrinkles, they may be preferred in different situations based on factors such as individual response, cost, and practitioner preference. It's important to consult with a qualified healthcare provider to determine which treatment is best suited for your specific needs.

I hear the term "botox" a lot.  Does that only refer to the brand Botox?

Since the Botox® brand was the first form of botulinum toxin type A used for cosmetic purposes, the name has evolved to represent a generic term for all botulinum toxin type A brands.  When you hear that someone received "botox", it doesn't necessarily mean that they received the brand Botox®.  It could easily have been Dysport, Xeomin or even other brands of botulinum toxin type A.

What are some examples of common medical conditions that are improved by botulinum toxin?

Hyperhidrosis

Botulinum toxin type A is an effective treatment for hyperhidrosis, a condition characterized by excessive sweating. When injected into the skin, it blocks the release of acetylcholine, a neurotransmitter that stimulates sweat glands. By inhibiting sweat gland activity, botulinum toxin type A can significantly reduce sweating in the treated area.

Botulinum toxin type A is commonly used to treat primary focal hyperhidrosis, which affects specific areas of the body such as the underarms, palms, and soles of the feet. It is particularly effective for underarm sweating and can provide relief for several months before additional treatments are needed.

The procedure involves multiple injections of botulinum toxin type A into the affected area, which is typically done in a healthcare provider's office. The treatment is relatively quick and generally well-tolerated, with most people experiencing little to no discomfort.

The effects of botulinum toxin type A for hyperhidrosis usually last for about 4 to 12 months, depending on the individual. Repeat treatments can be performed to maintain the results. Botulinum toxin type A for hyperhidrosis is considered safe and effective when administered by a qualified healthcare provider. It is important to discuss the potential risks and benefits of treatment with your healthcare provider before undergoing Botox injections for hyperhidrosis.

Migraines

Botulinum toxin type A is an FDA-approved treatment for chronic migraine headaches in adults and is covered by many insurance companies. Chronic migraine is defined as headaches occurring on 15 or more days per month, with headaches lasting four hours a day or longer, and at least eight of those headaches being migraines.

Botulinum toxin type A is injected into specific muscles of the head and neck to prevent migraine headaches. It is believed to work by blocking the release of certain chemicals involved in the transmission of pain signals, thereby reducing the frequency and severity of migraines.

Treatment with botulinum toxin type A for chronic migraine typically involves injections administered approximately every 12 weeks by a healthcare provider. The number of injections and the specific muscles targeted can vary based on individual needs and response to treatment.

Clinical studies have shown that botulinum toxin type A can reduce the frequency of migraine headaches in some people. However, the effects of treatment may not be immediate, and it may take several weeks to see a reduction in migraine frequency.

Botulinum toxin type A treatment for chronic migraines is generally well-tolerated, but it can cause side effects such as neck pain, headache, and muscle weakness. It's important to discuss the potential risks and benefits of botulinum toxin type A treatment with your healthcare provider before undergoing treatment for chronic migraine.

TMJ and Bruxism

Botulinum toxin type A is used off-label to treat temporomandibular joint (TMJ) disorders, particularly for the management of TMJ-related pain, bruxism (teeth grinding) and muscle spasms. Here's how botulinum toxin type A may be used for TMJ disorders:

Muscle relaxation

Botox can be injected into the muscles of the jaw to help relax them. This can be particularly beneficial for people with TMJ disorders who experience muscle tension, spasms, or clenching.

Pain relief

By reducing muscle tension and spasms, Botox can help alleviate TMJ-related pain. This can improve the quality of life for individuals with TMJ disorders, allowing them to chew, speak, and move their jaw more comfortably.

Reduced inflammation

Botox may have anti-inflammatory effects, which could help reduce inflammation in the temporomandibular joint and surrounding tissues, potentially reducing pain and improving function.

Improved jaw function

For some people with TMJ disorders, Botox injections can help improve jaw function by reducing muscle stiffness and improving range of motion.

Sculpting of the jawline

Many people who suffer with TMJ and bruxism develop large masseter muscles, which leads to a strong, boxy appearance of the jawline.  Botulinum toxin type A relaxes those muscles, thereby softening the appearance of the jawline significantly.

It's important to note that the use of botulinum toxin type A for TMJ disorders is considered off-label, meaning it has not been specifically approved by regulatory authorities for this purpose. However, many healthcare providers use botulinum toxin type A off-label for TMJ disorders based on clinical experience and research supporting its effectiveness.

How much does botulinum toxin type A cost?

• $14/unit if purchasing fewer than 40 units
• $11/unit if purchasing 40 units or more
• Some insurance companies offer coverage for some medical conditions.

How much botulinum toxin type A will I need for my facial fine lines and wrinkles?

The amount of botulinum toxin type A needed for your face depends on several factors, including the area(s) being treated, the severity of the wrinkles or lines, and your individual anatomy. Botox is typically measured in units, and the number of units required can vary widely.

As a general guideline, here are the average units of botulinum toxin type A typically used for different areas of the face:

• Glabellar lines (frown lines between the eyebrows): 20-30 units
• Forehead lines: 10-30 units
• Crow's feet (lines around the eyes): 5-15 units per side
• Bunny lines (lines on the nose): 5-10 units
• Lip lines: 2-6 units
• Dimpled chin: 2-6 units

These are just general guidelines, and the actual amount of botulinum toxin type A needed may vary based on your individual anatomy and the recommendations of your healthcare provider. It's important to consult with a qualified healthcare provider who is experienced in administering Botox to determine the right dose for you. Over-treatment can lead to unnatural results, so it's best to start with a conservative approach and adjust as needed.

Who performs botulinum toxin type A injections at Glendale Whole Health?

Dr. Speller is a Certified Aesthetic Provider™, having been trained by the International Association for Physicians in Aesthetic Medicine (IAPAM).  She is happy to provide injections of botulinum toxin type A, as well as dermal fillers and Sculptra® to patients who are desirous of enhancing their appearance in a subtle, natural fashion.

Interested in receiving botulinum toxin type A for cosmetic or medical purposes?  Come in for a consultation.

Click here to book your appointment now or call (818) 551-0464!