The War of the Wrinkle Reducers

Since its commercial availability since 2002, Botox has revolutionized wrinkle treatment of the face with emphasis on improvement in the forehead and eye areas. There are few people who would not recognize the name, even if they may not understand what it exactly does.

Botox is so effective (although only temporary) and simple to do, it has given rise to an entire industry of treatments, cosmetic practitioners, and business models based out of strip malls to doctors offices. Billions of dollars of annual revenues have been created out of what is essentially a chemical poison. But the doses used are so small to treat wrinkles that it is harmless to humans. But calculated out per pound, Botox would roughly cost a trillion dollars… making it the most expensive material on the planet.

With such a proven and desireable commodity, it is no surprise that other manufacturers have been feverishly working on coming up with a competitive product. The recently available Dysport can now stake its claim as second in line. Whether it will make a significant dent in Botox’s business remains to be seen.

Dysport is not new and has been used around the world for years. In those countries where Dysport and Botox co-exist, the market shares of each are not that different. But Botox in the United States has tremendous brand awareness and a huge headstart. As a result,  it will likely be the ‘Coke’ for a long time in facial wrinkle treatment and Dysport can best hope to become ‘Pepsi’ in time.

Like any new product, Dysport must seek a marketing edge. Claims have been made that it lasts longer and costs less…the holy grail doctrines of the cosmetic industry. But a close look at the scientific studies and available evidence on Dysport does not support those marketing theories. The company does not actually claim them as the FDA would not allow such unsupported statements based on the studies that were submitted. Such claims appear to be the propagation of rumors and hope… and zealous physician marketing. In my experience, Dysport appears to be a good but equivalent treatment to Botox. In time, it may show a few select advantages (or disadvantages) but they are not obvious yet.

While competition usually drives down price, that does not appear to be the case in this battle of wrinkle reducers. Because they are given in different doses, it is not even possible to compare Botox and Dysport prices on  a unit basis…which is how they are given by injection. Because Dysport is new to the public, it is natural to assume that it may be better. Its value at this point, however, appears to be as a treatment alternative for those few patients who are either resistant to or becoming less responsive to their current Botox injections.

For those patients clamoring for a cheaper and better Botox, Dysport will not be the new fountain of youth.

Dr. Barry Eppley