Dysport is a drug based on botulinum toxin A (Clostridium botulinum A). When injected, it locally reduces muscle mobility, causing them to relax. Manufactured by the British company Ipsen Products, certified in Russia for use in cosmetology and the treatment of spastic conditions of peripheral muscle groups.
Dysport injections are called beauty injections, as they are used to eliminate facial wrinkles - the muscle relaxant eliminates the cause of the appearance of wrinkles on the skin; over time, a habit is formed of not using this muscle group, which serves to prevent the formation of new wrinkles. Injections are also used to treat hyperhidrosis - botulinum toxin blocks the transmission of commands from the nervous system to the sweat glands, as a result of which sweating becomes less intense.
Principle of action and description of the drug
The active component of Dysport is a protein group toxin, a waste product of the bacteria Clostridium botulinum. This is a potent organic poison that leads to local paralysis due to its effect on the nervous system. The toxin destroys the fibers through which signals are transmitted from the brain centers to the muscles.
After the injections, the muscles in problem areas stop compressing the skin. The relief formed due to active facial expressions is restored, the skin becomes smooth.
Local intramuscular injections in microdoses have a reversible effect - nerve structures are gradually restored, muscle activity returns. The effect of Dysport injections during initial use lasts up to six months; with repeated use, the effect lasts up to nine months.
Dysport is available in powder form for injection. Dosage of botulinum toxin type A - hemagglutinin 300 and 500 units. After dilution, the concentration of the toxin in both cases is 200 units per 1 milliliter. Additional substances in the composition are human albumin (helps restore tissue structure and improve their nutrition) and lactose to obtain a solution.
The drug is stored at a temperature of 2 to 8 ° C; after opening the bottle, Dysport is suitable for use for 8 hours. The product is not sold in pharmacy chains; it is distributed only to medical institutions.
Dysport lyophilisate for preparing solution for and 300 IU fl
Active substance
botulinum toxin type A
pharmachologic effect
Peripheral muscle relaxant. The active principle is Clostridium botulinum toxin type A, which blocks the release of acetylcholine at the neuromuscular junction, which leads to the relief of muscle spasm in the area where the drug is administered. The restoration of nerve impulse transmission occurs gradually as new nerve endings are formed and contacts with the postsynaptic motor end plate are restored.
Indications for the drug Dysport
- blepharospasm, hemifacial spasm, spasmodic torticollis, spasticity of the arm muscles after a stroke, hyperkinetic folds (expression wrinkles) of the face in adults;
- dynamic foot deformity caused by spasticity in cerebral palsy in children aged 2 years and older;
- hyperhidrosis of the axillary region.
Dosage regimen
Bilateral and unilateral blepharospasm, hemifacial spasm
The contents of a bottle of 300 units are diluted in 1.5 ml of 0.9% sodium chloride solution for injection, the contents of a bottle of 500 units are diluted in 2.5 ml of 0.9% sodium chloride solution for injection. 1 ml of both solutions contains 200 units of the drug Dysport.
For adults and elderly patients for the treatment of bilateral blepharospasm, the recommended starting dose is 120 units per eye. The drug is administered subcutaneously in a volume of 0.1 ml (20 units) medially, in a volume of 0.2 ml (40 units) laterally into the connection between the preseptal and orbital parts of the upper and lower parts of the circular muscle (m.orbicularis oculi) of the affected eye. For injections into the upper eyelid, the needle should be directed away from the center so as not to touch the muscle that lifts the upper eyelid (m.levator palpebrae superioris). Below is a diagram showing where the injections will take place.
The clinical effect can be expected within 2-4 days, the maximum therapeutic effect develops within 2 weeks.
Injections should be repeated every 12 weeks or as indicated to prevent recurrence of symptoms. With each subsequent administration, the dose of the drug should be reduced to 80 units per eye. For example, 0.1 ml (20 units) medially and 0.1 ml (20 units) laterally above the eye and below the eye. In the future, the dose of the drug can be reduced to 60 units per eye, by eliminating the introduction of the drug medially into the lower eyelid. The doctor determines subsequent doses in accordance with the effect obtained.
For unilateral blepharospasm, injections should be limited to the area of the affected eye. Similar treatment is carried out for hemifacial spasm.
Spasmodic torticollis
The contents of a bottle of 300 units are diluted in 0.6 ml of 0.9% sodium chloride solution for injection, and a bottle of 500 units is diluted in 1 ml of 0.9% sodium chloride solution for injection. 1 ml of both solutions contains 500 units of the drug Dysport.
Doses recommended for the treatment of torticollis are used in adults of all ages who have normal body weight and satisfactory neck muscle development. A reduction in the dose of the drug is possible in case of significant underweight or in elderly people with reduced muscle mass.
For the treatment of spastic torticollis, the initial total single dose is 500 units. This dose is distributed between the 2 or 3 most active muscles of the neck.
For rotational torticollis, the drug in a dose of 500 units is administered as follows: 350 units into the splenius capitis muscle, ipsilateral to the direction of head rotation, and 150 units into the sternocleidomastoid muscle, contralateral to the rotation.
For laterocollis (head-to-shoulder tilt), a dose of 500 IU is distributed as follows: 350 IU is injected ipsilaterally into the splenius capitis muscle (m. splenius capitis) and 150 IU - ipsilaterally into the sternocleidomastoid muscle (m. sternocleidomastoideus). In cases involving elevation of the shoulder by the trapezius muscle (m.trapezius) or the muscle that lifts the scapulae (m.levator scapulae), treatment may be required according to visible muscle hypertrophy or according to electromyography.
When injection of the drug into 3 muscles is required, a dose of 500 IU is distributed as follows: 300 IU is injected into the splenius capitis muscle, 100 IU into the sternocleidomastoid muscle (m.sternocleidomastoideus), 100 IU into the third muscle (trapezius or levator scapula).
For anterocollis (head tilt forward), 150 units are injected into both sternocleidomastoid muscles (m. sternocleidomastoideus).
For retrocollis (tilting the head back), a dose of 500 units is distributed as follows: 250 units are injected into each splenius capitis muscle. In case of insufficient clinical effect after injection, after 6 weeks the drug can be injected into the trapezius muscles (m.trapezius) bilaterally (at a dose of up to 250 IU per muscle). Bilateral injections into the splenius capitis muscle may increase the risk of developing neck muscle weakness.
When subsequently prescribing the drug, doses can be adapted in accordance with the clinical effect and side effects encountered. Recommended total doses are 250-1000 units. Use of the drug in higher doses may be accompanied by an increase in the frequency of side effects, in particular dysphagia.
Clinical improvement in spastic torticollis is observed within 1 week after injection. Injections should be repeated every 8-12 weeks or as needed.
For the treatment of other forms of torticollis, the use of electromyography (EMG) is of great importance to identify and administer the drug to the most active muscles. EMG should be used to diagnose all complex forms of torticollis or when re-examining patients with no positive dynamics after administration of the drug, for injections into deep muscles and in patients with excess body weight and difficult to palpate neck muscles.
Arm spasticity after stroke in adults
The indications for administration of the drug Dysport in the treatment of arm spasticity after a stroke are determined by a neurologist 3 months after the stroke.
0.6 ml of 0.9% sodium chloride solution is injected into a bottle with the drug containing 300 units, and 1 ml of 0.9% sodium chloride solution is injected into the bottle with the drug containing 500 units. In both cases, receiving a solution containing 500 units of the drug Dysport in 1 ml.
The maximum total single dose is 1000 IU, which is distributed between the following 5 muscles: flexor digitorum profundus, flexor digitorum superficialis, flexor carpi ulnaris, flexor radialis wrist (m.flexor carpi radialis) and biceps brachii (m.biceps brachii).
When choosing an injection site, one should be guided by standard EMG points, and the immediate injection site is determined by palpation. In all muscles, except the biceps brachii muscle, injections are made at one point. The injection is carried out into the biceps brachii muscle at 2 points.
The initial total dose of the drug can be reduced to 500 units to prevent excessive weakness of the injected muscles in cases where the target muscles are small in volume, when an injection into the biceps brachii muscle is not performed, or when patients are given an injection over several points of one muscle.
Clinical improvement occurs within 2 weeks after injection. Injections can be repeated approximately every 16 weeks or as needed to maintain effect, but no more frequently than every 12 weeks.
Hyperkinetic folds (expression wrinkles) of the face
The main area of application of Dysport® for cosmetic correction is the upper half of the face. The lower half of the face and neck are corrected by injecting botulinum toxin much less frequently.
The contents of the 300 IU bottle are diluted with 1.5 ml of 0.9% sodium chloride solution for injection, and the contents of the 500 IU bottle are diluted with 2.5 ml of 0.9% sodium chloride solution for injection. At this dilution, 1 ml of both solutions contains 200 units of the drug Dysport®.
The total recommended dose for a single injection into all four areas (the glabellar region, the forehead, the outer corner of the eye and the back of the nose) should not exceed 200 units of Dysport.
To correct vertical folds in the eyebrow area, injections of the drug are made into the corrugator supercilii muscle, 8-10 units per 2-4 points, and into the procerus muscle, 5-10 units per 2 points. The total dose ranges from 42 to 100 units.
Elimination of hyperkinetic folds in the forehead area is carried out by injecting the drug into the area of maximum tension of the frontalis muscle (m.frontalis). The number of injection points can be arbitrary. All of them should be located 2 cm above the eyebrow line on the same line or in a V-shape. The optimal total dose of Dysport® in this area is 30-40 units (maximum - 90 units) at a rate of 5-15 units per point, the total number of points is 4-6.
Correction of folds in the area of the outer corner of the eye (“crow’s feet”) is carried out by subcutaneous injection into points located 1 cm lateral from the outer corner of the eye, at the rate of 5-15 IU of Dysport® per injection point. The number of points is from 2 to 4 for each eye. The maximum recommended total dose on both sides is 120 units.
The frequency of repeated injections depends on the timing of restoration of facial muscle activity. The duration of the effect is 3-4 months.
If an adequate dose of the drug was administered during the first injection, then during the second and subsequent injections the total dose of Dysport can be reduced by 15-20 IU for the appropriate areas. In this case, it is possible to increase the interval between injections of the drug to 6-9 months. If the initial dose of the drug was insufficient, then with repeated injections it should be increased.
To correct wrinkles in the dorsum of the nose, injections are made into the middle of the belly of the nasal muscles. The dose is distributed at 5-10 units to 1-2 points in each muscle.
The muscle relaxant effect of the drug Dysport on facial muscles is clinically manifested 2-3 days after administration and reaches a maximum on 14-15 days.
Recommended doses of Dysport used in aesthetic medicine do not cause systemic side effects.
Dynamic foot deformity caused by spasticity in cerebral palsy in children aged 2 years and older
The contents of a bottle of 300 units are dissolved in 0.6 ml of 0.9% sodium chloride solution for injection, and the contents of a bottle of 500 units in 1 ml of 0.9% sodium chloride solution for injection, in both cases obtaining a solution containing 500 units in 1 ml.
The drug is administered intramuscularly into the calf muscles (m. gastrocnemius). The initial recommended dose is 20 units/kg body weight and is divided equally between the calf muscles (m. gastrocnemius). If one calf muscle is affected (m.gastrocnemius), the drug is administered at a dose of 10 U/kg. The optimal dose is determined individually; subsequent treatment should be planned after assessing the results of the initial dose. To avoid side effects, do not exceed the maximum dose of 1000 units. The drug is predominantly administered into the gastrocnemius muscle (m.gastrocnemius), but it is possible to inject it into the soleus muscle (m.soleus) and the tibialis posterior muscle (m.tibialis posterior). To determine the most active muscles, you can use the electromyography method.
In cases where the patient's target muscles are small in volume, the initial dose of the drug should be reduced to prevent the development of excessive weakness. Clinical improvement occurs within 2 weeks after administration of the drug. Injections are repeated as needed at intervals of at least 12 weeks, and the administered dose can vary from 10 to 30 units per 1 kg of body weight, depending on the effect of the previous injection.
Treatment of axillary hyperhidrosis
The contents of the 300 IU bottle are diluted with 1.5 ml of 0.9% sodium chloride solution for injection, and the contents of the 500 IU bottle are diluted with 2.5 ml of 0.9% sodium chloride solution for injection, obtaining in both cases a solution containing 200 IU in 1 ml.
The recommended starting dose is 100 units per axillary area. If the desired effect is not achieved, then a subsequent dose increase to 200 units is possible.
The area of drug administration is determined by Minor's test. The test is carried out before treatment and, if necessary, dynamically, at room temperature (22-24°C) after the patient has rested for 15 minutes. To carry out the test you need: 5% alcohol solution of iodine; potato starch; marker; antiseptic; brush; gauze napkins.
The patient is in a supine position with his hands under his head. The sweating area is treated with a 5% alcohol solution of iodine and after 1 minute a thin layer of potato starch is applied to this area with a napkin or brush. The test results are assessed after 5 minutes. In the presence of sweating, the treated surface is visually observed to turn blue. The intensity of color (from pale blue to blue-black) correlates with sweating activity. After the test, the area of hyperhidrosis is marked with a marker, then the starch is washed off with alcohol or another antiseptic.
Intradermal injections are carried out at ten points in each axillary area, 10 units of the drug in a volume of 0.05 ml are injected into each point, 100 units per area. The maximum therapeutic effect develops within 2 weeks. In most cases, the recommended starting dose suppresses sweating for up to 48 weeks. The frequency of repeated injections is determined individually when the initial level of sweating is restored, but not more often than once every 12 weeks. If there is any evidence of a cumulative effect with repeated injections, the timing of repeat injections is determined individually for each patient.
Before use, consultation with a specialist is required.
The method of administration and dosage regimen of a particular drug depend on its release form and other factors. The optimal dosage regimen is determined by the doctor.
Storage mode, interactions and side effects are indicated in the instructions.
Contraindications for use
- acute diseases (the drug is administered after recovery);
- pregnancy;
- lactation period (breastfeeding);
- hypersensitivity to the components of the drug.
Restrictions and contraindications
Before Dysport injections, you must consult with a specialist who will give an opinion on the use of the drug and conduct tests to identify existing diseases and pathologies of the body.
This is necessary in order to make a decision about using the drug. Relative contraindications include:
- Pregnancy and breastfeeding period.
- Exacerbation of chronic diseases, acute diseases.
- Skin lesions in the area of drug administration.
Absolute contraindications:
- Allergic reactions to the components of the drug.
- Some cardiovascular pathologies.
- Autoimmune neuromuscular diseases.
- Respiratory failure.
- Swallowing dysfunction.
- Some endocrine diseases.
Botulinum toxin injections are most effective for facial wrinkles. After 35 years, age-related changes in the structure of the skin begin, the intensity of collagen production decreases, tissue microcirculation worsens, and regenerative processes slow down. To combat natural changes, it is recommended to combine Dysport with anti-aging drugs.
Indications for the drug Dysport®
- blepharospasm, hemifacial spasm, spasmodic torticollis, spasticity of the arm muscles after a stroke, hyperkinetic folds (expression wrinkles) of the face in adults;
- dynamic foot deformity caused by spasticity in cerebral palsy in children aged 2 years and older;
- hyperhidrosis of the axillary region.
| ICD-10 code | Indication |
| G24.3 | Spasmodic torticollis |
| G24.5 | Blepharospasm |
| G80 | Cerebral paralysis |
| R25.2 | Cramp and spasm |
| R61 | Hyperhidrosis |
How does the procedure work?
Injections do not cause intense pain in most patients; anesthesia is not used for injections.
- The cosmetologist marks out places for the injection of Dysport and disinfects the skin.
- The drug is administered with a thin needle in a calculated dosage.
- A cold compress is applied to the injection area.
- After removing the compress, the patient is allowed to go home.
The first effect becomes noticeable within three days. The pronounced result is visible within one and a half to two weeks from the moment of the procedure.
What problems does dysport solve?
The skin on the face is directly connected to the underlying muscles. Therefore, during facial expressions, wrinkles form in the forehead, bridge of the nose and eyes. When facial muscles are blocked, the skin is able to completely smooth out, while folds and wrinkles disappear. Dysport eliminates facial wrinkles, but does not have a lifting effect; it is not able to eliminate excess skin. Only surgical lifting can do this. This issue is especially relevant for patients who believe that the later they start taking injections, the better. Indications for Dysport: wrinkles on the forehead, in the bridge of the nose, around the eyes and lips, correction of the shape of the eyebrows and treatment of hyperhidrosis.
Possible side effects
In the first 1-2 days after injections, the following may occur:
- Slight swelling, redness, small hematomas around the needle wound.
- Feeling of lethargy, muscle weakness in the treated area.
- Weakness, dizziness, headache.
These symptoms are a reaction to the drug, go away on their own, and do not require seeking help.
If, after using Dysport, severe muscle weakness in the body, allergic reactions, or other symptoms are observed, you should consult a doctor.
There is no effect from the administration of Dysport.
Causes:
- resistance to botulinum toxin type A. This group includes patients with a history of tetanus or other cross-diseases, as well as genetic insensitivity to this group of drugs. Further actions: increase the dose. If the effect is not achieved, then use other correction methods.
- antibiotic therapy during the botulinum therapy procedure. Further actions: repeat the procedure two weeks after antibiotic therapy.
- Resistance due to frequent injections or small doses You should not inject Dysport more than once every 4-6 months. When small doses are administered, a vaccination effect and “addiction” to the drug occurs. Further actions: you can do the procedure 6 months later, at least after complete restoration of facial activity.
Preparation and rehabilitation
Injections require little preparation:
- You should not drink alcohol the day before.
- On the day of the procedure, you must limit your mobility, do not make sudden movements, or bend over.
After injections:
- Do not take a horizontal position for several hours.
- Avoid sudden temperature changes.
- Don't exercise for a few days.
- Avoid stress on the heart.
- Avoid drinking alcohol for two weeks.
At the Academy VIP clinic in Nizhny Novgorod, procedures with Dysport are performed by cosmetologists of the highest category with more than 15 years of experience. In a multidisciplinary medical center, the patient can undergo a comprehensive examination to identify contraindications and receive recommendations on additional ways to improve skin texture.
- We work only with certified original Dysport. The effectiveness and safety of the procedure depends on this.
- The clinic complies with the storage conditions for the drug. If the temperature regime is not observed, use of Dysport is prohibited. We strictly comply with the manufacturer's requirements.
- We do not use an opened bottle for longer than the permissible period. The health of patients is our priority. We do everything to minimize the likelihood of complications.
- The clinic has all the conditions to provide assistance in case of an allergic reaction or other side effect.
You can make an appointment for a preliminary consultation with a VIP Academy cosmetologist by calling +7 (831) 200-47-38.
What is the difference between Botox and Dysport?
The difference between Botox and Dysport, in addition to different manufacturing companies, is storage conditions and the number of active units in the bottle. In terms of tolerability, effectiveness, duration of action and the presence of side effects, there are no differences between them. The ratio of Botox and Dysport activity units is constantly rewinding. The ratio currently accepted for calculation is 1:3.5. That is, for example, 10 units of Botox correspond in activity to 35 units of Dysport. This is the reason for the difference in the cost of 1 unit of the drug. In the case of Dysport, it will be 3.5-4 times cheaper than Botox. But the total cost of the procedures will be approximately the same.
