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(HealthNewsDigest.com) – It all began with the little toxin that was anecdotally found to soften lines of facial expression. The term “Botox” has made its way into the vernacular, and the brand known as BOTOX® is literally a household word that is well translated in most languages around the world. Botulinum toxins work by blocking the nerve impulses to the wrinkle producing muscles to soften contractions. The result is that the overlying skin appears smoother and lines and wrinkles are reduced temporarily. The treatment is simple, effective with minimal discomfort, and patients can resume normal activity immediately. The effects lasts from three to six months in most people, and it will need to be repeated to maintain the wrinkle relaxing results desired.
The late 1980s introduced the concept of minute doses of neurotoxin being injected into facial muscles to improve the appearance of frown lines. The treatment was met with immediate interest from the medical community, but a healthy degree of skepticism from consumers who raised questions about the safety of a “toxin” being used just for vanity. However, by the 1990s, Botulinum Toxin type A was gaining steam as a popular treatment in the offices of dermatologists, plastic surgeons, and cosmetic practitioners all over the U.S., used in an off label manner for softening lines and wrinkles. The expanded off label cosmetic uses grew quickly from just frown and forehead lines to include crows’ feet, neck muscle cords, upper lip lines, raising the tip of the nose, jawline lifting, and more recently, to off face applications as well. It was not until 2002, that the FDA announced regulatory approval of botulinum toxin type A (Botox Cosmetic – Allergan http://www.botoxcosmetic.com) to temporarily improve the appearance of moderate-to-severe frown lines between the eyebrows (glabellar lines). According to the BOTOX® Cosmetic website, 11 million women and men have experienced BOTOX®, making it the single most popular cosmetic treatment in the world.
The next botulinum toxin type A to appear on the scene was Dysport®, originally marketed by Ipsen in Europe. The US FDA granted approval for cosmetic uses for Dysport (abobotulinumtoxinA) marketed by Medicis Inc. In the U.S., http://www.dysportusa.com in 2009. Dysport got off to a somewhat slower start due to the wide acceptance of BOTOX® Cosmetic, and a learning curve among practitioners regarding the exact dosage to be used and rate of diffusion. However, Dysport has been well accepted in the U.S. among physicians and consumers, as it has been in Europe where it is marketed as Azzalure® by Galderma (http://www.galderma.com). As New York Plastic Surgeon Z. Paul Lorenc, M.D., F.A.C.S. explains, “There are seven distinct serotypes of botulinum toxins. Among the current range of neuromodulators, clinical variables include the onset of action, spread or field of effect, duration and safety. What is unique about Xeomin® is that it is considered a “naked toxin”, so it does not contain complexing proteins, which may offer some advantages.” Another distinction of Xeomin® is that the dosages used are the same as Botox® Cosmetic so practitioners will not need to alter their method of injecting.
Fast forward to July 2011, which marks the approval of the third botulinum toxin brand to the U.S. market. Hoping that the third time is the charm, Merz Aesthetics received FDA approval for XEOMIN® (incobotulinumtoxinA) for the temporary improvement in the appearance of moderate to severe glabellar lines in adult patients. According to Beverly Hills Dermatologist Derek H. Jones, M.D., who is an investigator for the Xeomin U.S. clinical study, “XEOMIN is a promising new option for both patients and physicians and we are encouraged by the response rates seen in the Phase III clinical trials.”
The good news for the growing number of consumers seeking to maintain a youthful appearance for as long as possible is that there are now three safe and effective wrinkle relaxing agents available on the market to suit their needs, and more products in the pipeline for the near future. Perhaps the biggest question remains; will the addition of Xeomin® change the price range of these treatments so more people will be able to enjoy the benefits of fewer lines and creases? Merz reports that Xeomin® will be available in Spring 2012 so we will just have to wait and see.
Wendy Lewis is President of Wendy Lewis & Co Ltd., Global Aesthetics Consultancy, author of 11 books and Founder/Editor in Chief of BeautyintheBag
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