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Like Botox, Dysport is a relaxer made from a strain of botulinum toxin type A. Dysport was also initially submitted to the FDA under the name, Reloxin. Dysport is FDA approved for treatment of cervical dystonia and for treatment of moderate to severe glabellar lines associated with procerus and corrugator muscle activity much like Botox. Aesthetic benefits of Dysport can be realized for up to four months.
Like Botox, PureTox® is a relaxer made from a strain of botulinum toxin. PureTox® is not as yet approved by the US FDA. It is anticipated that PureTox® will be used to treat facial lines and wrinkles that result from underlying muscle activity much like Botox. The precise nuances, advantages and disadvantages of the aesthetic use of PureTox® are not known at this time.
Xeomin (incobotulinumtoxinA) is a botulinum toxin type A that was approved in August 2010 by the FDA for the treatment of adult cervical dystonia and blepharospasm. In July 2011 the FDA approved the product for treatment of glabellar frown lines in adults. Xeomin is similar to Botox and Dysport in that it is a type A botulinum neurotoxin but unlike both Botox and Dysport that are produced in association with ancillary complexing proteins, Xeomin is made via a proprietary process that isolates the therapeutic component without the ancillary proteins. This may lessen the likelihood of antibody formation and because of this, it is possible that Xeomin may be more effective in patients who are resistant to other neuromodulators. The condition known as "injection fatigue" occurs when the duration between treatments becomes shorter and shorter and this may be due to antibody formation against the complexing proteins. Xeomin is more like Botox than Dysport in that it takes about one week for full effect but these three "relaxers" cannot be used interchangeably due to dosing differences. Xeomin does not require refrigeration prior to reconstitution, which may help ensure product potency at the time of injection.
Revance is a gel form of botulinum toxin type A. Because it is applied topically to the skin by a physician and does not need to be injected with a needle this product has the potential to be useful to patients who are averse to needles or those with concerns about bruising and pain. Early reports claim that Revance works well in the crows foot area (where the skin is thin) and, like Botox and Dysport, the product may have a direct beneficial effect upon the appearance of the skin. Revance is also being studied for treatment of axillary hyperhidrosis and it could also have use in treatment of wrinkles around the mouth. Because the product is not as yet FDA approved only limited information about safety and effectiveness is available.