BOTOX Cosmetic, Dysport, Xeomin

Botox was the first of a group of products now known collectively as neurotoxins. These products are approved for cosmetic and non cosmetic uses. Botox was introduced in 2002 and is FDA approved for the treatment of moderate to severe frown lines between the brows. Dysport gained FDA approval in 2009 for treatment of frown lines as well. They are fundamentally the same in that they block the release of the neurotransmitter, acetylcholine. Off label use includes treatment of forehead lines, crow's feet, down turned corners of the mouth and muscle bands in They will soften that tired, angry look frequently caused by the muscles between the eyebrows (glabella), improve forehead wrinkles, improve the fine lines around the outside corners of the eye creating a softer appearance by temporarily weakening the facial muscles where injected.

Treatment with neurotoxins is often a first step for people considering cosmetic surgery, as it may give them a better idea of what to expect. The procedure takes only a few minutes and consists of a series of tiny injections around the muscle causing the wrinkles. Patients return to work the same day.

Each of the three has a slightly different action resulting from their manufacturing techniques. Botox, the go to product, takes effect in 2-3 days and lasting 3- 4 months. Dysport seems to take effect more rapidly, lasting up to 4 months. Xeomin, which was introduced to the US market in 2011, has a mechanism of action closer to that of Botox, and it consists of "purified" product, lasting up to 3 months. These minor differences can lead to better responses in some patients. These products can be repeated when muscle activity begins to return. Side effects are rare.

Botox has other uses on the face and neck as well. It received FDA approval for treatment of migraines. It can be used to treat a condition called "hyperhidrosis" or excess sweating under the arms or on the palms.