Has Botox become an eponym?
Botox is a term that much of the population today has heard, even if only in the media or while watching the latest episode of “Keeping Up with The Kardashians”. One might say that it’s become somewhat of a household name, although it’s questionable that everyone who has heard the term could accurately describe its use or purpose. Unlike Kleenex or Chapstick, other familiar proprietary eponyms, where the use of and product is easily understood, botox is still somewhat of a mystery to many individuals. (I was speaking with a colleague recently who believed Botox to be the substance used to fill lips and make them big. That’s a topic for another day! 😉 )
Regardless of how we describe botox, it is safe to say it’s a name that is used widely and known as an injectable treatment for cosmetic purposes. But did you know that since the inception of Botox, three other similar medications have been developed and are now used widely by cosmetic injectable providers? The development of botox, its successors and future use of these medications offer a very interesting story.
History of Botox for Cosmetic Use
Botulinum toxin is produced by a bacterium, Clostridium Botulinum, which we have learned through historical medical studies will cause your muscles to paralyze. Discovered in the 1920s, researchers sought to isolate the toxin and learn more about its medicinal benefits. Attempts to progress this research didn’t occur until the 1970s when medical studies were conducted on monkeys to determine if botulinum toxin could be used to address “strabismus” or cross eyes. While testing, researchers discovered that botulinum toxin showed a reduction in wrinkles in the glabella (skin between the eyebrows). The pharmaceutical company Allergan became the first company to license the injectable medication for treatment and brand named the product Botox. Botox is branded both for medical and cosmetic use and has received several FDA use approvals between 1989 – 2013 for conditions such as hyperhidrosis, migraines, urinary dystonia, glabellar, crow’s feet, and more.
Allergan has been the leader since 2002 in FDA approval for cosmetic use of botulinum toxin and in that time has solidified its place in the cosmetic injectable space. In 2018*, 7.7 million people in the U.S. received cosmetic botulinum toxin treatment, an 845% increase year over year since the original use for cosmetic purposes. This number is believed to be even higher since this data point was derived only from treatments performed in a plastic surgery office, and we know that several other providers are now offering this treatment outside of this specific type of medical office.
Botox, a leading brand
Botox was the leading brand name in botulinum toxin cosmetic injectables for several years and went unchallenged until 2 new products came on the market 2009 and 2010. Dysport was developed by Ipsen Biopharmaceuticals and received FDA approval in 2009. In 2010, the pharmaceutical company Merz Pharma came out with Xeomin, a third botulinum toxin product comparable to Botox.
There are subtle differences between the 3 brands but in general they all produce a similar result. The therapeutic agent Botulinum Toxin Type A used in all 3 medications, acts to block the release of a chemical that messages the muscle to contract, therefore relaxing the muscle movement where the agent is placed. A very small dose of the toxin is used and has proven to be safe and effective to treat the underlying muscle structure to reduce wrinkling caused by muscle movement.
What’s the difference between Botox, Dysport and Xeomin?
- Toxin Purity
The Botox and Dysport toxin each are encased in a protein structure, an additive that is not used in the production of Xeomin and why Xeomin is considered the purest form of all of the neurotoxins offered. Although it is rare/unlikely, the protein additive in Botox can cause immune reactions and, with some frequent clients, reduced efficacy over time. Xeomin is considered a good alternative for patients who have developed a resistance to Botox since it does not contain the added protein.
- Surface area used
Dysport is offered in a more diluted form and providers may prefer to use this brand primarily for larger surface areas such as the forehead, where the toxin can spread more easily. Xeomin is the most precise and concentrated and thus preferred for the smaller treatment areas such as glabella (between and above the eyebrows) and crow’s feet (corners of the eyes).
- Speed and duration of results
And finally, another interesting difference is that patients may see the quickest results with Dysport due to its more diluted and absorbable nature (48 hours), whereas optimal results with Xeomin and Botox can be anywhere from 7 – 14 days. Effects for all products will last anywhere from 3 to 6 months and will vary from person to person based on the rate in which they metabolize the medication.
One additional product has recently joined the botulinum toxin ranks with FDA approval in 2019 – Jeuveau, developed by Evolus. A couple interesting facts about Jeuveau, the name – the French word ‘nouveau’ or recent/modern because it’s the newest toxin on the market and it wants to be recognized as a true equivalent to Botox. Evolus created Jeuveau ONLY for cosmetic use, unlike its competitors who have approved FDA use for both cosmetic and medical treatments.
What’s in a name?
As the owner of a medical aesthetic practice, I am constantly challenged with how to represent our treatment for relaxing wrinkles. Allergan is trying desperately to hold on to its trademarked name Botox from becoming a proprietary eponym or genericized in the market. But let’s face it, Botox holds a 10-year edge and a 70% share of the toxin market. During my research for this blog, I found it difficult to find macro-trend results without Botox called out generically throughout the article.
Most injectable providers are turning to alternative terms to market their Botox treatments if they do not exclusively use the Botox brand product. Common marketing terms you might see are neurotoxins, neuromodulators, wrinkle relaxers, toxins, tox, etc. all in an effort to avoid possible lawsuits. At the end of the day, Google tells us that everyone searches the term “botox”. Allergan should take it as a compliment and allow Botox to go down in the history books with Kleenex, Chapstick and Xerox!
Neurotoxins used at Rytualist
At Rytualist, we use all three primary toxins; Botox, Xeomin and Dysport; to treat wrinkles. If you are noticing early signs of aging from premature wrinkling due to facial expressions or would like to prevent wrinkles by relaxing repetitive facial muscle movements, neurotoxin treatment may be the perfect treatment for you!
Book a medical evaluation with one of our medical injection specialists and we can create a treatment plan that works for you! Call 207.317.3570 or book online here.
*Data is from the 2018 Cosmetic Plastic Surgery Statistics Report. Reported in 2019. More recent reports showed significantly lower rates of treatments/services in all categories due to COVID impact to elective treatments.