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What’s Your Poison? A Look at Cosmetic Neurotoxins

This is a guest post by Diana Abshire of Allergan Cosmetic.

So. What’s your poison? A common question at any given watering hole, but how about when it comes to your choice of neurotoxin? This may become a question more common in the medical aesthetic industry as new neurotoxins are ramping up to enter the market. What does that mean for you? Well, of course you will have more choices. Possibly, the price of the product may go down in response to market competition. But what should you know when it comes to one neurotoxin over the other, and how will you decide?

It’s true that neurotoxins are derived from one of the most deadly natural toxins found on earth (clostridium botulinum), previously considered as a possible weapon of global warfare and still closely guarded in its unadulterated form by the government. However, over the years it has been tamed, denatured and has evolved into one of the most widely used therapeutic and medical aesthetic drugs used worldwide. The most commonly known name brand of these neurotoxins is Botox, the first to be FDA approved, with the longest history and safety profile for therapeutic and aesthetic use, and the only one to have 3 FDA approvals for aesthetic indications. You may know some neurotoxins by other brand names, most notably Dysport and Xeomin, which are frequently described as “the generic Botox”.

The real truth of the matter is, that each one is different and behaves in different ways. For example, one may take longer to take effect in the muscle than another, one may have a more subtle effect than another and one may last longer than the other. Each and every neurotoxin on the market is made with a different “recipe”. They all start with the same basic neurotoxin (clostridium botulinum) and then it’s the manufacturing process (i.e. how long the growing process is, which proteins are incorporated into the mix and which carrier agent is used, along with the method of stabilization) which really makes each and every brand of neurotoxin formulation extremely unique. Each neurotoxin brand is truly as unique as a person’s thumbprint!

Looking forward to 2019, there are two new neurotoxin formulations that are expected to get FDA approval and hit the aesthetic market. One claims to be a very similar molecule and formulation to Botox, and the other is claiming to have a 6 month duration (current neurotoxins on the market have a 3-4 month duration once they are administered). Why are so many claiming to be “the next Botox”? Because Botox Cosmetic is a household name at this point and it has been on the market the longest with the highest patient satisfaction. Therefore, understandably, it has the biggest market share. So far, that is. At this time, it remains to be seen if the new neurotoxins, if approved, will perform the same as the grand dame of neurotoxins. Basically, you, the customer, will be the final judge of that. So….what’s your poison?