and what about the others?
Are you concerned about facial lines and wrinkles?
Confused about the different types of botox available?
Then read on.
(This is a brief article about the differences between Botox, and Bocouture, two of the main types of Botulinum Toxin Type A we have for cosmetic use here in the UK. There are others like Xeomin, Dysport and Azzalure which we are not going to go into in this article. You can find out more information about anti-wrinkle treatments at Elm Skin Clinics.
Here in Sheffield and Barnsley in South Yorkshire, our clients commonly request Botox or Bocouture injections for the treatment of wrinkles and lines. Botox is itself the brand name for a specific formulation of this medicine, not the name of the drug itself which is Botulinum Toxin Type A.
“Esther is the ultimate professional. She is also very caring and made sure that I was happy at every stage. Esther also messaged me to check that I had no side effects. I would highly recommend Esther to anyone. I will definitely be back. Thank you Esther. F.B. Barnsley”
“Thank you Esther. I had been considering treatment to help deep set lines between my eye brows, didn’t want to look mask like and you were brilliant. I am very pleased with the result and have every confidence in you to continue to make me look refreshed and relaxed instead of angry and tired….. See you in a few weeks. AT, Sheffield”
Botox was just the first Botulinum Toxin which became licensed for cosmetic use for the treatment of glabellar lines and is therefore in all likelihood the most familiar, however other Botulinum Toxin Products are available. It’s a bit similar to Heinz being synonymous with ketchup when Heinz is just one company that makes a condiment.
Differences
So, is there any differences between them, and does it matter which brand we decide to use for your treatment?
In a few words, yes there are a few slight differences, and no, it does not matter much which brand we use.
Firstly, both types contain the active ingredient; Botulinum Toxin Type A. This ingredient is a biologically active medicine produced by process of fermentation. The bacterium (Clostridium botulinum) makes this and every company that provides the medication uses the same strain of the bacterium, meaning the active ingredient is identical with differing formulas. The differences between them are mainly in the manufacturing process which extracts and purifies the medicine, and in the excipients (other added ingredients) in the final product.
Botulinum Toxin
Let me explain how Botulinum Toxin works in the wild. What we now use as a medical treatment was at one time known for being a cause of food poisoning, that we call botulism. The bacterium could survive in preserved food and then get into someone when he or she eats. The gut would then absorb the toxin produced by the bacterium and create its effects (muscle weakness, paralysis and finally death of the person). Now, this microbe has evolved alongside mammals for millennia and has developed mechanisms to allow this process to occur. The human gut is acidic and full of digestive enzymes. The effect of this gut environment is not just to digest food into smaller molecules but also to protect the human from pathogenic microbes (bacteria that can cause diseases). Acid and enzymes in the gut will break down most of the bacteria we accidentally swallow.
So as the Clostridium botulinum has co-evolved with us, it has evolved its processes to overcome the human gut. The active molecule or drug that has its effect is only a small part of the compound that is excreted by the bacterium. The toxin complex is a combination of the active component, surrounded by a more significant number of non-active proteins. These proteins in nature act to allow the active element to survive the process of ingestion and digestion and thus the active part can reach the bloodstream undamaged.
Non-active proteins
Let us get back to the differences between the medicines; I mentioned that it is related to the manufacturing process and purification process. What that means is the different brands, while having the same active component, have different amounts of the non-active proteins.
We measure the amount of the additional proteins as the weight of a complex; the complex is the active molecule and its associated proteins.
For Botox, the complex weighs in at 900 kD (kilodaltons)
Bocouture weighs in at 150 kD; this is the actual weight of the active component alone. This means that the Bocouture has no extra complexing proteins in the combination, containing only the active part.
The other difference besides the amount of protein, or biological material in the vial is the excipients. These are different things added to the bottle to help maintain the stability of the drug before it is made up and injected.
Most noteworthy, Botox contains Human Albumin and Sodium Chloride, Bocouture has added Human Albumin and Sucrose.
None of the excipients (other added ingredients) has any biological or medical activity.
Studies
There have been many studies made out to assess the differences between the alternative preparations. There is a vast amount of anecdotal evidence collected as expert opinion from doctors who have completed thousands of treatments. Studies reveal the duration of effect, the side effect profile, the spread, the diffusion, patient and practitioner satisfaction. So far no significant reproducible difference in the clinical effect between all three preparations is identified.
So finally!
For the patient, there is no significant clinical difference between the formulations; they are all good! The main thing is to make sure your practitioner is familiar with the product which they are currently using. At Elm Skin Clinics you can be reassured that we have experience with both formulations.
If you would like to find out more about the products we use at Elm Skin Clinics contact us or email us at [email protected]
Message us today to book a Free Consultation, or simply for a chat about your concerns. You will find our prices very competitive. It is a legal requirement that anyone seeking botox or bocouture has to have a face to face consultation with a prescriber before treatment is prescribed. Esther is a Nurse Independent Prescriber. Our aim is to give you the time and the information to make an informed decision. You will never be pushed into a treatment that you don’t want or need.
Please note: We require a deposit to secure your booking for a consultation or treatment. Please read our terms and conditions prior to booking.
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Ref: The content of Botulinum Neurotoxin in Botox / Vistabel, Disport / Azzalure, and Xeomin/Bocouture. Jurgen Frevert, Drugs R D, 2010 Jul; 10(2) 67-73
