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The difference between Botox and Azzalure... Dr Alan




Both of these products have the same intended action – to cause muscle relaxation, which in turn reduces the ability to cause dynamic facial lines. They both have the same core neurotoxin – botulinum toxin type A.


There are several differences between Azzalure and Botox. However, these in reality do not make a major impact on the end result.


Botox is manufactured by Allergan, a USA company. Azzalure is manufactured by Galderm, a Swiss company. Both are pharmaceutical companies.


The key difference, at the molecular level, are the protein complexes that are bound to the core toxin. Both Azzalure and Botox have differing sizes and shapes and weight of these proteins bound to the core toxin. These proteins have no effect on relaxing the muscles. On a practical level, these do not make a difference to the final outcome of treatment. However, there have been some studies looking into whether these proteins affect how quickly the toxin is broken down in the body, and whether some protein complexes in some individuals promote an antibody production response.


There is a difference between the described units or dosing used as well.

For Botox, the dosage is simply described as ‘units’. I.e. a client may have 10 units of Botox to the forehead.


For Azzalure however, they are described as Speywood units. I.e a client may have 25 Speywood units to the forehead.


This means that the dosages are not directly interchangeable between the two products. This is important if a client decides to switch from one product to the other. The clinician may be able to estimate the best dosage based on the previous product’s dose.


Also, the reconstitution (adding the saline water to the vials) differs, more commonly that for Azzalure less saline is used compared to Botox. Although some practitioners do vary the saline used for Botox when injecting for specific reasons.


The points above generally apply to clinicians.


As for the client, the question they may ask is, which product is the best? Or which one works the longest? Or which one is safer?


If we look to science, some trials have been done which compared the different products, and it did not find any significant difference between efficacy or longevity of treatment. The same applies for side effects. Although we do see clients who swear by one product that it works better for them. And some clinicians do prefer a particular product because they are either comfortable with the dosing and reconstitution or have connections to one particular manufacturer.


The bottom line is, for a client who has never had anti-wrinkle botulinum toxin treatment before, the clinician cannot confidently say one product is better than the other for them.


Now… which product would you like to use?


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